Comprehensive Analysis of Quality Management in Health and Social Care

This report provides a comprehensive analysis of quality management within the health and social care sector, specifically focusing on the Stretton Nursing Home in the UK. The report begins with an executive summary highlighting the issues identified by the Care Quality Commission (CQC), including deficiencies in responsiveness, staffing, training, and overall service quality. The introduction sets the context by emphasizing the importance of quality in healthcare and introduces the case study. The main body of the report delves into the perspectives of stakeholders on quality, the role of external agencies like the CQC and NHS, and the impact of poor service quality on various stakeholders. It then explores existing standards for measuring quality, different approaches to implementing quality systems, and potential barriers to quality delivery. Further, the report examines the effectiveness of existing systems, factors influencing quality achievement, and ways to improve service quality. The report concludes with methods for evaluating health and social care service quality and the impact of user involvement in the evaluation process, offering valuable insights into improving healthcare service delivery.

Managing Quality In
Health And Social Care

EXECUTIVE SUMMARY
Managing quality in health and social care is one of the important concept in health care
industry. A UK based Stretton Nursing Home is taken in this report in which an investigation is
done by CQC (Care Quality Commission). The quality of service within the nursing was not up
to the mark. It had lacked in various service standards such as responsiveness, staffing level,
prescription, lack of training and supervision, morale of staff team etc. Different solutions also
been provided to the nursing home in order to improve the quality of service to the patients. The
solutions were provided to the nursing to enhance the safe, effective, caring, responsive and well
led services. This will result into improving the service quality of nursing home.

Table of Contents
EXECUTIVE SUMMARY.............................................................................................................2
INTRODUCTION ..........................................................................................................................1
MAIN BODY...................................................................................................................................1
TASK 1............................................................................................................................................1
1.1 Perspectives that stakeholders in health and social care have regarding quality...................1
1.2 Role of external agencies in setting standards.......................................................................2
1.3 The impact of poor service quality on health and social care stakeholders...........................3
TASK 2............................................................................................................................................4
2.1 Standards that exist in Health and Social Care in measuring quality....................................4
2.2 Different approaches to implement quality systems..............................................................5
2.3 Potential barriers to delivery of quality in health and social care services............................6
TASK 3............................................................................................................................................7
3.1 Effectiveness of systems, policies and procedures used in health and social care setting in
achieving quality in the service offered.......................................................................................7
3.2 Factors that influence the achievement of quality in health and social care service.............8
3.3 Ways in which health and social care service can improve its quality..................................9
TASK 4..........................................................................................................................................10
4.1 Methods for evaluating health and social care service quality regarding external and
internal perspective....................................................................................................................10
4.2 The impact that involving users of service in evaluation process has on service quality....11
CONCLUSION..............................................................................................................................12
REFERENCES..............................................................................................................................13

INTRODUCTION
Health and social care is one of the important department regarding the health of
individuals. The quality of these places should be up to the mark so that the patients and their
attendants will not face any issue. This report is based on Stretton Nursing Home which is based
in Hereford, Herefordshire. This is a care home, in which it provides accommodation and
nursing facilities to the older people. In this report, differing perspective of quality in relation to
health and social care services is understood. Apart from that, strategies are also understood in
terms of achieving quality in health and social care. Different systems, policies and procedures in
health and social care services is also explained. In the end, methodologies for evaluating health
and social care quality is defined.
MAIN BODY
TASK 1
1.1 Perspectives that stakeholders in health and social care have regarding quality.
The degree to which health care services for individual sand populations increase the
likelihood of desired health outcomes is known as quality care. In health care, quality is one of
the major issues. The doctors with a specified nursing home or hospitals should keep in mind the
safety, security and other faculties of treatment so that patient will not feel depressed within the
premise (Health and social care, 2019). Since a patient already suffers and does not have a good
reason to smile, therefore it has become mandatory for the management to take care of their
needs and wants. The special need for maintaining the quality can be hygiene, safety,
effectiveness, caring, responsiveness etc.(Brummel‐Smith and et. al., 2016).
Stakeholders may be referred to the corporate, an accountant, group, organization
member or system that affect or can be affected by the organizations actions. In case of Stretton
Nursing Home, the stakeholders could be patients, staff, vendors, government etc. All these
stakeholders are being impacted or gets impact from the steps or decisions made by the
organization.
In case of Stretton Nursing home, staff are one of the important stakeholders which have
impacted greatly with the ineffective services. The perception of staff members is not good with
respect to the available facilities of nursing home. They are not able to provide effective services
to the patients because of lack of services. The equipments which are present in the hospital are
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also not good. Hence they are not satisfied with their job and feel unimportant for the
organization.
Medical representatives are another stakeholders of Stretton Nursing Home which are
affected with the poor services quality. These stakeholders provide necessary equipments to
serve better facilities for the patients. The management of nursing home had not ordered the
latest equipments, therefore their productivity had slowed down (Cascio, 2015). In addition to
this, they ought to find other clients which can help them to increase their productivity.
Therefore the perception of medical representatives is also not good about SNH.
Government of UK is another stakeholder which have affected with the poor services
quality of Stretton Nursing Home. It had incorporated many regulations which are based on
providing proper services to the patients. SNH is not providing effective services, therefore the
government has incorporated an inspection with CQC and found many areas for improvement.
Therefore perception of government is also not good with the performance of SNH.
1.2 Role of external agencies in setting standards.
External agencies are the National bodies of UK which are formed to monitor a service
providing organization so that they can serve better services to their clients. There are several
agencies which are working in UK. These agencies have the responsibility of monitoring,
maintaining, law and order, modify and create new rules and regulations and other rights also.
Apart from that, these bodies have also the right to cancel the licence of such health groups
which are not maintaining the proper quality of services to the patients. The external agencies
which are used in the case study of Stretton Nursing Home are stated as follows:
The first agency is CQC (Care Quality Commission). This is an independent authority in
England which is liable of the quality and safety of care. Care provided by NHS, local
authorities, independent providers and voluntary organizations in registered settings are also
included in this commission. They regulate health care providers of people to all ages, including
hospital, ambulance services, mental health services, clinics and other services (Curtis and
Burns, 2015). The main role of CQC is to register the health care organization and inspect them
to check whether the standards are being met or not. They are basically set quality and safety
standards that describe right of individual in order to providing them quality services. They
protect the rights of services taker by considering different acts and regulations. One major role
of CQC is to carries out in-depth investigations to look at care across the system. In terms of
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quality services they can restrict the services that the care provider can offer as well as can
cancel registration of them for further future services. They have an authority to issue warning
notice in order to requisite improvements. From October 2014, CQC has launched a new
inspection model through which it can be specified that when they will visit the premise of a
health care organization. There were 16 regulations through which CQC can check the standards
of a health care but now these regulations has reached to 11. With the help of these regulations
CQC check the standards of a health care organization.
The second agency is NHS (National Health Service). This is a publicly funded national
health care system which is responsible for maintaining health care services in England and in
four other countries. It is the largest single player healthcare system in the world. This statutory
body is responsible in monitoring all the issues regarding health care services within UK. This
body is important for developing the standards because it allows the health care organizations to
provide better services to patients. The main role of NHS is to set the priorities and directions for
health service and to improve the health care programs.
The third agency is NHS CCG (Clinical Commissioning group). This is a group created
by following the Health and Social Care Act, 2012 (Durbin and et. al., 2016). This group is
formulated to provide best possible outcome to the local population. This group is responsible in
buying the services on behalf of the patients. This organization is important for setting up of
standards because the standards are helpful for the local population in getting quality health care
services.
1.3 The impact of poor service quality on health and social care stakeholders.
Poor service quality refers to the dissatisfaction of services to the patients. This results in
decreasing the quality of health care services within Stretton Nursing Home. It has lacked in
various issues regarding the quality of services. The issues are safety, effectiveness, caring,
service responsiveness, service well-led etc. These issues will not allow the management to
provide satisfaction among the patients. With the impact of these poor services on different
stakeholders.
In case of patients, when the different issues occur in the quality of services provided to
them than they feel dissatisfied with the offerings of nursing home. The poor quality of service
included, safety, caring, service responsiveness etc. When all these standards will not give
satisfaction to the patients than they feel disagree with them. Poor quality insists them not to
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participate in the services of Stretton Nursing Home in future (Edwards and et. al., 2015).
Sometimes poor service quality can cause serious damage to the body of patient No response to
the patients can leads in delaying the services. This can result into serious damage to the health
of patients. Availability of staff to attend all the patients and perform various other services was
not present and this leads to poor quality of services.
The impact of poor service quality also affects the working of staff. When poor service
quality is given to the patients, the mind-set of staff also changed according to the situation. They
become careless with their work and their performance also degrade (Ellner and et. al., 2015).
Lack of resources within SNH does not allow the staff to provide effective services to the
patients. Hence the performance of staff will not meet the required standards.
Another stakeholder is policy maker which has also impacted by providing poor services
quality of Stretton Nursing Home. Public of UK have faith over their policies maker that they
develop necessary health care policies for to them. In case of SNH, poor service quality affect
the reliability of patients on policies maker of country. Patients think about the carelessness of
policy maker on regulating such organizations. Therefore poor services quality has a great
impact over policies maker who develop policies and legislation for respective sector.
TASK 2
2.1 Standards that exist in Health and Social Care in measuring quality
Standards are the set of rules and regulations which are set for the delivery of services to
the patients. These set of standards does not allow the health care providers to provide service
below the standards. Therefore, a set of quality approved health care service is available for the
local population. These set of standards are set by the national statutory bodies such as NHS,
CQC and CCG (Gradinger and et. al., 2015). Apart from that, there are many health care
organisation in UK but these are the main organisation which are engaged in setting up of
standards.
The main purpose behind setting up of standards is the quality of services. The
government is assuring its local population that they will provide better services to them. These
services allow the patients to take better treatment for any disease. The standards are useful for
both tangible or intangible disease. Diseases that can not be identified without examining the
patients are termed as intangible disease. On the other hand disease that can be noticed by simply
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looking to patients is considered as tangible disease. Following are the set of standards for
quality of services in Stretton Nursing Home.
CQC gives policy of vague standard regarding quality of services which helps to create
wide framework and improve quality of health and social care facility. Code of legislations and
practices are provided in these standards then leads to enhance consumer experience during their
treatment. One of the important standard of CQC is person-centred care. SNH has violated this
standard as they have not responsive towards the calling of patient. This leads to violation of the
standard of CQC.
CCG is another organization of setting up of standard service to have best practice in
Stretton Nursing Home. To follow this suitable diagnosing and medication facilities will be
provided to patients. In this standard rights of patients, correct diagnosing, effective plan of
medication procedure are clubbed together. This will improve quality of service in the
organisation.
NHS is allow to follow a information standard which can be used by the health care
organizations to convey the data. This is a document containing standard that relate to the
processing of information. Using that information standard data can be communicate across the
organization. This will help them better to provide effective services to the patients within SNH.
2.2 Different approaches to implement quality systems
Quality systems are the systems which are up to the mark in serving facilities to the
patients. These systems can include, services, equipment, responses, etc. There are many
approaches which are helpful in the developing quality of product. TQM is an approach which is
used by the organizations to implement quality systems. One of the approach is TQM which is
based on implementing the following management system such as Quality management system,
Environment management system and HSE management system.
Apart from these management systems, this approach has some principles also which are:
 Focusing on the customers: The first principle of TQM is good understanding of the
requirement set by customer is key basis for a quality basis. In case of Stretton Nursing
Home, the organization should keep in mind the needs and requirements of customers
(Healy, 2016). When patient is asking for a response than it should be given instantly
because anything can happen with the condition of patient.
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 Strategic approach to improvement: The second principle of TQM is constant
education of employees directs company to respond to market demand. In case of
Stretton Nursing Home, the organization should train the employees so that they can
serve better for the patients. This will allow them to work with their potential and thus be
able to satisfy the needs of customers easily.
 Improving continuously: The third principle of TQM is a clean and healthy work
environment stimulates interest and development within the nursing home. Therefore, the
organization should clean the nursing home so that a positive environment can be created.
 Encouraging teamwork: The fourth principle of TQM is risk free with constant
improvement of Health and safety at work allows the staff and patients to feel safe. These
kind of approaches can be possible while there is an opportunity of teamwork that help in
reducing burden upon individuals. This allows the staff to work with their potential and
thus satisfying the needs of customers.
Advantages
 The advantages of TQM are that it allows to improve the quality of services in Stretton
Nursing Home.
 Apart from that, training a development process help the employees to develop their
professional career as well.
Disadvantages
 This approach is largely focusing on improving the quality of services rather than
management.
Another approach is socio-technical approach which is used to construct the quality
systems against the traditional you must follow the information delivered during lectures However
you can read that information in any book, journals or any articles for better understanding
oriented approach. Socio-technical approach is bottom-up, incremental, information technology
facilitated and indicator driven approach (Kondasani and Panda, 2015). This approach has the
main purpose of providing quality assurance in the health care organizations.
In case of Stretton Nursing Home, the TQM approach is helpful in improving the quality
of organisation. This approach is best suitable because it also allows to train the employees
according to the trends and technology. This approach is soluble for the longer solutions.
Therefore, it can help the company in improving its quality of services.
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2.3 Potential barriers to delivery of quality in health and social care services
Potential barriers are the hindrance in availing the services and products to the
organization. In case of Stretton Nursing Home, the potential barriers do not allow the
management to provide services to the patients. Therefore, patients cannot be able to satisfy
themselves with the services of Nursing Home. The barriers of quality services are stated as
follows:
Training and supervision
This is one of the main barrier in order to achieve the quality of services. The staff of
Stretton Nursing Home does not have sufficient skill so as to help the patients. The staff did not
have proper induction before caring of patients. This increases lack of services among them
(Mboi, 2015). Training and supervision help the staff members to work for the betterment of
patients with their potential. They will gain the required skill and training of handling the issues
of patients easily. Therefore, training and supervision has great influence over the quality of
services to patients.
Responsiveness
In case of Stretton Nursing Home, the staff members bell did not work properly and thus
patients were not able to reach towards the patients. Apart from that, the staff not always respond
to them whenever the patient needed. This disrupts the quality of services to the patients. If a
patient is calling for aid or assistance than the staff member should be there in order to help it.
But due to failure of ringing bell and inattentiveness of staff, patients are suffering with improper
facilities of Nursing Home.
Updated prescription
In case of Stretton nursing home people were not receive their prescription so as to take
the medicine. They often take their medicine with the older prescription. The doctor had not
always signed the prescription report and allow the patient to take medicine. This is not ethical in
providing quality of services to the patients. Therefore the quality of services will be hindered by
the staff of Stretton Nursing Home.
Lack of enough staff
When in organisation there is lack of staff then it proved harzdous for them to give their
best to their consumers and not able to give delighted experience to their consumers base. Along
with this an organization also not able to attain their goal and objective in effective manner. This
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is so because when there is less employees then existing employees feel burden that will directly
impact on their productivity and companies profitability.
Lack of leadership
In case of Stretton nursing home this is lack of leadership due to which employees not
able to conduct their work in effective and appropriate. This is so because they didn't able to get
appropriate guidance in order to attain task. That will also leads to some mis- happing and
dangerous situation at respective workplace.
TASK 3
3.1 Effectiveness of systems, policies and procedures used in health and social care setting in
achieving quality in the service offered
Systems are the set of things working together as part of mechanism as a whole. In case
of Stretton Nursing Home, systems are the management of Nursing Home as a whole part. This
includes management of machineries, administration, safety and security and human resources of
Nursing Home. Policies are the set of rules and regulations which are followed by the
administration of Stretton Nursing Home. These polices are made for the better management of
services towards the patients and also for Nursing Home. These policies can be made by
hospitals individually and also by the government of UK. Procedures are own set of rules to
perform some tasks in a certain way. In case of Stretton Nursing Home, the prescription etc. are
some procedures which are necessary for the smooth running of systems. Procedures are helpful
for the functioning of system within Nursing Home.
Following are the effectiveness of three systems within Stretton Nursing Home-
Score system is designed in the organisation to rate quality of work and services that are
provided by staff members. Giving rating to employees on the basis of their performance gives
motivation to perform well and earn high ratings. Quality of service got enhanced and consumers
experience also boos with this system.
Administration is the system in which different aspects of SNH are managed properly.
These systems will help the SNH in managing the resources effectively. Resources includes
human resources, machineries etc. All these resources when managed effectively will help SNH
in delivering the quality of services to the patients. These services will increase the productivity
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of staff and accuracy in the machineries. Therefore management of administration is necessary
for the organization. (Leyerle, 2016).
Quality assurance system in an organisation is based on set various rules and regulations
that are provided by health and social care departments. This quality assurance system improves
level of services and efficiency to keep on increasing on continuous basis (Valentine, Nembhard
and Edmondson, 2015). Assuring quality of service will improves consumers trust and
organisation will be benefited by achieving set objectives.
Effectiveness of medicine management system: Medicine management- It consist of giving safe and secure effective management to
utilises the benefits by giving treatments and best outcome to giving delighted experience
to consumer base. To give best results and safety measures to consumer base
effectiveness plays major role to amend in systems to get desirable goals and objectives. Monitoring system- This is accountable for coordinate and control tools as well as
techniques that use by an organisation to evaluate or analyse their contribution in
operation's and performance by detecting errors. By this manager of Stretton Nursing
Home able to develop strategies and plans accordingly and effectively.
 Infection control system- It is an discipline or principle that connect with preventing
from nosocomial or healthcare infection, by practical discipline and base on health and
care. For this Stretton Nursing Home fix machines which kill or minimise bacteria of
infections and they also ensure about cleanness of respective organisation.
3.2 Factors that influence the achievement of quality in health and social care service.
In case of Stretton nursing home, there are many issues which supports the dissatisfaction
of patients. These issues can disrupt the issuance of quality services in Nursing Home. Therefore,
it has become necessary for the management to counter the problems related with quality of
services. The factors that influence the quality of services to the patients are stated as follows:
Lack of risk assessment equipments
In some critical areas of Stretton Nursing Home which requires to have proper
maintenance of infections. The staff have improper guidance to secure the patients and others
staff members from the infection. This leads to provide ineffective quality of services to the
patients. Apart from that, the staff members were also not serious about the concept of
cleanliness in the nursing home. Thus results into low quality of services.
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