roles and organisation in health and social care sector

What are the three sectors of H&SC?

• public sector

• Private sector

• Voluntary sector

What does the public sector involve?

• free services payed through tax and national insurance contributions

• Includes primary (e.g GPs dentists), secondary (e.g hospital) and tertiary heath care (e.g specialists)

What four organisations are involved in the public sector?

NHS England, Scotland, Northern Ireland, Wales

• NHS foundation trust

• Adult social care

• Children’s services

• GP practices

What is the NHS foundation trust?

• aims to move decisions making to local communities

• Provides care so people can live as independent as possible (e.g palliative and urgent care and specialist services)

• Financed by government and managed by board of governors

What is Adult social care?

• for those over 18 who can’t support themselves due to their condition

• Provides domiciles and respite care and day centres

• Managed by local authority social service departments

What are Children’s services?

• aims to support and protect young people, their families and young carers

• Does this by providing safeguarding services, under 5s day care and fostering and adoption services

• Managed by local authorities

What are GP practices?

• primary healthcare in local communities

• Makes initial diagnosis and refers to specialists

• Involved multidisciplinary working and holistic approaches

• Funded by central government

What does the private sector involve?

• providing services for central government and local authorities e.g NHS

• managed by commercial companies that must make profit to stay afloat

What is the private sector funded by?

Service users, health insurance companies and central and local government services

What private care providers are involved in the private sectors?

• private schools

• Nurseries and preschools

• Hospitals

What does the voluntary sector involve?

• large charities such as NSPCC

• Smaller charities that rub specifically for the needs of the local community such as Mind

• Relies on donations and support from central local government

What is MENCAP?

A charity that provides residential and day care and educational services for those with learning difficulties

• this must be payed for by the service user

What are the key features of voluntary organisations?

• not run for personal profit

• Involved mostly volunteers

• Independently managed

What are the six health and social care service settings?

• hospitals

• Day care units

• Hospice care

• Residential care

• Domiciliary care

• Workplace care

What to hospitals provide?

• outpatient and inpatient services

• Service users get referred here by a primary care giver

• Departments are organised by medical specialty e.g oncology (cancer)

• Most hospitals have an A&E department

What does say care centre provide?

• a friendly, stimulating and supportive environment for socialisation for specific client groups (e.g elderly)

• and educational facilities and support for jobs

• Can be provided by statutory (public), voluntary or private providers

What does hospice care provide?

• holistic end of life care for those with terminal illnesses

• Improves QOL , physical, social, emotional, spiritual and practical needs of the individual their family and carers

What are the two types of residential care?

• Residential homes - specialists units providing care day to day for specific client groups (e.g elderly) for support with personal care

• Nursing homes - 24 hour nursing care providing help with planning, supervising and monitoring of healthcare tasks

What does Domiciliary care provide?

• ST and LT care in the individuals own home

• provided 24hrs or a visit a day

• Provides support with everyday tasks and personal care to ensure service users live as independently as possible in their own home

What does workplace care provide?

• assistance for employees to regain fitness after an illness or injury

• By helping then receive support by a healthcare professional in the workplace

How are referrals classified?

• self referral - contacting a care provider personally

• Third party referral - contacting a care provider on another’s behalf

• Professional referral - health or care professional contacting other care service provider to request support for a service user

What is a community care assessment?

• Professional assessment of care needs and advice for the best suitable way to access services for the service user provided by the local authority adult social services department

What is a carer’s assessment?

Assessment of the needs of informal (unpaid) carers to see if they need any support

What is the Care Act 2014

Service users must be provided with a written copy of their assessment report that identifies the needs and action agreed to be taken

What is the eligibility criteria?

• decides if a person is entitled to care and support from the local authority

• Need to consider if their needs are from a physical/mental illness OR have an inability to complete at least 2 of the daily activities

What are the Next steps if an individual meets the criteria?

1. Local authority has duty to make sure the identified needs are met (costs money)

2. Local authority Carries out financial assessment to see if individual can pay for their care

3. Service users recieve personal budget if they need support paying for their care

What are personal budgets?

• Money from local authority to help service users to pay for their choice of care

• They have no fixed sum and depend on their needs and financial assessments

How can personal budgets be recieved?

1. Direct payment straight into bank account

2. Into council managed account

3. Into account managed by a relative

4. Into independent living trust held by a trusted party

What are the advantages and disadvantages of personal budgets?

Advantages - service users can choose where to buy their care

Disadvantages - may be hassle employing carers or helpers through interviews and figuring out wages and contracts

What are some barriers to services and why?

• financial factors - may be expensive

• Inconvenient location- have to pay for travel and hard to access services

• Scarce resources- long waiting times due to lack of beds for example

What do charities do?

They represent service users and may act as pressure groups to complain to improve services offered to their members

• e.g Shelter provides advice, guidance and support for those with housing issues and represent them when applying for housing benefit for example

What do patient groups do?

Usually in hospitals and represent the needs of patients and support complaints made by service users

What is advocacy?

• Volunteers speaking on others behalf’s if needed

• they gain trusting relationships to accurately represent the service users

• Can advocate their care meeting, forms, letters, emails etc

What is the purpose of complaint policies?

To ensure service users and informal carers understand how to access and use complaint procedures if their unhappy with their quality of care

What are the complaint rights of service users?

• their complaint is efficiently dealt with

• Their complaint is formally investigated

• They are told the outcome of their complaint

What is the purpose of whistleblowing policies

• they provide protection for staff who tell outside organisations that the quality of care at their workplace is dangerously poor

• Provides anonymity for complaints made

How are regulations and inspections carried out?

1. All service providers register with the CQC

2. services are continually monitored and regularly inspected

3. Inspection teams carry out checks to ensure the service provider meets the standard of safety and have the resources to ensure high standards of care, supported by evidence

What evidence may these inspection teams collect?

• feedback from individuals

• Written reports of care procedures

• Information from linked local organisations

• Complaints

• Inspections of care

How may individuals or organisations respond to regulation and inspections?

• can be stressful

• Managers made aware of weaknesses in the provision.

• CQC published the outcomes of each inspection which may encourage service providers to always provide high quality care and know what to improve on

What does the regulator do if the practice doesn’t meet the standards after inspection?

• require / recommend improvements

• Issue a requirement notice/ warning notice to set out what improvement to make and when by

• Pursuing criminal prosecution in extreme cases

What is the role of the CQC?

• monitor and inspect health and social care services in England to ensure they’re of high quality and deliver effect, safe and compassionate care

Where may the CQC inspect and monitor?

• GP practices

• Hospitals

• Dentists

What are the overall questions the CQC follow to ensure settings meet the standards?

1. Is the service safe

2. Is the service caring

3. Is the service well led

4. Is the service responsive

5. Is the service effective

What are some examples of questions for these overarching questions ?

1. Safe - are there regular fire drills?

2. Caring - are personal care needs respectfully adressed?

3. Well led - Are policies and procedures up to date?

4. Responsive - are care plans personalised to individual needs or generalised?

5. Effective - are staff fully trained and is this training up to date?

What does ofsted do?

Regulated and inspects services that educate people through:

• state funded schools and colleges

• Nurseries and preschools

• Initial teacher education

• Fostering and adoption agencies

What do these inspections make judgments on?

• the effectiveness of leadership and management

• The quality of teaching, learning and assessment

• Outcomes for children and learners

How is the report graded after an inspection?

• grade 1 - outstanding

• Grade 2 - good

• Grade 3 - requires improvement

• Grade 4 - inadequate

What impacts does a failing school have on young people?

• health and wellbeing impacts

• Lack of risk assessments affecting safety

• Lack of multidisciplinary working

What are the three regulating councils?

• nursing and midwifery council

• Health care professions council (HCPC)

• General medical council (GMC)

What does the nursing and midwifery council do?

• regulated the standards of professional practices of all nurses and midwives in the UK

• Sets high standards for education, training, practice and personal conduct

• To continue on the register nurses and midwives must provide evidence of continuing training

• Investigated an allegations against staff

What does the HCPC do?

• regulates many health and care professionals who are register with this council by having relevant qualifications and meeting standards of professional practice

• Investigated members who aren’t meeting their standards and may get suspended

What does the GMC do?

• an independent organisation that regulated doctors

• Provided overseas UK medical education and training for doctors

• Sets standards for doctors

• Investigates serious concerns against doctors

How do services improve by regulation?

Set high standards of education, training and practice to protect the public

What are the responsibilities of organisations?

• respect preferences and beliefs

• Dignity and respect

• Advocacy

• COSHH

• Promote users rights

How must organisations implement codes of practice?

• have a sufficient number of staff

• Provide and support training and professional development

• New staff must complete induction programme within 12 weeks of starting the job

What is the National Occupational Standards (NOS) ?

Standards of professional practice that should be met in the workplace

What is professional development?

• updating health and care practitioners skills to ensure best practice is followed and up to date

• This is done by regular training

How are complaints dealt with in organisations?

• through internal disciplinary systems in the organisation (regulatory body)

• Professional body involved in serious complaints e.g GMC

• Many practitioners members of trade unions that support and protect them if they’re accused of anything

What are protocols?

Accepted codes of practice and behaviour required of professionals by their regulatory bodies

What do regulatory bodies do?

Provide protection for employers