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Involving the Service User in Shaping Services Continues to Be an Important Activity Within Government Policy. Drawing from the KICK Materials Critically Discuss the Issues, Challenges and Benefits in Involving the By Marseilles In the current economic climate, managers are expected to provide a quality service at the same time as making financial savings. Critically evaluate the role of the manager in the light of the current economic climate. Introduction This assignment has its starting point on defining quality in health and social care ND how it can be delivered in a care setting.
Subsequently, the role that the manager has in promoting, supporting and delivering the provision of good quality service to service users will be discussed. Moreover, as this process is not exempt from obstacles, especially in the current economic climate; it is therefore important to explore the elements that managers need to consider when assuring quality and saving costs. Finally, it will also be discussed how the service provided is evaluated so managers can ensure that a good service is provided to service users.
What is quality? Every person has given or received care through life. However, whether the experience has been satisfactory or unsatisfactory depends on the quality of the service delivered and the quality of life experienced. Under those circumstances, it is possible to determine that quality in health and social services has an enormous importance as it is related to people’s lives. (Walker, Murray and Atkinson, 2003, p. 159). Different authors have described the concept of quality from different points of views.
According to Patterson (1997) and Donated (1980), even though quality mains as an important part of the health and social care agenda, it is still an elusive concept and a mystery to be unraveled. Colluded and Mullioned (2001) sustain that quality in practice refers to the provision of services that are fit for their purpose, but doing so at a reasonable cost and ensuring that people who use the services make choices based on information (Walker, Murray and Atkinson, 2003, p. 159).
In ‘A quality Strategy for Social Care’ of the Department of Health (Bibb) the concept to quality is described as a process to changing and modernizing services in order to make them accessible and consistent. These services are delivered by competent workforce to meet the needs of those who use them (Walker, Murray and Atkinson, 2003, p. 159). It could be argue that to define quality as a concept that can be applied universally is a challenging task. Therefore, it is best to define what it meaner in practice, in other words, in terms of people’s experience.
People can recognize what good quality is when they experience it at first hand. Martin and Henderson (2001) acknowledge that based on this assumption, quality derives from knowing who the service users are, understanding their needs and what their expectations are as well as responding to their requirements in an effective way (Walker, Murray and Atkinson, 2003, p. 160). Therefore, a high- quality service needs to be responsive, enabling, and inclusive (Walker, Murray and Atkinson, 2003, p. 161) What role the manager has in achieving quality?
Managers in health and social care play a key role as they are greatly involved in having to think, do, and measure quality along with facing a number of quality initiatives that might seem confusing. Providing quality is supposed to be everyone’s accessibility, albeit it is the responsibility of the manager to deliver it (Walker, Murray and Atkinson, 2003, p. 1 59). The manager’s role in social care is continuously changing and having to adhere to an excess of policies and procedures and not getting real recognition of the day-to-day challenges and dilemmas encountered (Henderson and Sudden, 2003, up. 7-88). To sum up, managers are responsible for ensuring client, worker, departmental and governmental needs (Henderson and sudden, 2003, p. 93). About Quality Before the sass’s, quality was approached from an introspective point of view. The profession was defined in terms of skills, knowledge and competence needed to do the Job. Moreover, it focused on inputs of the professionals. However, this approach fell short of taking into account the service users’ experience and the productivity of the service delivered (Walker, Murray and Atkinson, 2003, p. 63). Consequently, due to government and service users that challenge the professional view of quality, procedures that are more objective originated. Besides, the need to improve services developed the concept to quality control to assure high standards to care (Walker, Murray and Atkinson, 2003, p. 165). Quality Control and Quality Assurance methods were introduced in order to assure high standards of care. Quality control has to do with monitoring services, it is top- down and reactive and it only identifies where practice has not met standards.
On the other hand, Quality Assurance is proactive, bottom- up, promotes quality instead of imposing it, and involves more staff when it comes to deliver quality care. It is a systematic approach to service delivery that consists of documenting processes, ensuring and supporting staff along with reviewing practice. It also implies a change in the culture of the services, in terms of preventing errors, so that the idea of quality becomes embedded (Walker, Murray and Atkinson, 2003, up. 166-168). Is it possible to ensure good quality service while keeping the costs down?
Managers face continuous challenges to ensure quality service. However, given the current economic climate, the major challenge facing all health services today is keeping costs down and improving services at the same time. Value for money is part of quality. However, sometimes “getting value for money” meaner accepting deductions in quality as part of getting a lower price in a tendering exercise (Standard, 2012). On the contrary, it could be argued that limited budgets do not inevitably lead to cuts that will result in poorer quality services.
It is possible to mitigate the impact of the cuts by implementing innovative and everyday approaches. In a residential setting, for instance, a practice-led manager can monitor quality within services. Firstly, internal audits on a regular basis are needed to ensure that what should be done is done and implement a plan of action otherwise. In the course CD -Room (KICK, Managing Care at Walbridge CD-ROOM, scenario 4) Julie at Walbridge considers that the quickest and simplest way to reduce unit costs is to employ more agency staff and lose the overheads which permanent staff cost (e. . Sick pay, holiday pay, overtime hours). However, Julie emphasized that it is essential to be careful not to create unnecessary Job losses and implement the use of agency staff gradually to retain the most committed and reliable staff. Furthermore, as the provision of quality care, it is correlated to the staff knowledge and skills to meet the residents’ needs; in souse training to reduce costs could be a useful way to minimize expenses. Besides, the same outcome can be achieved by booking staff on free training courses offered by City Councils and NASH trusts.
Moreover, another way to facilitate saving for the institution is by implementing a person-centered care that is responsive to individual needs and preferences. Thus, reducing costs by targeting resources that are not needed. Additionally, managers who deal with services that help people who need care but live in the community can also deliver quality care by introducing innovative ways. For instance, moving people on trot residential care to supported living options translates into reducing costs as it decreases over-support.
Equally important, it does not only entail progression but it also entails focusing on what people can do for themselves. Moreover, giving people budgetary control can and does lead to more efficient use of resources as they know best what their needs are (Coping with the cuts, 2011) What other elements of quality do managers need to consider? The quality of services can be seen from two subjective perspectives. Firstly, from the sews of those who provide the service and secondly, from the views of people who receive them.
Therefore, managers need to consider a number of factors that determine the quality of life, quality of the environment, and quality of the experience of using the service (Walker, Murray and Atkinson, 2003, p. 161). Quality of life of the service user meaner how good that is . Quality of the environment refers to aspects such as cleanliness, brightness or welcoming features etc. Quality of the experience of using the service reflects how open, respectful, responsive the service is to those who receive care.
Quality of the workforce refers to how valued the staff are and how they interact with others (KICK learning guide, 2003, up. 70-71). According to Andy, a project coordinator, valuing staff is crucial as when people feel valued they will give and deliver better care along with challenging difficulties (KICK, Audio 1, track 4). How the service provided is evaluated? To ensure the provision of a good service, managers need to measure quality. Fortunately, there are frameworks that prove to be useful when scoring a service.
Firstly, the Audit Commission and Social services Inspectorate were the two main dies responsible for improving quality. Since 1998, the two bodies have started Joint Reviews, followed by Quality Protect Programmer and Best Value (Walker, Murray and Atkinson, 2003, p. 169). The Audit Commission uses indicators based on performance to evaluate the functioning of public services. The social Services Inspectorate supports and inspects quality assurance approaches in local authorities. Joint Reviews evaluate how good services are from the point of view of people who use them.
The Quality Protects Programmer focuses on improving the quality of children’s services and Best Value views entails local authorities to review services by using the four CSS (challenging, comparing, competing and consulting) (Walker, Murray an d Atkinson , 2003, p. 174) As quality is about improving services to users, it is therefore important to gain better understanding on how to implement quality the best possible way. In the health and social care field, two approaches are used to translate quality into practice. These are Quality Management and the Excellence Model.
Total Quality Management looks at every aspect of quality. It focuses on process and outcomes by combining quality assurance and quality control. The main advantages of this model are that it creates a culture of quality within a team or organization. It is also determined by service users, it is continuous and it has no boundaries (Walker, Murray and Atkinson, 2003, up. 175-176). On the other hand, the Excellence Model enables an organization to assess itself against a set of criteria for excellence and to use the assessment to achieve excellence.
It identifies the areas that need improving and how to generate the appropriate changes Thus, highlighting the fact that good exults mean good services (Walker, Murray and Atkinson, 2003, up. 179-180). In the current economic climate, implementing Total Quality Management approach might be better than sticking to The Excellence Model as it focuses on ‘developing a culture of quality, in other words, embedding continuous practices that lead to good quality. Moreover, as this approach focuses on all the aspects of monitoring services it proves useful when gathering systematic information that comes from both external and internal audits.
For example, in a care setting that provides catering revise for the service users, it is possible to control food costs, eliminate waste and fulfill different dietary needs by doing weekly stock takes and negotiating prices with food suppliers. In addition the use of a person-centered approach can be used as a cost-cutting measure by assessing the amount of support that is needed and avoid unnecessary high staffing levels. Total Quality Management also involves staff, service users and the wider community in the process of achieving quality. These people are known as the ‘stakeholders’.
In the quest for quality, staff can be involved by having supervision and appraisal to view progress, set individual targets or identified the training that is needed. The provision of staff meetings is also a way to encourage cooperation to evaluate or discuss quality (Walker, Murray and Atkinson, 2003, up. 179). However, this can also bring out difficulties from the staff and the manager’s perspective. Staff might not be willing to engage in the process or to express their opinions due to a lack of trust in the system under the assumptions that these might be used against them or, simply, that no action will be taken to improve quality.
From a manager’s perspective, the halogen is about finding ways to encourage staff to observe critically at the service so that they can identify what improvements need to be done and communicate their opinions on development. Organizations can involve service users, relatives and wider community in the evaluation of quality initiatives. Managers can involve service users in evaluating the quality to the service by setting groups or individual interviews to consult people about their experiences, designing service user’s satisfaction questionnaires that reflect how good the experience of care provided is (KICK learning guide, 2003, p. ). However, this process is not straightforward and presents challenges too. Managers need to be aware that feedback correlates with the engagement of the individual. Therefore, when seeking feedback, they need to take into account factors such as the willingness or the ability of an individual to make and communicate decisions. Under those circumstances, managers need to reflect on options that can be used to assess quality e. G. Questioning style.
For instance, when designing a feedback questionnaire it is necessary to keep in mind that the instructions given are clear and what types of questions will be used , open-ended or closed questions (KICK learning guide, 2003, p. 74). According to Rockford (2000) as cited in the Reader (Henderson and Sudden, 2003, p. 85) another issue that managers face is that they are the first in line for blame, but not always the first in line for training. However, as mentioned in the Course Reader, the best practice Journey is to link up with another manager to become a critical friend to each other in order to develop a peer review (Evans, 2003, p. 1 12).
Conclusion Because quality is an elusive term, it is best to measure it into practice. This practice is about achieving excellence. To achieve ‘excellence’ different models have been introduced through time to measure quality. Quality is measured by people’s experiences. Therefore, it is necessary to involve the service providers and service users in the process. However, the manager has a key role in knowing how to make this happen. In the current economic climate, the biggest difficulty that managers face is keeping the costs down without Jeopardizing the quality of the service. Through innovative approaches, it is possible to achieve this.