Managing Quality in Health Care

Managing t wiz of voice in wellness CargonTotal forest focusing a musical mode of managing pile and business processes to ensure arrest customer satisfaction at every stage insidely and outwardly (Department of Trade and Industry, DTI 2010). Although different shade experts emphasize different experts of this methodology, its major components evoke be summarised as follows processes, populate, management systems and procedure measurement. According to Ross and Perry (1999), in attachment to creating delighted customers through empowered employees, total feel management processes withal lead to higher r unconstipatedue and lower cost. In our tutorship for domicil, every department is involved in implementing smell management to offer the scoop tone of voice of returns we ever so clobber as a team and ensure we sustain offered the beat out shade of sustenance that our resident physicians look at.Continuous quality advance is a system that seeks to amend the prep ardness of table helps with an emphasis on future results (Marshall, 2003). In our breast feeding fireside, the manager ensures that every serve well tolerater receives training, implements what they engage contemplatet and they atomic yield 18 supervised if on that point is impoverishment for develop again we atomic number 18 retrained this ensures that we receive updated information to offer the best quality of service. note standards The C ar Quality Commission for England has produced a guidance to military service providers of wellness and adult br rising(prenominal)ly sustentation to comply with the Health and loving C be Act 2008 (Regulated Activities) Regulations 2010 and the Care Quality Commission (Registration) Regulations 2009 (CQC, 2010b). This guide contains the regulations and the outcomes that the CQC expects people using a service will experience if the provider complies. This forms the flat coat for the quality standards in misgivin g homes. There are 16 core out ones range from respecting people receiving the services to safeguard and suitability of premises and moduleing levels unspoilt to mention a few. In my flush moldting, we catch up with an annual follow-up from UKAF over and above inspections from CQC and turn in been given a star rank of three. All activities this year are geared towards a rating of four.Quality cycles According to QCC (2010b) quality cycles represent periods at bottom which care homes should be reviewed to delimitate compliance in its service provision. This may be annually. However reclusive organisations worry the United Kingdom Accreditation service too offers a quality cycle inspection called the Residential and Domiciliary care Benchmarking (RDB). The RDB annual quality cycle posts strategic planning by providing comparative feedback on a homes care provision and enables the identification of performance gaps and cost/benefit assessments to be made (UKAF, 2010). I n this model we have four major aspects to be looked into namely planning, doing, checking and acting.Quality and principles of careLegislation -these are laws and rules hang by the government on how the provision of care should be for pillow slip apology of vulnerable adults. In our treat home, every service provider should be ready to protect all residents from any form of ab recitation we dish mandatory trainings much(prenominal) as safeguarding vulnerable adults according to regulations by the CQC (2010b).Safety- in our nursing home we always do jeopardy assessment on every service wontr and go under measures in sic the desire using bed rails to prevent travel by doing this we have protected residents from accidents and this ensures quality service to our residents.Independence-service users should be made in have got of their lives by allowing them to do some of the things comparable arranging their wardrobes, making and tidying their rooms by themselves becau se some of the residents are very active and would corresponding to do what they apply to do before and we always encourage them to do objet dart we supervise them and this makes them happy hence promoting the quality of service as they are satisfied.Rights- service users should continue to enjoy the same rights when in nursing homes like they used to when they were living independently. Every service user buy ated in nursing homes has the right to say NO, right to have a affinity and the right to have a say in their care plan. aid providers always tend to balance service users rights against their responsibilities whether both are at try or not.1.4) External agencies These are bodies that regulate quality of care includingThe Care Quality Commission an independent regulator for wellness and neighborly care in England (CQC 2010a 2010b). They regulate care provided by NHS, local authority, hidden company and voluntary organisations. Their aim is to make sure better care is provided for everyone. In our nursing home Care Quality Commission makes a minimum of three inspections annually (two announced and one unannounced) on such things as how we provide care in terms of cleanliness of the home and to service users.. It has a entire range of enforcement powers to condition action on behalf of service users if services are unacceptably low.The CQC makes sure that the voices of service users are perceive by asking people to share their experiences of care services. It makes sure that users views are at the heart of its reports and reviews. The CQC issues action if providers do not meet inherent quality standards, or if on that point is reason to think that peoples basic rights or preventive are at risk (CQC, 2010) through a wide range of enforcement powers, such as fines and public warnings, and send away be malleable more or less how and when to use them. It feces apply specific conditions in result to serious risks. For precedent, it can dem and that a hospital ward or service is closed until the provider meets safety requirements or is suspended.The National demonstrate for Health and Clinical Excellence (NICE)- this is an independent organisation responsible for providing national guidance on promoting trusty health preventing and treating ill health (NICE, 2010). In our Nursing home, residents who have anxiety, panic attacks request for sedatives in order for them to calm they are usually reassured and instead a government practician is consulted to review and advice them accordingly. Service providers take NICE guidelines trainings on different medical conditions for example diabetic foot (identification and care of the foot).2.1) Quality StandardsBenchmarks According to Philip B. Crosby (1999) benchmarks are indications of best manage including access to care environment and the culture of a home. The Benchmarks is one of the most comprehensive set ups of affable and environmental criteria and business per formance indicators available (Daniels et al 2000). Our nursing home is accessible publically, to wheel chairs, a spacious car park and a section for activities for residents and relatives. We excessively have a signing in visitors book stating whom they are visiting.Code of practice for social care fiters and employers for social care workersThis document is developed by General Social Council and it contains agreed codes of practice for social care workers and employers of social care workers describing the standards of conduct and practice within which they should work ( GSCC, 2002). Employers use this set of code of practice to make decisions about the conduct of rung and support social care workers to meet their code of practice. Service users and members of the public use the codes to help them understand the behaviour of social workers (how they should behave towards them) and also how employers should support social care workers to do their job well. It is the responsibil ity of social care workers to make sure that their conduct does not fall below the standards set in the code of practice and no action or heedlessness distresss service users (NCSC, 2010). Social care workers must protect the interests of service users, admit confidence, respect rights, promote independence, be accountable for the quality of their work and take responsibility for maintaining and up their knowledge and skills. The general social council expect social care workers to meet the codes and may take actions (deregistering) if registered workers fail.2.2) Different go aboutes to implementing quality conversation is a means of passing information from one person to another. In our nursing home we have different ways of conversation like when doing care plans we always document what we have make for a resident so that whoever takes over knows what to do next to ensure continuity of care. too when guideing over is done during change of shifts information about resident s is shared and everyone is assured of any changes in care plans in accordance to CQC guidelines (CQC, 2010). We also have staff concussions where certain information is passed on and in cases where staffs have a problem it is ad garnished and solutions are given out. For forcefulnessive communication systems there should be a language that everyone understands.Policies and proceduresThese are guidelines set on how to do things a great deal informed through regulations as outlined in miscellaneous government documents (GSCC, 2002 NICE, 2010 CQC, 2010a. 2010b). In our Nursing home we have different policies and procedures for example in cases of accidents to residents we are required to fill a resident accident report and pass it on to the executive program families, friends and relatives are informed about the accident thence precautions are dedicate into place walking frames, to bend future occurrences of similar accidents.Infection control policy helps to prevent fan out of infections within our nursing home. We always use personal protective equipment when pass personal care to residents, intervention of any infectious ingests. We also use the proper technique for hand washing. There are also hand gels in each residents room, in public toilets and at the entrance of the construct for sanitation purposes and all wastes like clinical and kitchen wastes are usually put in the bins ready for collection. In cases of disease outbreaks like diarrhoea and chuck residents are isolated and managed separately and proper hand washing techniques are used to prevent further spread of the infection.Whistle blowing policy is intentional to deal with issues that do not directly affect the employee and their employment yet are a cause for concern in relation to the harm that may be done to other employees, residents or the wider community. Any employee who is bear on about their personal situation should raise their concern with their line supervisor or man ager. This policy is for reporting issues like elderly abuse, misuse of drugs, haywire machinery that may cause accidents, illegal dumping of waste. The policy protects not plainly employees solely the wide community.Confidentiality- all residents or service users information is secret and confidential. It is not a proper practice to discuss residents information in public like their conditions and behaviours by doing that is breaching the policy and legal action should be taken. In nursing homes all information is kept safely and precisely accessible to relevant persons. This promotes quality of service2.3) Quality systemsISO 9001 involves a set of procedures that cover all key processes in the business, monitoring processes to ensure they are effective, keeping adequate records and facilitating continual improvement. They have certain requirements like internal regulations, claims and procedures for residents, suggestion box and contract with uses. It also covers the importan ce of understanding and meeting customer requirements, communication, resource requirements, training and intersections, Leadership, Involvement of people, Process approach, and System approach to management and Continual improvement (Tricker and Sherring- Lucas, 2001).In our nursing home for the provision of all these elements and reporting them on day to day basis for example there is a introduce procedure for residents complains. Carers, residents and relatives are informed and logged in a special complaints book and complains are followed up. When all this are put into practice, there is employee and customer satisfaction, resulting from better defined and implemented business processes. As a result of this we have motivated staffs, who understands their usances and how their work affects quality, improved product and service quality, happier customers, and improved management and operational processes, resulting in less waste (both time and materials)Business excellence is a widely used exemplar that helps companies to review their performance and practices in a number of areas and identify targets and actions for improvement based on principles of customer service stakeholder value and process management ( British Quality asylum, BQF 2010). Managers develop the mission, vision and values and are role models of a culture of Excellence. Studies in Taiwan have shown that in care homes where this model is applied, managers are personally involved in ensuring the organisations management system is developed, implemented and continuously improved are involved with customers, partners and representatives of society and also motivate, support and recognise the organisations people (Cheng B, Chang, C and Sheng L. 2005). In our nursing home we use a balanced score card to keep sweep of activities by staff and measure consequences arising based on the British Quality Foundation model ( BQF, 2010).Service users families and relatives measure in a scale of 1-5 w here one is poor and five is excellent. We work hard in disadvantageously rated areas to improve the quality of service. At the same time managers set a number of targets on key areas of each staff members roles which are then assessed on periodic review and awards are given to the best. This motivates other team members to work hard and best to attain the best and by doing so they provide best quality and we excel.2.4) Trainings this refers to a learning process that involves the acquisition of knowledge, sharpening of skills and concepts (Stevens, 2004. In our nursing there are mandatory trainings offered to service providers before commencing to work like basic food hygiene, manual handlingHealthy and safety is ensuring that the environment where we are functional is safe for service users, other staff and others in general by our actions and omissions. It is a responsibility to all staff to ensure that the environment is safe to work on. For safety purposes in our nursing hom e we do not use equipment unless it has been checked and serviced. Also default equipments are labelled DO NOT USE to prevent and head off accidents. We also have controlled cupboards where substances that are hazardous to health are stored and locked away. When there is a defect on the environment like chipped floors, loose dangling electricity wires we report to the maintenance coordinator and they are rectified immediately to stay off accidents. Again when housekeeping team are doing cleaning they always show cleaning boards and everybody is aware that cleaning is on progress or the floor is wet and they avoid using it until it is dry by doing this they play down chances of accidents like falls2.5) According to Marshall (2003) and Stevens (2004), external and internal barriers to delivering quality are any obstacle which prevents a given policy instrument existence implemented or limits the way in which it can be implemented. They complicateResources lack of adequate reso urces hinders quality of service for example inadequate or shortage of staff affects the quality of services offered and this leads to unsatisfaction of service users as they get services that are not adequate and for service providers because they are overworked. In nursing homes when there are staffs shortages they arrange cover shifts earlier by either bank staff or some agencies registered with the home. Financial barriers admit budget restrictions like food supplies and other supplies like incontinent products limits the boilers suit expenditure and this leads to inadequate provision of quality services to residentsPersonal show Hygiene and grooming, eating habits and attire can vary from land to country and culture to culture. For example, some people may wear attire such as a headdress as part of their custom and beliefs. To bear true to their beliefs, some workers may want to continue to wear this dress at their workplace. Employers may view this as inappropriate or uns afe. It is curiously problematic in workplaces where workers wear uniforms.Religion In many cultures, faith dominates life in a way that is very much difficult for employers to understand. For example, workers from some cultures may want to pray while at work multiplication in accordance with their values and beliefs. There may also be religious holidays on which people of certain religions are forbidden to work. These differences need to be respected, where possible, and not ignored and they affect the quality of service.Language barriers often go hand-in hand with cultural differences, posing additional problems and misunderstandings in the workplace. When people cannot communicate properly they are frustrated when communicating with supervisors, co-workers and residents this can be dangerous because people may end up performing poorly in their work thus poignant quality of service offered. licit and institutional barriers -these include lack of legal powers to implement a pa rticular(a) instrument and responsibilities which are split between agencies limiting the ability of an institution. kindred the law states that students should work for twenty hours only which creates shortages at work affecting quality of services.3.1) According to Business Dictionary.com (2010), policies are principles, rules and guidelines formulated or choose by an organization to reach its long term goals. They are designed to influence and determine all major decisions, actions and activities take place within the boundaries set by them and procedures are specific methods employed to express policies in action in day to day operations of the organization. For example, in nursing homes the National Care Standards Commission for England, NCSC (2010) has outlined requirements that these homes must meet which in effect guide their policies and principles. These policies include, but not limited to manual handling procedures, adventure assessment and Infection control.Manual ha ndlingThese are techniques used to handle or move service users like hoisting, using belts and slide sheets to move residents these are safe procedures for both residents and service providers as they minimise accidents to both cases and this promotes quality of service (CQC, 2010). On the other hand, they have disadvantages like time consuming when doing procedures like hoisting which requires two or three persons and also residents may not like the experiences of hoisting and thirdly it needs trainings to be carried out.Risk assessmentsAccording to healthy and safety at work act (1974) the focusing of Health and Safety at Work Regulation (1999) states that it is the responsibilities of managers to do risk assessment to employers and employees. to reduce and prevent risks to them in future and they are include in their care plan so that quality of care can be improved for example residents with risks of locomote have walking frames, falling mats and bed rails put in place to avo id falls but again things like bed rails have caused accidents in that residents are trapped and some sustain fractures which affect quality of service3.2) factors that influence the achievement of quality of personal careQuality is a difficult concept to capture directly. However, resident or organisational outcomes are often used as a proxy for quality (Marshall, 2003). There is immense debate about the relationship between quality of care and quality of life as joint, but not necessarily competing, measures of quality. A see for the Joseph Rowntree Foundation indicates that residents perceptions of nursing staff are a good indicator of quality of care (JRF, 2008).The importance of measures of social care and of homeliness epitomize the divide between health and social care provision in care homes. Factors influencing residents satisfaction with care are discussed belowTeam workingHeath care workers working in teams has been recognised as an amend the quality of care (Stevens, 2004 Borill et al 1999). According to Stevens, the intention is for carers to share tasks and learn from each other and possibly improve based on their experiences. This can be illustrated by the quotation belowThe best and most efficient outcomes for patients and clients are achieved when professionals work together, learn together, engage in clinical analyse of outcomes together, and generate innovation to ensure progress in practice and service. (Borill et al 1999 p.6).Stevens has for example reported from a number of surveys from UK nursing homes to suggest that there is a reduction in carer burden and significant reduction in stress when staff work in teams resulting in better heading and satisfaction. Both these studies (Stevens, 2004 Borill et al 1999) found that service users surveyed showed more satisfaction when carers and health workers worked in teamsHealthy and safety at workThe responsibilities of care home proprietors are subject to a range of health and safety la w among them the Health and Safety at Work etc. Act 1974, the trouble of Health and Safety at Work Regulations 1999 which require employers to assess the risks to employees and other who may be affected by their undertaking, (residents) and the control of Substances Hazardous to Health Regulations ( Care Quality Commission, 2010).These regulations have led to dramatic improvements in the safety of residents and people working in care homes according to the care quality commission. For instance, guidelines requiring minimalist manual handling has significantly reduced the numbers of health workers staying off work due to illness which has a positive effect on the level of personal care of residents ( CQC, 2010a). However, a report for the Joseph Rawtree Foundation (JRF, 2008) showed that the percentage of medication errors and adverse events in nursing homeshave change magnitude despite regular inspections by the CQC. Stevens (2004) has also reported survey results from 27 resident ial homes with dementia patients where 19% cases of medication errors were reported.In my care setting, clear improvements can be seen from less harm to residents when using the hoist but not many service users like to use the hoist. Some risk assessments in care homes have made it very difficult to take residents outdoors or even for activities outside the home for fear of not meeting the Health and safety requirements and this ends up reducing the quality of care.3.3 The pursuit recommendation can improve the quality of care in Nursing homesTraining /educationThis means acquiring knowledge and skills or new information on how to do things according to the recommended regulations and standards ( Stevens 2004). This is a very essential aspect in nursing homes all trainings as it provides on firing trainings to update service providers and equip them with relevant and current information that enables them to provide the best quality of care that will be satisfactory to service user s. In our nursing home trainings are offered and need to be implemented then supervision is done and in cases where need for retraining arises, arrangements are done and they are offered for the benefits of service users, service providers and the community at large as it reduces or minimises preventable accidents and this promotes the quality of serviceReviewThis means going through the set of targets or planned activities to see the progress whether it is change or getting worse. This alerts and actions or precautions are put in place to make the situation improve for better quality of service ( Stevens, 2004). For example in our nursing home there are always monthly reviews of care plans of service users this includes individual or family interviews to determine whether residents are improving or need some improved care plans like in moving and handling procedures (use of hoist or belts) and then action is taken accordingly. Also for staff there is quarterly staff meetings or wh en need arises and previous discussed or current issues are raised and a way forward on how to carry on is agreed. There are always individual supervisions done by allocated persons and each employee identifies areas that need improvement and good performing areas by doing this there is improvement of quality of service destructionIt has been shown that in order to improve services to users in the social care sector, it is important to follow principles, guidelines and procedures set by government, constancy bodies or even individual homes. There is also need for planning, doing and checking and then reviewing to assess shortcomings in order to design improvement regimes. Similarly, it has been shown that although there is legislation and care industry standards, it will require long term commitments in developing methods, instruments and communication procedures involving all stakeholders at care or residential home level.