This report discusses the significance of managing quality in health and social care services, highlighting the contributions of stakeholders, people's perspectives, and the roles of external agencies. It also examines the barriers to effective service delivery and provides methods for improving quality at a chosen organization.
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MANAGING QUALITY IN HEALTH AND SOCIAL CARE INTRODUCTION Within the social and health care services, quality in facilities delivery is very essential. Quality is important facet to service provider and users as well as others individuals within business circle.Thepresent report explainstakeholder’sperspective that connected with NHS service quality and examine role of external agencies in setting level for quality in health and social care.In addition to thisexplain the affect of poor service quality on stakeholders connects with NHS under consideration (Patti, Rapp and Poertner, 2014). Furthermore, report willclarifystandards that subsist in health and social care for measuring quality and also evaluate various approaches that implement systems quality. Q.1. Quality is conforming to customer requirements and expectations and customer is happy when requests or expectations are met. Beforecustomers’requests can be met, there is the need for the organization to know who the customers/service users are and understand what they expect from the service provider as well as develop a ‘Quality Culture’ with the organization.Firm need to understand customers/staff perspectives that help in the process of deliver good quality services in health and social care.One concept – many dimensions, the only way one can overcome this is to meet the standard. These are the ingredient needed to provide good quality service. According to Juran (1986), quality is fitness for purpose.This means if an item fits and serves the purpose for which it is intended, it is a quality product.When you deliver good service, your client will be happy with your service.Crosby (1984) defined quality as conformancetorequirementsmeaningcustomermustbehappy.Inaddition,the requirements have to be stated, and are often in the form of ‘standards’ (for example national minimum standards for social care workers). In relating to the case study, the quality of health and social care services provided by the London NHS hospital has been decreasing over the years and does not meet the service user’s requirement that impact on patients' behaviour (Alicia, R.) as she stated she was wrongly diagnosed as a result of which an incorrect treatment plan was prescribed having ignored important symptoms with no apologies. For an organisation to satisfy its customers,
the staff definition of quality perspective must be similar to the perspectives of the service users. Quality perspective could be external or internal. For example, internal perspective is service users, service providers and other health professionals.External are Care Quality Commission (CQC), National Institute of Clinical Excellence (N.I.C.E.) Perspective on quality: different stakeholders hold different perspective about quality. Service User’s Perspectives – The perspectives on quality by users of health and social care includes the following: Outcome s of their treatment and care The way they are treated by staff The time taken to receive service The professionalism of service providers Ease and convenience in use of equipment Effectiveness of the treatment or intervention Ethical guidelines – London NHS hospital s are not ethically guided. Q.2. The external agencies play an important role in setting quality standards in health and social care at London NHS hospital. Apart from setting quality standards, the hospital is now collaboratingandreceivingsupportfromtheNationalInstituteforHealthandCare Excellence(NICE)andCareQualityCommission(CQC).Bothagenciesgiveproper guidance to NHS for improving their service quality in health and social care sectors that impact on user's and other people effectively. NICE: provides national guidance, advice, quality standards and information services to improve health, public health and social care.In addition, NICE’s role is to improve outcomes for people using the NHS for example – patients using London NHS (Alicia). They do this by (a) producing evidence-based guidance and advice for health (b) developing quality standards and performance metrics for those providing and commissioning health and providing a range of informational services for commissioners, and practitioners.
CQC:is an independent that regulates health and social care in UK.They work in the following ways to set standards of health and social care (CQC 16), Ensuring perfect services to meet required and basic standards of services – that means it is people’s right to get fundamental services when they are going to receive. CQC registers care services that meet their services. Inspecting, regulating and monitoring health and social care services to ensure that they are following standards incessantly. Protecting and ensuring the rights of vulnerable people.It also protects rights of the people i.e. those that are restricted under Mental Health Act. Receiving feedback from the service users and take necessary actions. Working with other organisations – local, public and people. By involving them, they work as partnership to create standards Q.3. The most important reason of establishing good quality in health and social care is because without this the health of service users may suffer (Brett and et.al., 2014). So, if the standards and quality of health and social care are not properly set, then there might be a serious consequence.Only planning and regulating health and social care will not fulfil the expectations of the locals, that mean the satisfaction of patients will not be met. Quality must be ensured. The impact of poor service quality mainly on three segments of health and social care.Poor service quality highly impact on stakeholders like patients, employee's and other people that connect with NHS hospital in London. It affects the entire business process of supply goods and services to people that minimize their facility quality and decrease profit margin more than the other health and social care organizations. Firstly, on the poor facility quality of the health and social care services impact on different stakeholders, the service user complained of wrong diagnosis, delay in treatment and poor communication of care staff.As a result, the service user lost confidence in the service provided by London NHS hospital. This poor standard could lead to a fine by CQC. The service given to Alicia does not fit for purpose.Quality entails a lot of things and the only way the service provider can overcome this is to meet the standard.
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Q.4. There are different standards that already exist in health and social care for measuring its quality particularly in residential care facilities that given by the other members. CQC-StandardsformCarequalitycommission(CQC)isanexecutivenon departmental public structure of health and social care department of the UK. Thus, for measuring the health and social care service quality CQC play their effective role in this process that help to ensure about facilities which has been given in residential places. Their duty is to provide equal health treatment as per according to the Health and Social Care act 2008. CQCinspector’smeasure level of health and social care service that given in Nursing home by knowing about the treatments which they provide to patients. The entire process is based on set of 11 regulation that refer to fundamental standards of safety and service quality. The most important role of CQC is that they identify that facilities which has been provided by the HSC to patients is appropriate or not. Through inspection their team members measure treatment quality while residential given at the time of treatment to patients. Entire inspection should be conduct at least once in three years and basically a day on site and as announced. They focus on patents problems that they face during the treatment and also to tools that use at the time of giving treatments to people. NICE-Another standard is National Institute for Health and Care Excellence (NICE) that help to measure residential care service quality. They use new technologies that identify the quality of treatments, medicines and procedures that use by the Nursing home, hospitals and other places.This factor seeksto change health and social care to help humanity in every endeavours. They guide people about health publicity and ill health avoidance and also to social care users and services. NICE follow government legal process for health and social care service which aim is to control unnecessary charge on health services and to give good health and social care service to people. All the standards that are set in health care sector by CQC and NICE to improve quality health and social care of users in terms oflinking social values so they can assist in the caring by complete control of their lives.
Q.5. There are various approaches of implementing quality systems such as Appraisal, supervision and CPD (Doherty, Horne and Wootton, 2014). In health and social care systems, all the approaches are used interchangeably with constant quality improvement. Appraisal- Itis the best approach that implements service quality in health care. It is formal process concern to review of social care staff's performance and betterment over a timeperiod,basicallyannually.Italsoincludesevaluationofobjectivesandgoals, identifying area for improvement and analyse and plan for developing needs will meet to people during treatments. Through the entire process of appraising staff NHS implement health and social care service quality system effectively. Supervision-Thisis another approach that has been applied by NHS to improve or implement their staff service quality.This is a two way process that motivates,supports and enablesthe development of effective practice for individual workers in social care.As a result, thisactivityimplementsthe quality ofNHS facilities to their patients.Supervisor of NHSsupervises the entire staffto deliver health and social care services properly.Itacts as a regular base connection between supervisor and workers of this organizationto understand monitoring by reflecting on the practice appraisalto improve their services quality in more approachable manner.It also supports NHS workers to understand the organisational values. Here, the concernedemployeewill begivenspecificresponsibility by the NHShospital's administrationto work incollaboration with other employees'insuch away to meetthe definite organisational, personal and professional objectivesby bringing changes in the quality systems as well. CPD-Itfocuses on worksettings, learningstylesof employees and theirinterests, employment status etc. CPD intended to assist doctors and workers to meet the needs and requirements for revalidation and appraisal.With the help ofthismeans,NHS hospitalgive training to their staff/workersbymaking plans,maintaining the surroundingsandcollecting evidencewith respect to theongoing clinicalactivities. Thus, by using all these approaches,thisorganizationhas maintained theservice quality systems than other institutesofUK.
Q.6. Waiting time:Time management isanimportant process that influencetheservices to be given by NHS totheirpatients. In the case of Alicia Richman,there was a major obstacle in treating her on time. This reflected that she was diagnosed incorrectly due to availability of staff's time and led to her worries. Thus, it also led that few symptoms were ignored and impacted on Alicia's health. Due to lack of time-availability, the staff were unable to give proper treatment,thatmaximizes the risks. Lack of Training:Training isthat barrier that impact on theentire process of delivery services to patients. NHS staffdid not givegood services and behavedinappropriatelywith the people.Inthiscase study,she had a lump on her breast tissue, however, she was mis- diagonised and gave an incorrect treatment plan along with, there was ignorance towards some other major symptoms. This deteriorated Alicia's health. Additionally, there was lack of communication, hygiene issues and improper behaviour from the staff and other professionals who interacted with her.SuchPoor trainingimpactedontheservice supply process thatwas given by NHS hospital to patients. Poor communication:NHS staffdidnot communicate with Alicia effectivelyand acted as great barriers in diagnosing her conditions and led to improper data collection and wrong treatment plan.Without effective communication among NHS staff and patients, they cannot collect all the information aboutthe causes and symptoms of the diseases and cannot give medication. Poor Hygiene:NHS staffdidnotmaintain the hospital'senvironmentproperly. This affected the patient's health which became the majorbarrier in delivering quality care in context to their services to their patients and other visitors. Staffing level:In the case study of Alicia Richman,it was indicated thatstaffing levelwas much lower,thus, it led tocommunicationgaps between the patients and their families with theprofessionals. Unsystematic staffing levelposed as crucialbarriers in the whole supply activity of healthcare services.The organisational structure was insufficient and lacked a leader to solve the issues that impacted the quality of services. Lack ofpoliciesand procedures:NHSnevergaveproper treatment totheirpatientswith respect to the policiesand procedures thatdirectly affected their staff behavioural problems
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in addressing the queries of patients and influenced adversely ontheir services quality and organization'sreputation. Q.7. Effectiveness of system, procedures and policiesusedin health and social caresettingto achieve service quality Planning:Health and social care institutes make their service plans according toa structured and systematic procedure.They makesuchplansin terms of the legal framework andpoliciesofhealth care, which is important tolay the foundation for abasic planto provide instructions on managing tasks and roles given to the staff/workersandsupport in decision-making.Thisprocess isaneffective way forproviding safety and security to the entire organisational frameworkin health and social care. Innovation:This emphasison making effective plansandpolicies forbetterhealth systemsandimproving the working practices of thesocial care institutesby bringing innovation in their servicestoimprove their quality for achieving organizational goals and objectives.With this,theycanimplementanynew oralternative choice to bring changes in services, tools for treatments, processes, policies, organizational structure to improveall the interconnecteddomains of health and social careby removing the disparities and increasing health care quality. Feedback and monitoring:Thisisaneffective way to collect information about services quality that hasbeenconductedperiodicallyby health and social care institutes.This method is useful in understanding the shortcomings in the institute's services and the behaviour of their staff in treating the patients who visit them. Patient's feedback reflects their experience of care and treatment areas thatreflects uponthe effectiveness of systems and procedures. Monitoring helpsin knowingabout theservices and its relatedeffectiveness when treating or conducting tests of the patients. Staffing:Recruitment and staffing is the most important partof providing qualitative servicesto people. Health and social care institutemust adopt strict staffing processesfor smooth running of all the operational activities. The administration must try to recruit skilled and resourceful employees who would prove beneficial in all aspects while conducting the required responsibilities. This would enhance thework performanceeffectively and assist in improving the productivity and profitability.
Involvement of the service users: Service user involvement(SUI) mustbe an integral part of health services that bring effectiveness in theworking-environment.They help in maintaining the quality of conducting tests, treatments and other procedures by focusing on policies to make it betterand competent. Training:Training is the most importantelement inhealth care services totreat the patients effectively. Health and social care organizations need to hireexperiencedpeoplewho can giveproper training.This would aid in management of the supply withquality servicesto satisfy the expectations of public.Henceforth,Training is the best way for improving effectiveness of policies and systemsin order to achieveobjectives and goals. Preventing problem:Thisis important forprovidinggood qualityin thehealth care services. Health and social care organizationsmust be well-informed regardingtheir health care team about treatments and medicines. Thus, ifanyproblemarises, thenthey can be able to understand the crisis and give solutions to it for proper addressing the issues so that such incident must be avoided in the future. Management and leadership:Good management and leadership willhelp in the development of policies along with improving theeffectiveness of procedures and policies. Bothfactorsare important for delivery of good health services to patients.The Administrator must be assuredabout the availabilityofresourcesby collectingall the informationand know about the schedules, duties andperformance to runthe operationseffectively. Q.8. Knowledge and technical skills are the factors that influence health and social care servicestoachieve good quality.Here,Quality is depended onperformance ofworkers that help to increasetheservice level in efficientmanner(Cameron and et.al., 2014). Staff knowledge about technicalaspects and principles would improve health and social care services. The most importantfactorsthat influence the service quality of health and social care are the knowledge, commitment and expertise and examining people properly. Using proper method or technique during treatment processwill proveeffective to achieve service quality. Health and social care institutesfocus on theservice quality by using proper treatment techniques to achieve goals.Also,By making new policies and procedureswill support in quality improvement in health and social care services.
Q.9. Time management, training, communication and good hygienic environmentcan be considered asthe bestwaysto improve health and social care services andassociatedquality component.Moreover,in orderto improve all the areas, theorganizations need totraintheir nursing staff for developing goodrelationships withpatientswhich also help in performing functions proficiently(Cameron and et.al., 2014).Trainingwillimprove theoverallquality parameterin health care servicesby developing their knowledge and updations regarding currentdiscoveriesandmedications.Thefacilitiesmustbeamendedforeffective communication between doctors and staffwith the patientsand otherservice usersin an organization.Transparent communication channels will build trust and loyalty and create credibility and reputation. Along with, maintaining thehygienic environmentproperly would help in improving patients healthin better manner with an increased response rates.Healthcare organizations mustmaintain hygiene andmake all the surroundingareascleanaround patients.This will prevent infection and illness.Emergency casesshould be attend immediately and time management must be effectively implemented by coordinating with all the departments on consistent levels. Additionally,usinglatest and advancedtools and techniqueswill increase the efficiency and time-availability of thehealth care institutesand their staff.This will automaticallyhelpinincreasingtheknowledge,awarenessetc.tobringeffective modifications in thework performanceandtheir services inbetter ways to deliver quality. CONCLUSION This report has concluded that managing quality in health and social care has a direct influence on overall services and organization's growth.It explained about contribution of stakeholders as well aspeople perspectives about health care services whichis connected to its quality level. Furthermore,it also justifiedthe role of external agencies for increasing the standardsof service quality.Italsodiscussed about thehealth and social care standards that measuredquality and approaches for implementing service systems effectively. It also described aboutbarriers thathas animpact on health and social care service deliveryby explainingfactors thathas an overall impactand also discussedfewmethods thatsupported in improvingthe quality of health and social care servicesat the chosen organization.
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REFERENCES Book and Journals Brett, J. and et.al., 2014. Mapping the impact of patient and public involvement on health and social care research: a systematic review.Health Expectations.17(5). pp.637-650. Cameron, A. and et.al., 2014. Factors that promote and hinder joint and integrated working between health and social care services: a review of research literature.Health & social care in the community.22(3). pp.225-233. Doherty, T. L., Horne, T. and Wootton, S., 2014.Managing public services-implementing changes: a thoughtful approach to the practice of management. Routledge. Cameron, A. and et.al., 2014. Factors that promote and hinder joint and integrated working between health and social care services: a review of research literature.Health & social care in the community.22(3). pp.225-233. Patti, R.J., Rapp, C.A. and Poertner, J., 2014.Managing for service effectiveness in social welfare organizations. Routledge.