Health and Social Care Analysis

How the design and review of services promote and maximize the rights of users of health and social care services

Legislation

The health and social services sector is guided by legislation and policies that govern how services are delivered in the sector to maximize and uphold the rights of users at all times (Folland, Goodman, and Stano 1). The legislations are very important since they provide a legal framework that makes it a right for users to access high quality and equitable services without any hindrances.

The first legislation is the Health and Social Care Act of 2012. The main aim of the Act is to support the integration and regulation of health and social care service provision through working together in partnerships (Saxena et al. 878). The Act is responsible for the ensuring the availability of services to all users in the country’s health and social services sector. In this case, the implementation of the legislation ensures that the users’ right to access services is upheld at all times. To guarantee equitable and adequate access to health and social services, it is important to ensure adequate resources in all health and social services centers throughout the country (Epstein et al. 1489). In this case, the Health and Social Care Act of 2012 guarantees the availability of resources to promote smooth running of the health and social services facilities in the country (Collins 1173).

Another important legislation that promotes and maximizes the rights of users of health and social care services is the Mental Health Act of 1983 and Mental Capacity Act of 2006. The Acts are responsible for the protection of rights of people who use Mental Health Services (Cameron et al. 3). In this case, they recognize that people with mental health disorders also require their rights to detention while getting the appropriate treatments. Further, they ensure that patients with mental health disorders can access legal redress against some approaches to their care such as detention and treatment options (Munn-Giddings and Winter 6). Concisely, the Acts defend mental health patients in the most vulnerable states of mind, thus protecting their rights in the system.

Other important legislations include Care Quality Commission Regulation of 2009 and the Human Rights Act among others. The main aim of all the legislation is to promote the rights of users of health and social care services in the sector. To apply the legislation at the health facility level, organizations must put in place specific policies, which guarantee the promotion and adherence to the relevant legislations. Further, organizations must allocate adequate resources that will ensure that the requirements of the legislations are met.

An appropriate outcome that will be achieved for the service user is that individuals who suffer from mental health disorders will enjoy their rights to detention while getting the suitable treatment. Such patients will enjoy right of entry of legal redress against some approaches to their care such as imprisonment and healing alternatives.

Organizational Policies and Procedures (Inside and Outside Factors)

Various organizational factors affect the promotion and maximization of rights of users of health and social care services. These factors include:

  1. Policies and procedures in an organization such as staffing
  2. The existing legislations
  3. Professional development
  4. The ability to adapt to changes in the health and social services sector

Some of the organizational policies include fairness and diversity, solitude and self-respect, discretion, and equal opportunities (Berwick, Nolan, and Whittington 759). The practices that are important to the delivery of care and promotion of the rights of users include roles and responsibilities, answerability, service provision, and examination and checking among others that influence how an organization adheres to its goals of providing high-quality health and social care services.

Each of the factors, policies, and practices discussed above is applied in different health and social services settings at varying levels to meet the needs and demands of the users. Hence, it is very important for health and social services to ensure that the rights of Dementia patients are protected at all times (Berwick, Nolan, and Whittington 786). Further, it is vital to promote confidentiality and privacy of the patients and their families during their stay in nursing homes. In addition, the service providers should put in place measures that guarantee that the patients are not discriminated while receiving care. Most importantly, patients are required to have a choice on the kind of care to receive or as dictated by legislation on Mental Health Acts and related legislations.

In a nursing home for people with Dementia, the factors that are relevant for my analysis include the consideration of the prevailing legislations that address the rights and needs of the patients (Cameron, Nolan, and Whittington 6). For instance, the application of Mental Health Act of 1983 and Mental Capacity Act of 2006 is relevant in this case.

Communication and Other Factors

Communication is a central part of health and social service delivery. The communication skills are applied using various approaches, depending on the context and individuals involved in the communication process. As such, communication can be personal, professional, or procedural. For instance, when communicating with a 19-year-old woman who has a learning disability and living in a residential home, it is important for a care worker to apply personal communication skills. Such skills include showing empathy and patience to the young woman. Further, it requires an individual to maintain clarity of communication while using a tone and communication pace, which factors in the challenges of the young woman. There is also the need to consider the proximity to the young woman and further applying reflective listening to guarantee smooth communication.

The applied communication skills are professional between the key worker and the young woman’s social worker. In this case, the communication involves sharing information that will enable the service user to make unique decisions. However, during such communication, it is very important to respect the privacy and confidentiality of the user. Further, the user must be engaged in the communication. The key worker and the social worker should use the preferred language, either spoken or sign language.

As an example, the care worker who is in charge of taking care of the 19-year-old young woman living in a residential home and with learning difficulties may realize that the woman has problems with reading and/or grasping the right words when communicating. The care worker can advocate for the young woman by ensuring that every person interacting with the woman, including the key worker, demonstrates patience and understanding when it comes to the learning needs of the patient. When reviewing the young woman’s care plan, the care worker can communicate in a tone that is welcome not only by the 19-year-old, but also by other parties involved.

How to promote the participation and independence of users of health and social care services

Factors that Promote Participation and Independence of Users

Several factors may lead to loss of independence, social exclusion, and non-participation. The mental conditions of the individuals focus on the determination of the person’s ability to make independent decisions or the risk of self-harm or harm to others. Hence, one of the specific major factors that can lead to social exclusion across all groups mentioned above is the mental capacity of the service users (Epstein et al. 1491). The physical capacity of the users of the health and social care services determines the level of participation. This specific factor is very important in older people and consequently a key determinant of the participation of the users of social services. The availability of resources and services is a major factor that also influences the independence when it comes to the use of health and social care services (Saxena et al. 880). For example, the necessary resources should be availed to support and provide adequate services to teenagers with learning disabilities in a residential home, as well as senior citizens living alone. If such resources are obtainable, the users of health and social services are in a position to be supported independently in their respective residential areas.

To understand these factors, this section will review the cases of three vulnerable groups. These groups include the elderly individuals who live alone, teenagers with learning disabilities living in a residential home, and people with a history of mental health problems who find it difficult to relate to anyone they do not know. For instance, for senior citizens who live alone, the mental capacity is very important in determining whether they can take care of themselves without any supervision. If the people cannot take care of themselves, they are likely to lose their independence, social inclusion, and non-participation (Collins 1189). On the other hand, teenagers with learning disabilities and people who have difficulties in interacting with those they do not know require an assessment of their mental capacity. If they are a risk to themselves and others, then it is important for increased measures, including loss of independence and non-participation, to be addressed.

Management of Organizational Structures and Procedures

Systems and processes in a residential unit for recovering mental health patients can be managed to promote the participation and independence of service users. Firstly, one of the most important approaches to the management of organizational systems and processes involves ensuring their full-time operation and accessibility of the health and social care services (Munn-Giddings and Winter 8). In this case, it is important to ensure that the health and social care services are available and open to different people who need such services. When the services are accessible, it becomes easier for users to receive the best care conveniently while giving them the ability to choose between different options of care as per their preferences.

Guaranteeing consistent quality of services of the systems and processes is also another way that managers can promote the involvement and autonomy of service users. The management of the organizational systems and processes must be done in a manner that will guarantee that users of health and social care services can receive the best outcomes. Managers of the systems and processes should ensure that enough funds are allocated to facilitate smooth operations, hence guaranteeing independence and service use participation (Collins 1186). The provision of health and social care services is also a function of the personnel offering the care and services (Folland, Goodman, and Stano 25). In this case, the facility’s management should have the appropriate recruitment, selection, and development procedures that ensure the recruitment, selection, and development of the qualified and able social workers who can offer the required care for recovering mental health patients. Employees should be trained to upgrade their skills to respond to the changing needs of patients, as well as in their practice. The facility should also implement and monitor regulatory frameworks in the process of service provision. Regulatory frameworks guide how health and social care service facilities can offer the appropriate services while adhering to professional legal frameworks. Good monitoring approaches must focus on the various strategies and services offered in the facility to maximize the benefits to the recovering mental health patients.

Tensions

In the process of providing health and social care services, the interest of the patients is central to all the services and the existence of such services and facilities. However, in the quest of safeguarding the best interest of the patients, anxiety that arises when responsibility conflicts with the civil liberties of individuals to sovereignty and choice can often derail the provision of health and social care services. Firstly, risk management versus individual autonomy is one of the major tensions that arise in the quest of providing healthcare services (Saxena et al. 881). In this case, both issues of tensions are protected and provided under various legislations that guide the provision of health and social care services. On one hand, it is important for social workers to ensure that the individual is protected from self-harm and harm to others. However, sometimes it is difficult to draw the line between when to decide that an individual poses risk of harm to self and others and/or when to allow such individuals to exercise autonomy and to have choice of the kind of treatment and services to access.

The second tension that arises involves the expectations of the family/friends versus the resources of the care provider. In this case, health and social care service provider has to balance between the interests of family/friends and the available resources in the given facility (Epstein et al. 1491). In most cases, family and friends may demand more services, which may be beyond the capacity of the healthcare provider. If not well handled, such tensions may affect the quality of the care the users receive, hence affecting the outcomes of the patient.

As an example, a family may have a 19-year-old male victim who demands services that can improve his learning capabilities. The family may dictate the length of time that the social worker should take for their patient to record improvement. A tension here arises since the patient may have other underlying issues that may take the social worker extra time to identify and remedy. The patient’s relatives may not be aware of them. Hence, the case where the social worker explains the reason behind the extended stay of the patient in the therapy may attract conflicts since the relatives have the right to make independent and final decision concerning their patient. Besides, the care worker also has his or her right to offer thorough services that satisfy all patients and their families.

The responsibility of managing and monitoring risks in health and social care settings

Risk Factors-The Case of Ms. P

Health and Social Care Services recipients have different levels of exposure to risk due to their vulnerabilities from the health challenges that they face. The case of Ms. P, a woman with learning disabilities, is an example that will be discussed in this section to highlight various risks of harm that patients often face. The case reveals various risk factors faced by Ms. P. For instance, she has a learning disability and hence at an increased risk of exploitation. Secondly, she lives alone. Such isolation compounded by the fact that she has a mental condition increases her vulnerability drastically.

Firstly, Ms. P is at risk of physical harm. In this case, she stays alone, despite her condition requiring her to receive care on a daily basis. However, although her parents have taken the necessary steps of providing support of a caregiver, the worker has not been consistent. Hence, such care has been partial. Ms. P is not always supervised. Thus, she is at an increased risk of self-harm or harm from other people within the location where she stays.

Secondly, she is at a risk of emotional harm and exploitation. For instance, the social isolation that comes with staying alone poses a major risk of emotional harm. In addition, the intermittent services she is receiving from the caregiver show a high risk of emotional abuse since the caregiver is withdrawn from her roles. The fact that she has withdrawn is a sign that she is at risk of emotional abuse and harm. The care plan requires Ms. P’s situation to be reviewed after every four weeks. However, she has received only one review, thus making it difficult for her parents to determine whether she has been abused since the review. It is important for the pending review to be undertaken to ensure that her condition and progress are determined to stop any possible emotional abuse before it is too late.

Ms. P is also at risk of sexual exploitation due to her condition. The case highlights the concerns raised by her parents relating to a male neighbor who Ms. P mentions as a close friend. Sexual abuse and exploitation are common among people with learning disabilities since they may lack the capacity to make consent to sexual activities. Therefore, it is important for the necessary actions to be undertaken to ensure that the friendship between Ms. P and her male neighbor is not exploitative in any manner.

The parents of Ms. P are very concerned about the welfare of their daughter. Hence, they are ready to do what it takes to ensure that she leads a comfortable life. In this case, it is easy for them to fall victim of financial exploitation as already evident in the case provided. For instance, the care plan requires monthly assessment and review to ensure that their daughter receives the necessary care. However, despite the fact that such requirement is provided for in the care plan, only one assessment has been undertaken. Efforts to have the second review have not been initiated. Therefore, it is important to address the issue before it becomes an obvious financial exploitation to the family since it has already paid for the services that are not being offered.

Effectiveness of the Policies, Procedures, and Managerial Approach

The case of Mr. L highlights a good scenario for the assessment of the policies, procedures, and managerial approaches that are important in guiding risk management in a supported housing complex. Firstly, in such a setting, it is very important to implement policies that safeguard the welfare of the occupants. However, the effectiveness of the policies is an essential part of the supported housing complex. For instance, it is evident that the usefulness of the policy confidentiality and privacy has been protected in the housing complex. In the setting, each person has his or her unit, although a shared clubhouse where individuals can interact is provided.

However, it is difficult to implement the policy on equality and diversity due to the varied demands and background of different people in the areas (Munn-Giddings and Winter 89). For example, it is evident that Mr. L is already bored with the monotonous life of isolation and routine. Thus, he is ready to try new things outside the housing complex. Such demands show the difficulties in ensuring that all the residents are satisfied with the services since they have varying physical challenges, which require varied services and care that the complex may not adequately provide.

It is important to consider various procedures that allow the residents in the housing complex to have a reduced risk of harm while in the complex. Some of the effective procedures include inter-agency working, information sharing, whistle blowing, feedback and complaints, and risk assessment (Folland, Goodman, and Stano 13). Presently, the effectiveness of the above procedures is questionable since the case does not highlight whether any of the procedures has been implemented. However, the benefits of such procedures cannot be overlooked. Inter-agency working is important since it ensures the service providers can work collaboratively with the relevant health and social care providers to guarantee high-quality services to the residents of the housing complex (Collins 1188). In addition, information sharing allows relevant organizations and concerned parties to deal with the arising issues and concerns to avail the best outcomes to the residents. On the other hand, whistle blowing ensures that any risks or mistreatments to the patients or people at risk are raised and consequently necessary measures undertaken to address the issues. Feedback and complaints form another important procedure that has been implemented effectively in the housing complex. For example, the complaints from Mr. L have been received, thus showing the effectiveness of the procedure. However, the fact that the occupants of the residence often access alcohol shows that the risk management and assessment procedures are not effective as they should be and hence the need to review them.

Management approaches are very important in any organization or setting. The case of Mr. L highlights an example of a setting where the role of management is evident. Various managerial approaches can be applied. For instance, micromanagement is a managerial approach characterized by close monitoring and supervision by a manager (Munn-Giddings and Winter 71). However, such a managerial approach is not appropriate in the supported housing complex in the case of Mr. L. The use of laissez-faire managerial approach where the service providers are free to provide the services and care required by the residents is allowed. However, the application of the managerial approach requires the implementation of effective monitoring and risk assessment framework to ensure that the appropriate services are offered.

How good practice in the administration of medication is essential for users of health and social care services

Current Legislation, Codes of Practice, and Policy

The administration of medication is essential for users of health and social care services. However, this sensitive area requires good practice and availability of necessary frameworks that guide the administration of medication. From the point of view of a care worker in a residential home for elderly people, one of the good practices that are essential to the administration of medication is the assurance of high-quality health care services to all elderly people while upholding fairness and equality of access to the services. The current legislation provides various guidelines that ensure that the ordering of medicines is done appropriately (Collins 1182). The process of ordering requires a close monitoring to ensure that the necessary medicines are supplied in a timely manner to meet the demands of the patients in health and social care services. Considering that the elderly people have weak immunity system, any misprescription may be too late to rectify.

Secondly, unsafe storage of medicines can lead to poisoning of patients or ineffectiveness of the medicine, which consequently may lead to unexpected outcomes. For example, health and social care facility that serves 100 elderly people must have the necessary policies and legislation in place to guide the storage of medicines. The care worker must always check whether all medicines have been stored as required. The administration of the medicine to the elderly is another important area of good practice of medicine in health and social services provision. It is important for patients to receive the appropriate medicines in adequate dosages within the right timeframe. In this case, the service providers should ensure that the social workers have the right knowledge and training on how to handle and administer medicines to patients.

Self-medication is also a common practice for patients in the health and social care services sector. Firstly, self-medication requires an individual to be physically and mentally capable of following the necessary guidelines throughout the process. Therefore, it is imperative for the health and social care providers to assess the physical and mental capabilities of the patients before considering self-medication (Munn-Giddings and Winter 36). Secondly, it is essential to ensure that the medical products have the necessary labels and instructions to guide the patients throughout the medication duration. For example, a health facility that takes care of the elderly may have some of its medical products’ labels out of place. A care worker in this facility should be on the look out to replace the labels correctly to avoid misinformation when it comes to drug prescription. It is also vital to ensure that the patients are advised on how to take the medicines appropriately.

Health and social care service providers must also ensure that they have apposite measures that guide record keeping and disposal. Record keeping ensures that the health and social care service tracks the patients’ medication history (Munn-Giddings and Winter 42). As such, it is easy to avoid medicines that the patient has a negative reaction to, thus averting serious or fatal medical reactions. Further, it becomes easier for the service provider to decide on the best medicines for the patients based on the history recorded. The disposal of record must also be conducted in a manner that will guarantee confidentiality and privacy of the patients at all times. Lastly, it is important for health and social care service providers to have regular audit and review of their medicines and medication procedures. The reviews and audit ensure that the service providers follow the right procedures and policies to protect the patients from any harm (Berwick, Nolan, and Whittington 766). Such reviews and audits also identify areas of weaknesses, which consequently guarantee that necessary measures are undertaken to correct any loopholes that may expose the patient to medication errors and harm.

Evaluation Considerations

It is impossible to gauge the effectiveness of any intervention without doing an evaluation of its efficacy. Health care organizations that deal with care giving for the most-at-risk people perform baseline surveys to determine the efficacy of their interventions. Such evaluation tells the organization whether it is indeed wise to invest in the particular intervention. If the strategy does not seem to provide excellent results as anticipated, the implication is that the intervention is not effective and hence no need to allocate resources and time to it. Hence, only through an evaluation that a health care institution can tell the way forward concerning a particular intervention.

Concerning the current case, the evaluation of the procedures in the administration of medication is essential to ensuring that users receive the best care. However, such evaluations must consider various factors such as ethics, costs, resources, reviews, and the role of relevant bodies that guide the quality care and patient safety. It is essential to understand the role of costs and resources when conducting the evaluations. The health and social care providers have different access to resources, which consequently affect the quality and costs of care offered in such facilities (Folland, Goodman, and Stano 28).

The process of evaluation also requires close cooperation with the relevant quality care and patient safety bodies to ensure that the guidelines provided by such bodies are considered. The health and social services sector serves different people. The sector is characterized by cases that require different approaches and considerations, which promote the participation and independence of users of health and social care services. In some instances, it has been found that lack of proper evaluation results in misappropriating of resources where drugs may be dispatched to the wrong patients to the interest of few individuals without the awareness of other relevant stakeholders. Hence, it is crucial for all shareholders to work together while adhering to all set guidelines. All health and social care providers must be registered. They should provide quality care as guided by the Care Quality Commission Regulation (2009). Further, the body is mandated with the power of determining care standards (Folland, Goodman, and Stano 53). The breach of such standards can attract penalties or deregistration of the health and social service providers. Lastly, the evaluation must ensure the patient safety considerations and guidelines are adhered to in the evaluation process. Therefore, the evaluation process is only complete once the evaluation process considers the various guidelines and requirements against which health and social care facility can be evaluated.

To evaluate whether the intervention is well implemented, the care worker should weigh it against the established ethical guidelines that dictate the administration of health and social care services. For instance, such considerations include privacy, confidentiality, and respect for human life and dignity for all people. Any intervention that contravenes any of these guidelines may be stopped immediately. For instance, a facility may have workers who do not offer quality services to the elderly. Such workers may be overlooking the need for the elderly people to be fed like children since majority of them may be incapacitated when it comes to feeding themselves. Such workers may be fired and replaced immediately with qualified others.

References

Berwick, Donald, Thomas Nolan, and John Whittington. “The triple aim: care, health, and cost.” Health Affairs 27.3(2008): 759-769. Print.

Cameron, Ailsa, Rachel Lart, Lisa Bostock, and Caroline Coomber. “Factors that promote and hinder joint and integrated working between health and social care services.” Research Briefing 41(2012):1-24. Print.

Collins, Stewart. “Statutory social workers: Stress, job satisfaction, coping, social support and individual differences.” British Journal of Social Work 38.6(2008): 1173-1193. Print.

Epstein, Ronald, Kevin Fiscella, Cara Lesser, and Kurt Stange. “Why the nation needs a policy push on patient-centered health care.” Health Affairs 29.8 (2010): 1489-1495. Print.

Folland, Sherman, Allen Goodman, and Miron Stano. The economics of health and health care, Hoboken, NJ: Pearson Prentice Hall, 2007. Print.

Munn-Giddings, Carol, and Richard Winter. A handbook for action research in health and social care, London, UK: Routledge, 2013. Print.

Saxena, Shekhar, Graham Thornicroft, Martin Knapp, and Harvey Whiteford. “Resources for mental health: scarcity, inequity, and inefficiency.” The lancet 370.9590(2007): 878-889. Print.