Analysis of Ireland's National Policy for Rehabilitation Services: A Critique

In this document we will discuss about Analysis of Ireland's National Policy for Rehabilitation Services and below are the summary points of this document:- The report analyzes the Irish Social Policy for Rehabilitation Services. The policy focuses on patient-centered care, citizenship, and quality of life. The policy provides general and specialist rehabilitation services and addresses weaknesses and strengths.

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Assignment 1- Policy Critique
Topic: National Policy for Irish Rehabilitation Services

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Introduction
The report analyzes how an Irish Social Policy named ‘National Policy for the provision of
Rehabilitation Services’ associated with residential home care, involves the concepts of patient
centered care, citizenship and quality of life.
Structure of the essay will involve (a) the concept of Irish Social Policy; (b) the Developments
which address the weakness and strength of the policy (c) Developments to ensure Quality of
Life (d) Developments to ensure patient centered care and (d) Developments to ensuring
citizenship.
The concept of Irish social Policy
According to National Quality Standards (NQS) for residential care setting for Irish older people,
the Authority of Health Information and Quality considers certain health policies that should be
reviewed and implemented every year, as a part of Irish Social Policy (National Rehabilitation
Hospital, 2009). These health policies involve cognitive impairment, rehabilitation,
communication, swallowing, hydration, nutritional status, etc. The Residential Care settings can
be defined as any private, public or voluntary services which offer long term care, rehabilitation,
respite and convalescence for older people. It offers a safe environment for nurturing the people
or old age adults, who cannot reside at homes or in foster care. In Ireland, the Irish Social
Policies for residential care are based on the National Quality Standards for creating, maintaining
and making the living conditions favorable for older people. These standards protect the older
people’s rights and set the conditions for respectable living environment. The main objective of
these policies is to consistently improve the needs of human welfare in terms of health,
education, social security and housing.
Developments that address the weaknesses and strengths of the policy
Rehabilitation is important part of Irish healthcare system, which leads to multiple benefits like
providing greater individual autonomy, and enhanced employment opportunities for disable old
age people. In residential care settings the policy supports the shorter length of stay at hospitals,
physician’s visits and reducing the readmissions. The increasing number of elderly population,

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elevating life expectancy, enhancing disabling conditions in the populations, drive the demand
for rehabilitation services (Health Information and Quality Authority [HIQA], 2019). Most of the
disabilities are perceived by the people in their adult working age due to underlying mechanical
trauma or related diseases. So, timely rehabilitation helps these populations restore the body
functions and re-achieve the skills required to get back active life.
The National Policy for ‘Rehabilitation Services’ provides important residential services from
acute care to long term community care, for the patients with disability. According to WHO
(2002), the rehabilitation of disabled people enables them to attain the optimal sensory,
intellectual, physical, social and psychological functional levels. The rehabilitation policy equips
these people with the tools required to attain the self determination and independence. The policy
provides general and specialist rehabilitation services to the disabled people.
For ensuring the Quality of Life, and making it a priority goal of the residential care settings,
adequate evaluation of services and need assessment of the patients is done annually so that the
identified needs could be met with available resources. Extraneous factors like caring for the
family and friends also improve the quality of life. The rehabilitation related needs of the patients
in these residential settings are assessed throughout their life span.
 There are Government appointed Organizations like HIQA (Health Information and
Quality Authority) which inspect and monitor the compliance of services in residential
care settings with the National Quality Standards (HIQA, 2019).
 There are specified National Standards for residential care settings for Irish old age
people which ensure 11 domains of Quality of Life: security, safety, relationships,
meaningful activities, enjoyment, spiritual wellbeing, order, physical comfort,
individuality, autonomy and functional competence.
 Residential Settings are provided access to all the facilities like home to facilitate good
quality of life.
 The provided services are high quality, abiding to the rights of old age people, respecting
their dignity and privacy while protecting them from neglect and abuse.
 Consistent and accountable services are delivered with adequate governance and
integration with community.

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Early interventions are planned to maximize functions and prevent complications. Coordinated
and timely continuum of care is provided in a comprehensive manner. The emphasis of services
is not just the treatment but also the prevention at primary and secondary level. The progress of
the person through continuum is not one directional. The people may leave or enter the services
at different times, and points. At every stage multiple service providers are involved.
According to a research by Kane (2011), five practices may lead the residential care settings
towards more patient centered care: The focus on patient direction, disability rights movement,
increasing attention to physical environments, growth of assisted living, and the initiatives to
incur cultural changes in residential care settings.
Every resident is given control of his life to increase his autonomy as per his preferences.
For ensuring Patient centered care, the patient is given autonomy to take part in decisions
related to his healthcare and other priorities. The care is imparted to encourage individuality,
considering the role of people in their health decisions. The Hub and spoke model is used which
reduces the cost of administrative overheads. The rehabilitation centers have links and
affiliations with other organizations like Psychological Society of Ireland (National
Rehabilitation Hospital, 2009). There is clear communication to encourage the resident
participate in recreational activities. His privacy and dignity is respected. The resident is given
the task of addressing his financial affairs as much as he can.
The routine of daily life is flexible and reviewed in every 3 months. Every Resident has a
lifestyle which is consistent with his expectations, culture, religion, language and social needs.
The residents are given timely meals and varied diet. The residents maintain contacts with the
friends, family, and local community as per their wishes.
One of the national policies aimed to establish Irish Neuro rehabilitation Services, 2016
identified that the plan was limited and failed to implement the needs of people in rehabilitation
process (Neurological Alliance of Ireland, 2016). There was lack of clear time frames and there
was basic weakness in implementing the plan for governance and leadership. The policy is
required to address the needs of wide range of people with the neurological issues and
incorporate community based neuro-rehabilitation services into account.

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The layout and location of residential care setting need to be accessible, safe, spacious, hygienic
and well maintained. There should be adequate safe area for walking, ventilated rooms and
comfortable environment. The residential settings need to have all the facilities like bathing and
toilet facilities, assistive living technology and accessible alarm system. The safety essentials
need to have safe working environment, infection control, fire safety, food safety, first aid, falls
management, maintenance of equipments and moving and handling.
For ensuring Citizenship, the rights of the resident about consent, privacy, dignity and religious
and civic rights should be respected. All the necessary information should be available to the
person in his own language, and in accessible format to help the resident in decision making. All
the policies and the practices need to reflect the rights of the resident to consult and participate in
the organisation of the setting. The informed consent of person is necessary to be taken as per the
legislation and most suitable guidelines.
Meaningful recreational activities, occupational, sensory, and physical activities are enhanced to
promote the self expression. The clinicians are trained to understand the communication
requirements of patients. The patient centered communication is promoted with every
interaction. The activities like life stories, sensory equipment, reality orientation, music and
validation are used to promote communication.
References
Health Information and Quality Authority[HIQA] (2019). National Quality Standards for
Residential Care Settings for Older People in Ireland. Available:
https://www.hiqa.ie/system/files/HIQA_Residential_Care_Standards_2008.pdf [Accessed 7 Feb
2019].

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Kane, R.A.(2011). Long-Term Care and a Good Quality of Life: Bringing Them Closer
Together, The Gerontologist, 41 (3), 293–304, https://doi.org/10.1093/geront/41.3.293
National Rehabilitation Hospital (2009). National Policy/Strategy for the Provision of
Rehabilitation Services. Available: http://www.nrh.ie/wp-content/uploads/2010/07/NRH-
submission-to-National-Strategy-forRehabilitation-Working-Group.pdf [Accessed 7 Feb 2019].
Neurological Alliance of Ireland (2016). National Policy and Strategy for the Provision of Neuro
Rehabilitation Services In Ireland. Available: https://www.nai.ie/assets/82/582DD430-8DCF-
4573-9ED5AB9CB12EA0D0_document/
Neurological_Alliance_of_Ireland_Response_to_Draft_Implementation_Plan_for_National_Neu
rorehabilitation_Strategy.pdf [Accessed 7 Feb 2019].
Power. M, & Lavelle, M.(2011). Qualifications of non-nursing residential care staff in the
Republic of Ireland. Quality In Ageing, 12 (3):152-162. Available:
http://dx.doi.org/10.1108/14717791111163587 [Accessed 7 Feb 2019].

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Assignment 2- Reflection
In a professional social care like residential care homes, effective teamwork can positively
influence the safety and outcome of patients (Woodward, Sendall and Ceccucci, 2009). The
physicians or GPs solely cannot deliver a quality care so patient centered teamwork has become
a necessity. The motivation of the team is needed to be backed up by the practical skills and
strategies to deliver quality care.

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The group projects or team based health care includes collaboration between the health care
providers, patient, their communities and family members to achieve the high quality
coordinated care. Sharing of the responsibilities with accountability in team members provide
great benefits. The group activities where the tasks are shared with each other include effective
communication between the team members. Such activities minimize the adverse events caused
by misunderstandings and miscommunication between the different people.
The healthcare teams can be of different types in the healthcare such as core team which is
directly responsible for caring the patients, coordinating teams responsible for resources
management and operational management, contingency teams, ancillary teams and support
services (Luginbuhl and Hamilton, 2013). The group projects involve specified values, benefits
and principles mandatory for every participant to follow. It develops team based competencies
like discipline, honesty, humility, creativity in the team members. They can have leadership,
measurable outcomes, effective communication, clear roles, shared goals. The group project
involvement improves the coordination of care, facilitating efficient use of healthcare services,
professional diversity and enhanced communication. The team members have improved job
satisfaction, enhanced well being and greater clarity of their roles.
The engagement in group project also benefits the Organization by reducing the cost and time of
hospitalization, reducing the unexpected readmissions, and improving the accessibility of
services for the patients (Vega and Bernard, 2017). The team members learn to adjust the
behaviors of each other and learn to respect the view point of others.
In terms of delivering healthcare requirements in residential care homes for elder people, the
clinicians working in collaboration have proved to deliver high quality responsible care.
According to a research done by Almidani et al (2018), the healthcare units act as cooperative
places where different healthcare staff members (physicians, paramedics and nurses) work
together in coordination maintaining effective communication by documentation (Almidani et
al.2018). Inter-professional collaboration (IPC) improves the patient satisfaction and experience,
reduces the cost of healthcare and improves the health outcomes. Every clinician working in
group tasks has to shift its focus towards sharing, partnership and collaboration instead of
working in isolation. According to reports of Institute of Medicine (2003), Poor communication

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often becomes a reason for medical errors (Greiner and Knebel, 2003). Healthy and
supportive relationships undoubtedly reduce the errors and enhance the quality of care.
The IPC facilitates effective sharing of information and efforts directed towards a common goal
of patient centered care. The transition from physician centered healthcare system to patient
centered care is important for the professional growth of clinicians’ career and the patients’
health.
The quality of life at residential settings can be improved by implementing effective
interpersonal team skills, problem solving, and self directed independent learning. The efficiency
of the staff in providing quality care depends on the progress monitoring, conducting open
discussion at every stage and peer evaluation (Battur, 2016). The Quality of life at residential
setting needs to reflect that the patients are living in a safe environment where people have good
intention. The clinical care at the settings needs to take care of the physical comfort and making
them pain free.
According to a report of Forbes (2017), the skills needed to raise the team engagement and
improve the team performance include communication skills, listening to others, engaging in
conflict resolution and persuading team members to increase productivity and avert productivity
(Fouts, 2017). Group engagements reduce the instances of miscommunication, misinterpretation,
lack of trust, misunderstandings and lack of clarity of roles.
The professionals engaged in teamwork have four main responsibilities- technical skills in
particular expertise, problem solving skills like finding the solutions, ability to collaborate
effectively with each other, communicating well and avoiding the conflicts with the subunits
(Anttony, 2018). Group activities also improve the social skills of the people improving their
social interactions.
Therefore, conclusively, the team based projects encourage cooperative learning and help in
addressing real issues. Peer evaluations help improve the professional skills such as level of
contribution, quality of work and time management.

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References
Almidani,E. et al.(2018). Departmental collaborative approach for improving in-patient clinical
documentation (five years experience). International Journal of pediatrics and Adolescent
Medicine. 5(2), June 2018, Pages 69-74
Anttony,D.(2018). 15 simple ways to improve team communication. Available:
https://www.workzone.com/blog/team-communication/ [Accessed 7 Feb 2019].
Babiker, A., El Husseini, M., Al Nemri, A., Al Frayh, A., Al Juryyan, N., Faki, M. O., Assiri, A.,
Al Saadi, M., Shaikh, F.,Al Zamil, F. (2014). Health care professional development: Working as
a team to improve patient care. Sudanese journal of paediatrics, 14(2), 9-16.
Battur,S. et al. (2016), "Enhancing the Students Project with Team Based Learning Approach: A
Case Study," 2016 IEEE 4th International Conference on MOOCs, Innovation and Technology
in Education (MITE), Madurai, 2016, pp. 275-280.
doi: 10.1109/MITE.2016.061
Greiner., A.C,and Knebel., E, et al (2003). Health Professions Education: A Bridge to
Quality. Washington, DC: National Academies Press; 2003. Available:
http://www.nap.edu/catalog/10681/health-professions-education-a-bridge-to-quality.
[Accessed 7 Feb 2019].
Fouts, M.(2017). Improve team collaboration with these key skills. Available:
https://www.forbes.com/sites/forbescoachescouncil/2017/06/22/improve-team-collaboration-
with-these-key-skills/#10bc7597329d [Accessed 7 Feb 2019]
Luginbuhl, S. C., and Hamilton, P. T. (2013). Cooperative Learning through Team-Based
Projects in the Biotechnology Industry. Journal of microbiology & biology education, 14(2),
221-9. doi:10.1128/jmbe.v14i2.608
Vega,C.P., and Bernard,A.(2017). Interprofessional Collaboration to Improve Health Care: An
Introduction. Available: https://www.medscape.org/viewarticle/857823 [Accessed 7 Feb 2019].
Woodward, B.,Sendall,P., and Ceccucci,W.(2009). Integrating Soft Skill Competencies Through
Project-based Learning Across the Information Systems Curriculum. Proc ISECON 2009, v26
(Washington DC): §3762 (refereed). Available:

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https://pdfs.semanticscholar.org/46e3/1e353a013159a5148df2fc3cbe69d721cda1.pdf [Accessed
7 Feb 2019].