Managing Quality in Health and Social Care

This document discusses the management of quality in health and social care, focusing on perspectives of stakeholders, roles of external agencies, impact of poor service quality, standards in health and social care, approaches to implementing quality systems, and barriers to delivery of quality in health and social care services.

Managing Quality in
Health and Social Care

Contents
Introduction......................................................................................................................................3
Task 1...............................................................................................................................................3
1.1 Explain perspectives that stakeholders in health and social care have regarding quality 3
1.2 Analyse the roles of external agencies in setting standards.............................................4
1.3 Assess the impact of poor service quality on health and social care stakeholders...........5
Task 2...............................................................................................................................................6
2.1 Explain the standards that exist in health and social care form ensuring quality.............6
2.2 Evaluate different approaches to implementing quality systems.....................................6
2.3 Analyse potential barriers to delivery of quality in health and social care services.........7
Task 3...............................................................................................................................................8
3.1 Evaluate the effectiveness of systems, policies and procedures used in a health and social
care setting in achieving quality in the service(s) offered......................................................8
3.2 Factors which influence achievement of quality services of health and social care........8
3.3 Ways in which quality of health and social care services could be improved.................9
TASK 4..........................................................................................................................................10
4.1 Methods for evaluating service quality of health and social with external and internal
perspectives..........................................................................................................................10
4.2 Impact that involves service users in evaluation process of service quality..................10
Conclusion.....................................................................................................................................11
References......................................................................................................................................12

Introduction
Present report is specifically based upon management the quality of different services
offered by Stretton Nursing Home, which is a care home of Stretton Care Limited. The
information is specifically based on the inspection done by CQC from dated 19, 21, 23 and 24
January 2018 which was also announced (Gonzalez, Mitra and Turel, 2018). This care home
specifically delivers on a range of services in relation to accommodation along with nursing care
for less than 50 older people. Including this, it will also so going to deliver the information about
perspectives of stakeholders within health and social care department in relation to quality,
different standards which regulate the quality within health and social Care industry and the
impact of poor service quality on stakeholders that are specifically investing and delivering
different services within health and social care home.
Task 1
1.1 Explain perspectives that stakeholders in health and social care have regarding quality
In context of health and social care department, quality of care specifically plays an
important role when it comes to deliver appropriate services to the targeted population and also
to improve the existing results (Reis, Paiva and Sousa, 2018). It has been analysed to that, the
quality of care required to be effective efficient, safe impartial and given to people on timely
manner. On the other hand, stakeholders for any organisation whether it is dealing with in health
and social care or any other sector plays an important role because they are the one who are
required and their support is highly important for organization’s goals to be achieved in a
specified time frame (Nedungadi, Jayakumar and Raman, 2018). Away with this, there are both
internal and external stakeholders that affects an organisation in different ways. If it is talk about
their perspectives, then it can be said that quality is required to be managed based on the
perspectives because they specifically know about the expectations of service users.
Service user expectations is something which is to be fulfilled by Stretton Nursing Home,
because they always carry high expectations of getting good quality and to get well in a short
span. But on considering the case study, it can easily be said that this care home was reaching the
different rules and regulations which impacted upon the quality of service given by them
(Simblett and et. al., 2018). This could be understood with the very good example where people

who were living in Stretton Nursing Home, word pleased at a high risk of dehydration and
malnutrition and also staff members were insufficient and were also not receiving any induction
in order to deliver care effectively to two people. However, the expectation of people who were
living in Stretton Nursing Home, that they will be getting Quality Services but somewhere
nursing home was lacking in it. Therefore, it can easily be said that perspectives of service users
not met (Paglialonga, Lugo and Santoro, 2018).
Including this, owners along with the providers of Stretton Nursing Home also having the
same perspectives of high quality and expected to deliver high range of quality based services to
the customers, but due to breathing of different rules and regulations, it impacted negatively on
overall performance level of the organization (Koblinsky and et. al., 2016).
1.2 Analyse the roles of external agencies in setting standards
The external agency that can be taken into consideration in present context are NMC, CQC
and NICE (O'Brien and et. al., 2019). Basically, these are the agencies that consists of front roles
like developing different range of policies for welfare of the public, inspection of the services
offered by a care home and so on.
Care quality commission (CQC), carries different range of roles where every single United
Kingdom scared home comes under and this agency specifically monitors the quality of the
service that has been delivered, set a range of standards to improve the existing health
specifications, and also regulates the health and social care department of United Kingdom
(Snowden and et. al., 2018). In context of the case, Stretton Nursing Home was specifically
being inspected by CQC where they found that the services are not effective and also so sir
versus were also not always caring because people were left in the situations which were
undignified.
The nursing and midwifery council (NMC), can be considered as a registered agency of
United Kingdom that consists of a specific role like regulating professionals who works as nurses
and midwives in United Kingdom and so on. If it is talk about care quality commission (CQC),
then it has found that people with dementia who were living in Stretton Nursing Home, going
through a number of difficulties because of the less number of training sessions given to staff
members that may help them in improving the quality of the service given by them and also
(Field and Brown, 2019). It could help them in in following the rules and regulations like Mental
Capacity Act. In present context, the nursing and midwifery council would help Stretton Nursing

Home in getting appropriate numbers of staff which was effectively required not only two to
fulfil the requirements of patients dealing with dementia but also to improve service quality as
well.
NIMC (the National institute for health and clinical excellence), is said to be registered
agency that belongs to National health service England. Basically, primal rule of this agency is to
effectively promoting or marketing the clinical services that are offered by NHS and also so to
deliver decisions and to take advice on the different treatments along with the drugs that are
provided by NHS to the patients (Harris and Kelly, 2019). On the other hand, CQC also
inspected the systems which were utilised by Stretton Nursing Home to monitor the different
risks that were attached to patients living with dementia and that was also not that much effective
in nature. Also, staff of Stretton Nursing Home was also not satisfied with their jobs and was not
even feeling valued of the different IT jobs that were performed by them on regular basis.
1.3 Assess the impact of poor service quality on health and social care stakeholders
It has been analysed to that poor service quality main impact negatively on patient's health
conditions. It can be defined as not meeting the standards of health and Care which are
standardized by different health regulatory bodies like CQC (Uysal, Sirgy and Kruger, 2018).
Stakeholders can be anyone from staff, service users, governmental agencies and so on. It can be
said that poor service quality may impact upon stakeholders in different ways which was not
only damage the organisation but it may also impact upon health conditions of service users.
Inspection done by CQC of Stretton Nursing Home, clearly stated that there was inadequacy in
quality of service given to the patients dealing with dementia (Cinaroglu, 2020).
Service users: Quality of service given by care home or if it is poor in nature then it is may
be possible that service users might not get satisfied or stay happy because they are not meeting
the worth of the cost that has been paid by them (Ritchie and et. al., 2020). As it was identified in
the inspection of CQC, that care plans followed by Stretton Nursing Home not that much
effective and also so whatever needed by patients were not given to them in specified time frame
even they rang the bell.
Staff members of Stretton Nursing Home: Another major stakeholder, who specifically
States connected to the service as they are the ones who deals with patients and deliver them
services based on their requirements. Poor service quality can easily stay connected with
insufficient number of staff members which directly enhances the heavy workload on the

existing staff members (Koblinsky and et. al., 2016). Considering the case, it can easily be said
that staff members of Stretton Nursing Home for not getting proper training and also there were
less in numbers then it was required to deliver quality based services to the patients dealing with
dementia.
Organisation: Poor service quality if given by any organisation dealing with in health and
social Care industry specifically goes through a range of problems where it can be anything from
low productivity, and satisfied customers and so on (Gupta and Rokade, 2016). If it is talked
about Stretton Nursing Home, then CQC has found that this organisation has already breached
ample number of regulations like mental capacity act and so on and this race to the concerns of
delivering poor service quality to patients who were living in this care home.
Task 2
2.1 Explain the standards that exist in health and social care form ensuring quality
In context of health and social care, standards can be defined or considered as model or
patterns followed by all the organisations coming under healthcare industry which are also
accepted by them because that can be measured by external agencies like CQC in order to judge
the quality of services offered (Gonzalez, Mitra and Turel, 2018). Based on the information
given, approximately 28 essential standard regulations are propounded by CQC from which
around 16 are essential for every single healthcare organisation to follow. In context of the case
study coma the mandatory regulation which is mental capacity act formulated by CQC was not
followed by Stretton Nursing Home, has resulted into changes that are required to be made in
order to deliver safer care and treatment to two patients dealing with dementia within Stretton
Nursing Home.
2.2 Evaluate different approaches to implementing quality systems
Quality system is considered as blueprint related to an organization that generally classified
the procedure as well as model related to business. Moreover, it will also provide measures
related to how a stakeholder with the workplace conduct works effectively in team so that
customer’s need, preference and demand get satisfied successfully (Ritchie and et. al., 2020).
There are several approaches which a company may adopt for the implementation of quality
system. In respect of Stretton Nursing Home, they adopt approach related to total quality
management which include different principles and aim that help management and employees to

conduct their work properly for the attainment of desire goal as well as objective successfully.
Explanation of principles related to total quality management in respect of Stretton Nursing
Home is mentioned below –
 Always focus on customer’s need – According to this principle respective company
management need to considered need, demand and expectation of patients as that will
help in developing effective decision. Moreover, development of proper decision leads to
delivering quality services to patients or clients successfully. In respect of this
management of Stretton Nursing Home need to adopt different practices in order to know
customer’s review such as take feedback, suggestion and so on (Reis, Paiva and Sousa,
2018).
 Leadership – In an organization leader plays major role in developing effective and
positive atmosphere where employees feel motivated as well as encouraged to conduct
their work properly (Cinaroglu, 2020). In respect of Stretton Nursing Home their leaders
must adopt proper leadership style through which they can motivate employees so that
they will deliver quality services.
 Involve staff or stakeholders – In respect of this management of Stretton Nursing Home
need to involve their stakeholders like employees, employers, investors, customer’s
reviews and so on in the decision making process. This is so because it leads to
development of effective decision which enhances quality and performance at hospital.
2.3 Analyse potential barriers to delivery of quality in health and social care services.
There are various issues or barriers that lead to affect the quality of health and social care
services. It is crucial for health and social care service provider to identify and analyse these
factors in order to increase quality of services and provide better treatment of patient. It has been
analysed that potential barriers that come across quality of social and health care services are
internal as well as external factors (Uysal, Sirgy and Kruger, 2018). In these internal factors
includes various elements such as lack of adequate technology in health care organisation,
communication system, lack of training to staff member and so on. These internal barriers are
related to employee’s performance as well as capability of organisation to provide proper care to
patients. Lack of effective services and poor management of health care organisation will lead to
have negative impact on performance of employees. These factors are barriers to respective

health care or social care service provider as it will direct affect the quality of services as well as
providing effective facilities to patients.
There are some external factors which will also affect the quality of services that is
offered by health and social care service provider. External factors include financing system,
lack of support from family and friends, in appropriate health insurance (Gupta and Rokade,
2016). These affect lead to have impact on the facilities or services offered by health care
provider. Staff member of respective health and social care service provider will not be able to
provide adequate services to its patients and this lead to affect quality of services. For example,
lack of training to staff of health care service provider will lead to have direct impact in
capabilities and potential of employees to identify the issues and provide accurate services to
patient.
Task 3
3.1 Evaluate the effectiveness of systems, policies and procedures used in a health and social
care setting in achieving quality in the service(s) offered.
It is essential for health care service provider have proper and effective system, policies as
well as procedure in order to carry out required task of business in correct and accurate manner.
There are different policies, procedure as well as system that will lead to provide direction and
guidance to in accurate manner (Koblinsky and et.al., 2016). it is crucial for health care service
organisation to develop effective policies, system and procedure as this will support in
maintaining professional standards of services that is provided by staff member. System that is
followed by health care and service provider will lead assist in maintaining proper and accurate
way for performing task. It is necessary that health care organisation have proper system in while
conducting its activities and performing task. This is effective in reducing errors or issues while
conducting health and social care services. Though proper system employees will be able to
conduct their required set of task in less errors.
3.2 Factors which influence achievement of quality services of health and social care
As quality of health care services is mainly depended on patient satisfaction, their loyalty
and productivity of staff members as well as associations (Simblett and et. al., 2018). Therefore,
there are number of factors present which affect these three aspects and can be categorised into
three main groups as –

Patient Related Factors – Socio-demographic profile, extent of illness and cooperation of
patients, influence their interaction with physicians, that impact indirectly on quality of health
services. If they do not understand the language of medical practitioners then it arises difficulties,
in taking consent of them regarding for type of healthcare services. Under this condition, lack of
interaction and cooperation among patients and staff within Stretton Nursing Home, will create
barriers in evaluating the personal needs of people for recovery of their health (Paglialonga,
Lugo and Santoro, 2018). The negative attitude and behaviour of patients highly impact on
behaviour of caregivers of this nursing home also. In this regard, they do not follow instruction
and medical orders prescribe to them for well-being, which ultimately affect quality of care
services.
Health practitioners related factors – Way of making interaction and influence patients
for taking a particular treatment, is another main factor that impact on quality services. Similarly,
well-trained, experience, level of knowledge and competence of staff help in measuring quality
of services provided by caregivers (O'Brien and et. al., 2019). Therefore, if medical staff do not
get prior training about how to deal with patient demographic issues and other problems, they it
raises difficulties for them to give desired level of performance. In context with Stretton Nursing
Home, its ineffective leadership and management practices, demoralise the motivation level and
performance of its staff. So, it directly reduces productivity of medical staff and impact
negatively on service quality as well.
Environmental factors – As it is fundamental right of patients to choose treatment
services and from whom they seek to get services, therefore, lack of referral system of HSC,
result in failure of meeting the same (Snowden and et. al., 2018). With respect to Stretton
Nursing Home, it mainly suffers from shortage of experience staff where with increasing number
of patients, demand of medical services also raises. Under such condition, it makes unable to this
association to concern on quality of services and work on improving the same. Unavailability of
resources and facilities, insufficient infrastructure and equipment, affects overall service quality
of this association as well.
3.3 Ways in which quality of health and social care services could be improved
Quality of healthcare services can be measured in terms of availability, accessibility and
affordability of facilities, with level of competency of medical staff, timeliness, accountability,
privacy, confidentiality and more (Field and Brown, 2019). Therefore, to improve quality of

healthcare services, it is recommended to Stretton Nursing Home, to focus on these aspects first.
It is required to this hospital to integrate social care into delivery of health services, by
examining the social needs and determinants of health, for achievement of better outcomes.
Along with this, its management need to make sure that all medical staff are properly trained and
have competency to make interaction, with patients in their languages. For this purpose, different
types of on-going and off-going training programs need to be organised. In addition to this, prior
information related to roles and responsibilities must be provided to staff members, so that
higher productivity of their work can be obtained (Harris and Kelly, 2019). This nursing home
also need to ensure about safety and security, way to reduce mortality and morbidity more, for
improving quality of life by involving patient decision in treatment services. Furthermore,
investment also need to be made on increasing availability of medical facilities, infrastructure
development at premises and more, with affordability of same to meet demand of patients for
better health improvement.
TASK 4
4.1 Methods for evaluating service quality of health and social with external and internal
perspectives
A number of methods can be employed for evaluating quality services of health and social
care sector, such as complaint procedures, semi-structured panels of interview and more. In
context with Stretton Nursing Home, its management is required to use marketing methods first
for identifying social care needs and take response of public, for quality of its medical services
(Gupta and Rokade, 2016). As perspectives of stakeholders are essential to evaluate and improve
healthcare facilities. Therefore, its management needs to overcome from internal issues first like
minimising the staff turnover rate, maintain quality standards, service delivery system and more.
This would help in increasing productivity of association, so that higher health outcomes can be
achieved. Similarly, as external perspective is mainly compromised with inspection agencies like
Care Quality Commission, who set the minimum standards for patient satisfaction. Therefore,
enrolling their perspectives and key suggestion will also help in achieving loyalty of service
seekers (Cinaroglu, 2020). In this regard, integrating both external and internal perspectives will
help present nursing home in understanding the way, for exceeding satisfaction and improving
healthcare quality services, in desired way.

4.2 Impact that involves service users in evaluation process of service quality
Since lack of the robust referral system as well as low medical tariff, considers as main
reason for tendency of medical staff to meet patient request. Therefore, it highly effects the
quality of services in a nursing home (Uysal, Sirgy and Kruger, 2018). Similarly, if quality
through external perspectives related majorly with way of meeting service user requirements,
then it is essential to evaluate the same first, before setting treatment procedure. For example,
patient of old age while taking nursing care services, then they seek to get freedom to do work in
own perspective way. While staff is trained to influence them for getting those services which
are beneficial for health improvement. In this regard, sometime conflicts or difficulties arise in
front of professionals for way to meet such patient requirements. Therefore, from perspective of
care providers, quality services can be improved only when there is a good relationship of
medical staff with patient (Ritchie and et. al., 2020). This would help in understanding mental
state of patients, including physical needs to meet living standards, to make good bonding and
gain trust of them, before offering services.
Conclusion
By conducting analysis of above mentioned points it can be summarised that for every
company it is essential to develop as well as maintain quality services because through it able to
attract and retain customers for the long time. In addition to this it will also help in increasing
sales, profitability ratio as well as market shares. In respect of health care industry, it is essential
for them to perform effectively and offer quality as well as appropriate services to the patients as
that will help in attaining their desire goal successfully. In order to develop strategies for the
effective and appropriate quality management a company need to considered several aspects
such as they need to considered viewpoints of stakeholders according to which decision must be
developed. Along with this they also need to considered rules, regulations and policies which is
developed by government for the specific industry. It is so because that will seem as the
guideline which helps in conducting business operations and functions properly and effectively.
Moreover, for a firm which is operating in health and care industry to follow each and every
policy as well as conduct business according to the standard set by expertise as that will help in
providing quality health care services to patients.

References
Books and journals
Cinaroglu, S., 2020. Efficiency in health services based on professionals consensus quality
indicators. International Journal of Healthcare Management, pp.1-9.
Field, R. and Brown, K., 2019. Effective leadership, management and supervision in health and
social care. Learning Matters.
Gonzalez, E., Mitra, S. and Turel, O., 2018. Motivational impacts on intent to use health-related
social media. Journal of Computer Information Systems.
Gupta, K.S. and Rokade, V., 2016. Importance of quality in health care sector: A
review. Journal of Health Management. 18(1). pp.84-94.
Harris, J. and Kelly, D., 2019. Management skills in social care: a handbook for social care
managers. Routledge.
Koblinsky, M. and et. al., 2016. Quality maternity care for every woman, everywhere: a call to
action. The Lancet. 388(10057). pp.2307-2320.
Nedungadi, P., Jayakumar, A. and Raman, R., 2018. Personalized health monitoring system for
managing well-being in rural areas. Journal of medical systems. 42(1). p.22.
O'Brien, M. R. and et. al., 2019. Meeting patients’ spiritual needs during end‐of‐life care: A
qualitative study of nurses’ and healthcare professionals’ perceptions of spiritual care
training. Journal of Clinical Nursing. 28(1-2). pp.182-189.
Paglialonga, A., Lugo, A. and Santoro, E., 2018. An overview on the emerging area of
identification, characterization, and assessment of health apps. Journal of biomedical
informatics. 83. pp.97-102.
Reis, C. T., Paiva, S. G. and Sousa, P., 2018. The patient safety culture: a systematic review by
characteristics of hospital survey on patient safety culture dimensions. International
Journal for Quality in Health Care. 30(9). pp.660-677.
Ritchie, A. and et. al., 2020. Hospital librarians’ contributions to health services’ accreditation:
An account of the health libraries for the national safety and quality in health services
standards (HeLiNS) research project, 2016-18. Journal of the Australian Library and
Information Association, pp.1-31.
Simblett, S. and et. al., 2018. Barriers to and facilitators of engagement with remote
measurement technology for managing health: systematic review and content analysis
of findings. Journal of medical Internet research. 20(7). p.e10480.
Snowden, A. and et. al., 2018. The relationship between emotional intelligence, previous caring
experience and successful completion of a pre‐registration nursing/midwifery
degree. Journal of advanced nursing. 74(2). pp.433-442.
Uysal, M., Sirgy, M. J. and Kruger, S. eds., 2018. Managing Quality of Life in Tourism and
Hospitality. CABI.