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  1. QUESTION

“Culture can be both an asset and a liability to an organization.” Discuss

Challenge facing organization in the contemporary business environment

 

Subject Health Matters Pages 11 Style APA

Answer

Facilitating change in health and social care

Task 1

Introduction

According to The Kingsfund (2012), ‘This paper (the first in a series on the future of health and social care in England) explores how the current health and social care delivery system has failed to keep pace with the population’s needs and expectations’. This is because the Health and social care services does not always amendments based on the old technology; which ends costing the NHS money. But rather the NHS can make changes by way of making something different by adding some alterations to the things that you already have in life. Change does not always mean turning your back on the old things and replacing them with new things or ideas but rather some amendments could be made in the organisational structure to improve their quality of services to both employees and service users. This in one way or the other will be able to help improve the lifestyle, health and wellbeing of the people who use services.

Explain the key factors that drive change in health and social care services

There are a of lot reasons that bring changes in the health and social care services may include:

UN Convention on Human Rights, some of their main principles to promote universal interdependence and indivisibility, equality and non-discrimination.

According to the Universal Declaration of Human Rights (Article 2) ‘Everyone is entitled to all the rights and freedoms set forth in this Declaration, without distinction of any kind, such as race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status’. My organisation makes sure each and every residents are given the right treatment in accordance to their human rights without being discriminated regardless of their cultural needs or illnesses. In 2009, The commission of Rights made a review in accordance to The Equality and Human Rights Commission (2007), ‘The Commission brings together the work of the three previous equality commissions (the Equal Opportunities Commission, the Commission for Racial Equality and the Disability Rights Commission). It also takes on responsibility for the other aspects of equality: age, sexual orientation and religion or belief, and has a mandate to promote understanding of the HRA’.

In order to review strategies that are used in delivering our services, we speak to service users every year to make sure they are happy with the service we are providing and if we identify any concerns, their responses are dealt with immediately. These feedback is also monitored to develop reviews on them continuously. This is to test whether the strategies that were being used to make the changes are working or not. For instance, if a service user feels he or she is left out because during Christmas, the care home is being decorated and celebrated, why can’t the care home do the same thing for Muslims or Hindus since we are living in a diverse society?. Therefore, the organisation have to put strategies in place by asking each service user their religious believes. So that a service user who is Hindu will be able to celebrate occasion such as, Diwali. As a service provider there is the need for all members in the home to recognize and respect our differences and celebrate it. In this way we the carers and service users will be able to learn other people’s culture; so that we will not offend them in one way or the other when making conversations.

According to Donald and Watson (2008), ‘The human rights requirement for transparency has been shown to result in better outcomes for service users, while also providing a clear ‘audit trail’ to protect public authorities from potential legal challenge’. Promoting inclusive practice will help to also avoid discrimination against people or treat service users unfairly on the basis of these differences and that negative stereotypes will be challenged while doing this. This will help service users to feel safe and thinks that he or she is in a secure environment.

Legislations: Legislations are laws that are made to help protect people. According to the Social Care Institute for Excellence (2013), ‘Safe practice is very important to the promotion of dignity in care. There are a number of legislative measures and regulations to support health and safety at work. These are intended to protect people in work, those using services and the wider public’. Health and social care are being regulated by government policies and procedures in order to promote a safer working environment and reduce the potential risks from occurring. But in some cases, new legislations are introduced into the health service to modify service provisions. An example is the Health and Safety at Work Act (1974), ‘The Act covers a wide range of issues relating to workplace health, safety and welfare across different sectors. Statutory instruments have developed to support the implementation of the Act and provide an interface with European regulations’. The Health and Social Executive (2011), ‘holds enforcement powers which can result in unlimited fines and prison sentences’. This legislation was introduced to minimize accidents and incidents from happening in the workplace. However, any employer or employee who go contrary to this legislation could be breaking the law and will be accountable for.

New Technology: Dr Nick Sevdalis and James Green (2013), led researchers at the Florence Nightingale School of Nursing and Midwifery and Kings College. The developed an ‘online assessment and feedback tool’, which has been launched by Public Health England (2014). This tool is purposely designed to meet the needs of cancer Multi-Disciplinary Teams (MDTs). These researchers believe that ‘it has wider applications, across multiple healthcare settings, including long-term conditions, to deliver meaningful improvements to team working and patient care’. By using new technology in MDT working, a team is likely to be more efficient. It will also help professionals to generate and shared knowledge gained to improve the outcomes of patients. With service users, who don’t get early appointment to visit their GP’s, if they are experiencing any signs of health risk, which might lead to late diagnose of an illness. But with this tool, it will potentially help with early diagnosed of an illness.

Assess the challenges that key factors of change brings to health and social care services

According to the Northumbria Healthcare NHS Foundation Trust (2015), Human resources priorities are ‘in relation to attracting, retaining, valuing and developing our workforce in order to meet its priorities’. But in a case where there are changes in how services are been delivered, organizations are likely to experience human resource issues and resistance to change.

Human resource issues is one of the major issues in the health and social care environment. Issues such as, shortage of employees due to financial problems and also taken on additional responsibility; by doing extra work to help the health system. A friend can sometimes persuade another to leave his or her care job to work for the business sector and the person will do exactly that. In one way or the other, humans have a way of influencing each other whether in a good or bad way.

Resistance to change occurs when one struggles to cope with amendments that have been made in the workplace. It is sometimes very difficult to adjust to changes and can also threaten businesses. The employer of my workplace sold the business to a different owner so we had to work under a different management. At first, we were uncomfortable due to sudden change. Many employees resisted the changes made by the new owner so they left and the new owner has to spend money advertising for new staff. In order for me to measure recent changes in the health and social care environment, there is the need for me to research and gather past information prior to the occurrence of the changes. This research will have to focus on the health system in the institution. When I take my workplace for instance, when we had a change of management, things were not going as planned. Our tax code began to change, hours of work were reduced and employees were asked to take on additional responsibilities. This was disappointing since the workload would be unbearable in some occasions leading to exhaustion and stress.

 

Task 2

Devise a strategy and criteria for measuring recent changes in health and social care

There have been lots of changes that has been going on since the changes with my organisation, which have had substantial impact on some of the staff members in the organisation. Some of the staff members were not attending care training because the allocated day and time was not very convenient to some of the staff. So this issue was addressed to the employer for it to be dealt with.

Strategies that were used are:

  • The employer started making compromises with the staff members by taking their decisions into account.
  • The government is also helping by making them pay a fine of £100.

As time went by, the employer has been making compromises with the employees and also include them in anytime somethings needs changing. Some of the staff members has been failing to update their CPD’s which are been funded by the government. Therefore the government has made some changes in a sense that anyone who start a government funding course and does not finished, will have to pay a fine of £100. This approach has been able to reduce the number of people who does not finish their CPD course work and is also helping to improve the quality of care given to service users.

Health and social care organisations work in partnership with governmental organisations such as, Ofsted, the Care Quality Commission (CQC), Nursing and Midwifery Council (NMC). These organisations make sure that the services provided to users are of high quality. This can also be ensured by following organisational policies and procedures, and fulfilling your duties and responsibilities as a care giver. My organisation is regulated by the Care Quality Commission (CQC), an independent organisation that makes sure hospitals, care homes, dental and GP surgeries and any other care services in the UK provide people with quality care. They also provide this in the person’s own home and ensure that national standards of quality and safety are met.

Below is the SWOT analyses we made due to recent changes in my workplace.

Strengths

  • Quick decision making
  • Not including staff in any decision making about changes made
  • Opportunity

    • Need to employ more staff
    • Free CRB’s and uniform

    Threats

    • Staff had little loyalty for their employer
    • Other competitors in the care business which pay more can steal staff members.

     

    • Action Plan

    Strengths: Promoting inclusion among staff and residents in decision making.

    Weakness: Duties rotas should be available in advance for staff to plan their daily routine alongside.

    Opportunity: Given incentives to staff, such as, free CRB, uniforms

    Threats: Increasing the wages of staff to avoid other competitors from persuading them to come and work for better pay.

    If we make up our minds and become passionate and committed to the care we are given and not relying much on the money received. This change will help us to provide high quality care to service users and also promote good interpersonal relationships with colleagues and good multidisciplinary team working.

    Measure the impact of recent changes on health and social care services against set criteria

    Service users and their families: According to The National Institute for Social Work (1988), if staff focus on their relationship with customers, it will act ‘as the object of quality measurement’. Making service users and families happy is the most important thing an organisation is expected at the end of the day. Some organisations does not know what their service users think of their organisation in general. But with our organisation, we make sure the people using the services are being met or not. In order to hear the views of our customers, we have made a yearly one-to-one with each residents to make sure they are receiving the right care. 

    Service provision: According to Stephen O’Kell (2002), ‘The independent care sector is currently going through a period of great change, stimulated by legislation on the way that care is commissioned, provided and inspected’. Employers should follow legislations such as; Care Standards Act 2000 which sets out the national minimum standards for accommodation, services, and good working practice in the care and protection of vulnerable adults. It established the protection of vulnerable adults (POVA) scheme that checked suitability of care workers. It identified professionals who had harmed individuals using services. It has now replaces the Criminal Records Bureau (CRB) and Independent Safeguarding Authority (ISA) with (DBS). The Disclosure and Barring Service (DBS) helps employers make safer recruitment decisions and prevent unsuitable people from working with vulnerable groups, including children.

    Staff providing the service: According to Tadd et al (2011), ‘If staff do not recognise dignity, if they feel taken for granted, if their self-esteem is dented, then it becomes more difficult for them to deliver dignified care’. If staff are not provided with enough resources in order to deliver the best care for people using services; it will not motivate staff members to treat service users in a dignified manner.

    Evaluate the overall impact of recent changes in health and social care

    According to Michael VanBruaene (2011), The overall impact of changes in an organization can be measured ‘depending on its operations, goals and objectives’.

    Efficiency: Efficiency of an organisation means how an organization uses its resources in order to accomplish its set objectives. An organisation should be able to operate effectively after changes on how it operate. An efficiency of an organisation is associated with how resources are been used to achieve the possible outcome of the services provided. An efficient organization is an organization which utilizes it resources effectively. For example, the NHS is becoming more efficient in relation to their service delivery; since its establishment in 1948. According to the NHS (2012) ‘The fall in the number of hospital beds from 480,000 to 190,000 in 1998’. This is as a result of practitioners discharging patients home early after treatment, if it not necessary to admit them.

    Increase in quality of service: According to (SCIE) Social care institute for excellence (2009), ‘All successful change genuinely involves a range of stakeholders, learns from their experience and expertise, and uses this to guide the change’. After changes have been made and all the flaws have been sorted, professionals takes the advantage in learning from any resistance, contributes to successful change and improvement. For example, if an organisation wants to know how service users think of their services. Then there is the need for the organisation to monitor it output by making a suggestion box for service users to put their feedback in the box. So in this way the organization in promoting inclusion. By putting service users at the centre of the service they are receiving and taking their opinions into account and act on them.

    Market share: According to (CQC) The Care Quality Commission (2014), ‘The Government has stated that a well-functioning care market should match services to the needs and demands of users, efficiently and effectively’. For care providers to succeed in the care market, there is the need for providers to make sure service users can participate with the market there by purchasing services. For example, Some care homes may have low prices but provide high standard of care to service users in the care market. If this happen, it increases the competition in the care market either lower prices or higher standard of care. In a situation where there are competitive prices and quality of care, it makes the market quite stable.

    Propose appropriate service responses to recent changes in health and social care services

    The Equality Act (2010), ‘legally protects people from discrimination in the workplace and in wider society. It replaces previous anti-discrimination laws within a single act, making the law easier to understand and strengthening protection in some situations’. It sets out the different ways in which it is unlawful to treat someone. In relation to the incident Winterbourne View hospital (2011); where some residents were physically abused by carers. Now these cares are being sentenced to prison, pending investigations by the Care Quality Commission (CQC). One of the victim’s son, Mr Bryan (2011), reported his concerns to both management at Winterbourne View and to the Care Quality Commission (CQC), but his complaint was not taken up. According to Ian Biggs (2012), regional director of the CQC for the southwest, “an opportunity to prevent abuse was missed when Mr Bryan’s complaints were not investigated’. The following can be introduced in health and social settings in order to correct the identified failings by CQC from happening in future:
    Training:  According to the
    The Care Act (2014), A ‘new safeguarding duties for local authorities including: leading a multi-agency local adult safeguarding system; making or causing enquiries to be made where there is a safeguarding concern; hosting safeguarding adults boards; carrying out safeguarding adults reviews; and arranging for the provision of independent advocates’. Safeguarding training given to staff will help them to make right and informed as to what to do when service are been abused.

    Change of management structure: In the review of The Department of Health (2012), ‘There was clear management failure at the hospital – with no Registered Manager in place and substandard recruitment processes’. This shows clearly that no one was in charge of management and therefore policies and procedures will not be followed accordingly. The Government ruled that ‘new guidance will be published on training standards, codes of conduct, better commissioning practices and a code of ethics by various national bodies in 2013.
    Change in service delivery: The government proposed (2012) that ‘The Department of Health will work with professionals, providers, people who use services and families to develop and publish by end 2013 guidance on best practice so that physical restraint is only used as a last resort where someone’s safety is at risk and never to punish or humiliate’. Any health and social care organisation, should make reasonable adjustment to treat people with disability according to their individual needs which was first introduced under the Disability Discrimination Act 1995.

     

    Task 3

    Explain the key principles of change management

    In order to correct the mistakes due to the changes made, the organisation could introduce training which is relevant to their work, employ new qualified staff and replace the existing hospital equipment. It is sometimes difficult to successfully measure change; as it will depend on the actions of a small subset of people in the organisation responding to the organisational demands. The small subset of people in the organisation could choose to do a different thing against what has been perceived and others may decide to perform according to the wishes of the organisation. Changes in an organisation consume energy over and above the routine of the management and staff members.

    According to Nadler (1993), He suggested that ‘resources which include, but are not limited to, financial, human, training, and consultative input must be provided for the transitional stage in order for change to occur’. Most changes that are made in the health and social care environments need resources such as, funds, people and ways the people will be able to focus and adjust to the changes that are being made. If an organisation does not have any of these, it will be unable it to initiate the changes required. When we had a change of management and the introduction of changes, most employees in the organization were stressed by the changes. The owner of the organisation should therefore hire a skilled human resources personnel to talk about the changes and how they would be implemented.

    On the other hand, the personnel can also introduce the new equipment and train staff on how to use them towards improving the care provided. Unfortunately, our organization failed to do this and thus increased pressure among the staff due to the pressure to perform.

Weaknesses

  • Staff taking on additional responsibilities
  • Duties rotas were not pasted on time for staff to know  their shifts

 

 

References

 

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