University Report: Managing Quality in Health and Social Care Services

This report provides a detailed overview of quality management within the health and social care sector, focusing on the perspective of stakeholders, including service users, service providers, and external agencies such as the Care Quality Commission (CQC) and the National Institute for Health and Care Excellence (NICE). It examines the impact of poor service quality on stakeholders, particularly in the context of the London NHS hospital, and clarifies the standards used to measure quality, including those set by CQC and NICE. The report further evaluates various approaches to implementing quality systems, such as appraisal, supervision, and continuous professional development (CPD), while addressing critical issues like waiting times, lack of training, and poor communication. The study highlights the significance of these factors in delivering effective and satisfactory healthcare services.

TABLE OF CONTENTS
INTRODUCTION .....................................................................................................................................2
Q.1.........................................................................................................................................................2
Q.2.........................................................................................................................................................3
Q.3.........................................................................................................................................................4
Q.4.........................................................................................................................................................5
Q.5.........................................................................................................................................................6
Q.6.........................................................................................................................................................7
Q.7.........................................................................................................................................................8
Q.8.........................................................................................................................................................9
Q.9.......................................................................................................................................................10
CONCLUSION.......................................................................................................................................10
REFERENCES.........................................................................................................................................12

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. The present report explain stakeholder’s perspective 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 this explain the affect of poor service quality on
stakeholders connects with NHS under consideration (Patti, Rapp and Poertner, 2014).
Furthermore, report will clarify standards 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. Before customers’ 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
conformance to requirements meaning customer must be happy. In addition, 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
collaborating and receiving support from the National Institute for Health and Care
Excellence (NICE) and Care Quality Commission (CQC). Both agencies give proper
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.

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- Standards form Care quality commission (CQC) is an executive non
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. CQC inspector’s measure 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 seeks to 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 of linking 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- It is 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
time period, basically annually. It also includes evaluation of objectives and goals,
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- This is 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
enables the development of effective practice for individual workers in social care. As a
result, this activity implements the quality of NHS facilities to their patients. Supervisor of
NHS supervises the entire staff to deliver health and social care services properly. It acts as a
regular base connection between supervisor and workers of this organization to understand
monitoring by reflecting on the practice appraisal to improve their services quality in more
approachable manner. It also supports NHS workers to understand the organisational values.
Here, the concerned employee will be given specific responsibility by the NHS hospital's
administration to work in collaboration with other employees' in such a way to meet the
definite organisational, personal and professional objectives by bringing changes in the
quality systems as well.
CPD- It focuses on work settings, learning styles of employees and their interests,
employment status etc. CPD intended to assist doctors and workers to meet the needs and
requirements for revalidation and appraisal. With the help of this means, NHS hospital give
training to their staff/workers by making plans, maintaining the surroundings and collecting
evidence with respect to the ongoing clinical activities.
Thus, by using all these approaches, this organization has maintained the service
quality systems than other institutes of UK.

Q.6.
Waiting time: Time management is an important process that influence the services to be
given by NHS to their patients. 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, that maximizes the risks.
Lack of Training: Training is that barrier that impact on the entire process of delivery
services to patients. NHS staff did not give good services and behaved inappropriately with
the people. In this case 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. Such Poor training impacted on the service supply process that was
given by NHS hospital to patients.
Poor communication: NHS staff did not communicate with Alicia effectively and 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 about the causes and symptoms of the diseases and cannot give
medication.
Poor Hygiene: NHS staff did not maintain the hospital's environment properly. This affected
the patient's health which became the major barrier 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 that staffing level was
much lower, thus, it led to communication gaps between the patients and their families with
the professionals. Unsystematic staffing level posed as crucial barriers 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 of policies and procedures: NHS never gave proper treatment to their patients with
respect to the policies and procedures that directly affected their staff behavioural problems

in addressing the queries of patients and influenced adversely on their services quality and
organization's reputation.
Q.7.
Effectiveness of system, procedures and policies used in health and social care setting to
achieve service quality
Planning: Health and social care institutes make their service plans according to a
structured and systematic procedure. They make such plans in terms of the legal framework
and policies of health care, which is important to lay the foundation for a basic plan to
provide instructions on managing tasks and roles given to the staff/workers and support in
decision-making. This process is an effective way for providing safety and security to the
entire organisational framework in health and social care.
Innovation: This emphasis on making effective plans and policies for better health
systems and improving the working practices of the social care institutes by bringing
innovation in their services to improve their quality for achieving organizational goals and
objectives. With this, they can implement any new or alternative choice to bring changes in
services, tools for treatments, processes, policies, organizational structure to improve all the
interconnected domains of health and social care by removing the disparities and increasing
health care quality.
Feedback and monitoring: This is an effective way to collect information about
services quality that has been conducted periodically by 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 that reflects upon the effectiveness of systems and
procedures. Monitoring helps in knowing about the services and its related effectiveness
when treating or conducting tests of the patients.
Staffing: Recruitment and staffing is the most important part of providing qualitative
services to people. Health and social care institute must adopt strict staffing processes for
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 the work performance effectively and assist in
improving the productivity and profitability.

Involvement of the service users: Service user involvement (SUI) must be an integral
part of health services that bring effectiveness in the working-environment. They help in
maintaining the quality of conducting tests, treatments and other procedures by focusing on
policies to make it better and competent.
Training: Training is the most important element in health care services to treat the
patients effectively. Health and social care organizations need to hire experienced people who
can give proper training. This would aid in management of the supply with quality services to
satisfy the expectations of public. Henceforth, Training is the best way for improving
effectiveness of policies and systems in order to achieve objectives and goals.
Preventing problem: This is important for providing good quality in the health care
services. Health and social care organizations must be well-informed regarding their health
care team about treatments and medicines. Thus, if any problem arises, then they 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 will help in the
development of policies along with improving the effectiveness of procedures and policies.
Both factors are important for delivery of good health services to patients. The Administrator
must be assured about the availability of resources by collecting all the information and know
about the schedules, duties and performance to run the operations effectively.
Q.8.
Knowledge and technical skills are the factors that influence health and social care
services to achieve good quality. Here, Quality is depended on performance of workers that
help to increase the service level in efficient manner (Cameron and et.al., 2014). Staff
knowledge about technical aspects and principles would improve health and social care
services.
The most important factors that 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 process will prove effective to achieve service quality.
Health and social care institutes focus on the service quality by using proper treatment
techniques to achieve goals. Also, By making new policies and procedures will support in
quality improvement in health and social care services.

Q.9.
Time management, training, communication and good hygienic environment can be
considered as the best ways to improve health and social care services and associated quality
component. Moreover, in order to improve all the areas, the organizations need to train their
nursing staff for developing good relationships with patients which also help in performing
functions proficiently (Cameron and et.al., 2014). Training will improve the overall quality
parameter in health care services by developing their knowledge and updations regarding
current discoveries and medications. The facilities must be amended for effective
communication between doctors and staff with the patients and other service users in an
organization. Transparent communication channels will build trust and loyalty and create
credibility and reputation.
Along with, maintaining the hygienic environment properly would help in improving
patients health in better manner with an increased response rates. Healthcare organizations
must maintain hygiene and make all the surrounding areas clean around patients. This will
prevent infection and illness. Emergency cases should be attend immediately and time
management must be effectively implemented by coordinating with all the departments on
consistent levels. Additionally, using latest and advanced tools and techniques will increase
the efficiency and time-availability of the health care institutes and their staff. This will
automatically help in increasing the knowledge, awareness etc. to bring effective
modifications in the work performance and their services in better 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 as people perspectives about health care services which is connected to
its quality level. Furthermore, it also justified the role of external agencies for increasing the
standards of service quality. It also discussed about the health and social care standards that
measured quality and approaches for implementing service systems effectively. It also
described about barriers that has an impact on health and social care service delivery by
explaining factors that has an overall impact and also discussed few methods that supported
in improving the quality of health and social care services at the chosen organization.

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.