Comprehensive Essay on NHS and Community Care Services and Care Plans

This essay provides a comprehensive overview of NHS and community care services, tracing their historical development from the late 1940s to the present. It examines key legislation, including the NHS and Community Care Act 1990 and the Care Act 2014, highlighting their impact on service delivery and the protection of vulnerable adults. The essay further explores the role of care plans, discussing their components and the three stages of implementation: assessing needs, care planning, and implementation and evaluation, with a focus on the practical application within the Five Star Dewsbury Care Home. The analysis emphasizes the importance of identifying needs, assessing care requirements, planning and securing care delivery, monitoring quality, and reviewing client needs to ensure effective and responsive services. The essay concludes by summarizing the evolution of community care services and the significance of care plans in enhancing patient outcomes.

ESSAY ON NHS AND
COMMUNITY CARE
SERVICES

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................3
MAIN BODY...................................................................................................................................3
TASK 1............................................................................................................................................3
TASK 2............................................................................................................................................5
TASK 3............................................................................................................................................6
CONCLUSION................................................................................................................................7
REFERENCES................................................................................................................................8
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INTRODUCTION
It is important to study the scope of Social care services in the present scenario because it
will give the learner the experience of being how the care services are delivered (Clarke and
et.al, 2016). Below report has been taken with the view of growth in the community care sector
along with National Health Sector. It lays emphasis on the protection of vulnerable adults. The
purpose of this Essay is to look beyond both the practical and theoretical aspects of community
care services for older people along with its relationship with other services, which is
NHS(McCann and et.al, 2015). For the purpose of study in this sector, 5 Star Dewsbury Care
Home is taken to provide more practical view of the topic. The essay discusses on the recent
developments, legislation, policy and procedures related to social care. Also as per researcher in
depth analysis of the topic, a care plan is to be suggested apart from the essay (Baldwin, 2013).
MAIN BODY
TASK 1
History of community care and NHS
The history of community care and NHS is said to be the history of the poor people.
From the late 1940's the idea of social care began to develop as a concept. When the poor were
ill or disabled, they need to leave their houses in order to get proper treatment which forced
them to live in institutions such as later workhouses and asylums(National Health Service
History, 2017). Public authorities responded in the way of institutionalization to those who could
not afford the care or financial support they needed. July 5 1948 – NHS was born. When health
secretary Aneurin Bevan launched the NHS at Park Hospital in Manchester (today known as
Trafford General Hospital) (Davies, 2015). Further in years NHS has introduced various new
things under its umbrella: 1952 – charges of one shilling are introduced for prescriptions, 1953 –
DNA structure revealed, 1954 – smoking and cancer link established, etc. Present scene of
community care services is on the line of developments from subsequent reforms which were
established in 1980's(Clarke and et.al, 2016). Sir Roy Griffiths was commissioned to take the
review of social care services that were prevailing. This marked the beginning of the
developments in community care services(Baker, Ware and Morgan, 2014). The origins of these
services can be traced back in 1948 with the birth of 'Welfare Act'. However, the origin lies back
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in 19th century and prior to that period as well. At the initial levels the merits of developing care
beyond the houses emerged in child care field(Baldwin, 2013). It was another decade before
similar conversion started to develop in the field of care and sudden shift was noticed from a
hospital care to community based services. It was not only the community care services who
were making the use of social security funds but on the other hand health authorities were
maximizing the opportunities too. They were transferring the patients from hospitals to voluntary
care homes where their fees was paid by the social security systems. For both the NHS and
Community care services the availability of these funds have been the factor in facilitating the
rapid Growth(McCann and et.al, 2015).
LEGISLATIONS
The concept relating to Social care at present is founded in NHS and Community Care Act 1990.
The NHS and Community care Act, 1990 was the biggest reforms of NHS since it cam e into
force in 1948. The legislation try's to bridge the gap between health authorities and local social
services, it was based on two white papers: Working for Patients(1989) and Caring for
People(1991). There are many rules and regulations which after foundation of welfare state have
defined the roles of local authorities in relation to social care(The National Health Service and
Community Care Act 1990, 2013). Care Act, 2014 gives the carers rights to assessment and
support. This act came into force on April, 2015. Basically this act was established for the adults
who help another disabled persons. This act provide support to adults to keep giving the services
they are giving. Through this act carers can now be accessed by the authority so that they can
know whether carer is in need of support or not & what are those needs (McCann and et.al,
2015). The laws which currently inform social care in general are governed by NHS and
Community care act, 1990 and Carers act, 1995. The acts which change the course of the way
community care has been viewed is NHS and community care act, 1990 which depicts its key
principles which are: Firstly, the act has provided that emphasis should be given on planning and
the requirement to produce a care plan for the particular area, discussing along with the
representatives of community and other agencies. Secondly, The act states the roles and
responsibilities of provider of the care and purchaser of the care as well as commissioner of the
care. Thirdly, the approach which is going to be used in the care management (McCann and et.al,
2015). The Health Act 1999 set up performance for health and social services to pool their
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budgets for services, and in many places there have been jointly-funded teams set up with
authorities of both NHS and Community services on the workforce(Davies, 2015).
The vulnerable adults lacks capacity to communicate to others or have a mental disorder
Scottish government passed a law which governs rights for those kind of peoples. The adults
with incapacity Act 2000 provides safeguarding the welfare and managing the finances of adults.
This act by Scottish government lay emphasis on the roles of the person who act on behalf of the
adults who are incapable. It explains the meaning of incapacity and decision making capabilities
of the representatives of adults(Clarke and et.al, 2016). The act has been safeguarding the
interest and properties of adults who are 16 and over 16. The main groups who get benefited
from these act are people with: dementia, learning disability, chronic mental illness, and people
with sensory impairment. The act has provided many ways through which a vulnerable adult can
be helped are: Power of Attorney, Access to Funds Scheme, Guardianship Order, Intervention
Orders. For the purpose of the act, meaning of incapable is acting and making of decisions in
relation to any particular issue which arises due to mental disorder or vulnerability to
communicate because of physical disability(Hockley, 2014).
There are five key principles for care management which were published in the white
paper "Caring for People: Community care in the Next decade and beyond". These are:
Identification of Need: The authority here has to obtain the information regarding the level of
need required in the particular area and also plans to meet that need. Five Star Dewsbury Care
Home should identifies needs in their locality (Baldwin, 2013).
Assessment of care Needs: This is the level of particular individual service client, assessing the
needs of care might be complex or simple. A complex assessment may become a collaboration
among the agencies and professionals(Scott-Samuel and et.al 2014).
Planning and Securing the delivery care: This involves the scheduling of the delivery of the
care with proper planning. No two deliveries should coincide at same point of time.
Monitoring the Quality of care provided: Monitoring is done on various levels: at the
individual level, it measures the care package effectiveness. on another level it measures the
effectiveness of service agreements between the local authority and various bodies who are
providing care(Hockley, 2014).
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Review of Clients Needs: People have a dynamic needs that may change as per time which
eventually leads to change in care needs.
From the above task, it has been concluded that from the 19th century to 21st century
their has been a significant rise in the Community care services and with the introduction of
various acts to empower or to protect the interest of adults it has given new dimensions to the
health care sector. Also 5 key principles of attaining good delivery services in context of
community care is discussed (Baldwin, 2013).
TASK 2
Care Plan is a plan which provides the nursing staff to perform certain activities towards
the individual care of the client. Every care plan is different because every person doesn't have
the same issue with its health as the other is having. Care plan is made to provide continuity of
the care and it is a means of communicating and organizing the actions of staff members of the
clinic(McCann and et.al, 2015). Care plan identifies which observations to make, what are the
actions that needs to be carried out, what instructions are for the staff and family members of
client(Hockley, 2014). Strength and Weaknesses of a Care plan which has been developed for
Five Star Dewsbury Care Home is:
Strength:
 Highly-skilled staff.
 History of successful Open day events.
 Clinic has a strong ethics of openness and commitment.
 Patients wanting to get involved.
 Local charities..
Weaknesses:
 Sometimes nurses are not available when patients come.
 Currently open day events are flop.
 Staff not clear in their role.
 Services to stretched for additional activity (McCann and et.al, 2015).
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TASK 3
Five Star Dewsbury Care Home wants to set a care plan and the proper care plan for them
to undertake should involve these components: Three stages through which a care plan can be
incorporated effectively is: Diagnosis the problem, Goals and outcomes and Nursing Orders
(Hockley, 2014).
3 Stages of care plan:
 Assessing needs: A diagnosis is used to define the appropriate plan for the care of the
individual. It is used to provide the actual problems or issues faced by the clients. It
allows clear communication among the care plan team and the collection of data in order
to improve the health of the patient(McCann and et.al, 2015). A nursing diagnosis is a
combination of a client's physical, sociocultural, psycho logic and spiritual response to its
disease or health problem. Nursing diagnosis takes birth when the individual's responses
changes.
 Care Planning: Goal in case of care plan is to achieve good health of the client, which
can be done through only proper managing the nursing orders. Goals and outcomes
always have been contrasting words. Goal is a general statement and outcome is
specific(Hockley, 2014). For Example a goal might be that clinic has to improve a
individuals health and outcome is that patient should attain something up to certain date.
 Implementation: Orders are instructions to the staff of clinic to achieve the desired
health of a client. A nursing order should contain: the date on which clients health should
be attained, action or the activities that needs to be undertaken by the nurses to achieve
the health. The time element that how much time it will take to improve the health
condition of the patient (Hockley, 2014).
Evaluation: After this 3 stages of health care plan, it is measured that the actions which are
planned are appropriately taken into account or not and if not then what are the reasons for the
failure. care plans help students to think creatively and how they can carry more personal
approach towards a individual to make his/her health grow in a positive manner(Hockley, 2014).
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CONCLUSION
From the above task, it has been concluded that from the 19th century to 21st century
their has been a significant rise in the Community care services. With high level of developments
in this sector various health agencies have been set-up to provide health care services and with
the introduction of various acts to empower or to protect the interest of adults it has given new
dimensions to the health care sector. This report has examined the factors that needs to develop
the effective health care plan in context with the Five Star Dewsbury Care Home. Further more
the report has laid its emphasis on the 3 stages of a Care plan.
REFERENCES
Books and Journals
Baker, M., Ware, J. and Morgan, K., 2014. Time to put patients first by investing in general
practice.
Baldwin, S., 2013. The myth of community care: An alternative neighbourhood model of care.
Springer.
Clarke, K., and et.al, 2016. 222 Subject index Care Act 2014 117–20. Rethinking Governance:
Ruling, Rationalities and Resistance. 24(1). pp.221.
Davies, N., 2015. Lessons from school: what nurse leaders can learn from education: Nigel
Davies describes the similarities between head teachers’ and nurse directors’ roles in
raising standards. Nursing Management. 22(4). pp.34-38.
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Hockley, J., 2014. Learning, support and communication for staff in care homes: outcomes of
reflective debriefing groups in two care homes to enhance end‐of‐life care. International
journal of older people nursing. 9(2). pp.118-130.
McCann, L. and et.al, 2015. “You Can't Do Both—Something Will Give”: Limitations of the
Targets Culture in Managing UK Health Care Workforces. Human resource management.
54(5). pp.773-791.
Scott-Samuel, A., and et.al, 2014. The impact of Thatcherism on health and well-being in
Britain. International Journal of Health Services. 44(1). pp.53-71.
Online
National Health Service History, 2017. [Online] Available through:
<http://www.nhshistory.net/shorthistory.htm>. [Accessed on 18th February 2017].
The National Health Service and Community Care Act 1990, 2013 . [Online] Available
through: <http://www.cavamh.org.uk/directories/mental-health-directory/legal-matters/the-
national-health-service-and-community-care-act-1990>. [Accessed on 18th February 2017].
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