Discuss how current legislation research and organisational policies impact on Domiciliary services. I’ve been the registered manager of Presious Healthcare for fourteen months; the organisation is a Domiciliary service set out to provide support in the service users own home. Presious Healthcare Ltd Policies and procedures have been written to meet all the regulatory, legislative and good practice guidance within the Health and Social sector in England. The main legislative policies we work in line with in the Uk are the Care Act 2014, Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Data Protection Act 2018 and General Data Protection Regulation 2016 (GDPR) plus many more.
Discuss how you have made changes to meet current legislation. The Home office department used to be responsible for requesting Criminal Record Checks it worked in conjunction with the Independent Safeguarding Authority, in Dec 2012 when they both merged together and now use The Disclosure and barring service. DBS is a check of the proposed employees criminal background, in compliance with the legislation this requires Presious Healthcare to ensure that requirements are meet, this is one step towards promoting safety in the work place. Keeping are service users’ safe as possible the company will ensure that in guidelines with the legislations, policies and procedures the employee will commence with the Care Certificate that was induction in April 2015. If the New Employee has experience in Health and Social care, it’s down to me as a manager to ensure that the they are aware of the Care Certificate units. With supporting training to the employee, with induction, supervisions, group meeting etc enhances the knowledge of the individual after completing the mandatory units they will do units that’s required to deal with the service users’ health needs i.e if we support the individual with Dementia, end of life care. The Care Certificate has placed an importance on ensuring that the staff are aware of their roles and responsibilities, also raises issues on how staff should be monitored and the consequences if policies are not in place
Impact of legislation on the provision of health and social care services: the availability of services, with the growing depend from the government to the resources from the hospital social worker and funding available to try to prevent bed blocking the demand to get the patients out of hospital as soon as fit for discharge. This has a great demand on the Domiciliary care providers due to the funding from the continuing health care funding or the Social care funding, to promote that the service user has the required time for assisting to their needs, without being rushed, dignity and respect must be adhered to the service users wishes, rights of service users within the services, Presious healthcare will discuss basic service level agreement. You should include the influence of person-centred practice. Include GDPR and its impact. Working with the service user the carer should read their person-centred care plan as this was wrote in accordance with the service users preferences. The service the service user will receive will be tailored to suit that individual, allowing the individual to make their own choices, the carer should support the service user to maintain their independence. The GDPR is designed to give individuals better control over their personal data, this has been established across Europe, consent needed, right to withdraw, erased when no longer required.
When we obtain data we have to make sure that the following things are made clear to the individual: 1. Contact details of company. 2.The purpose of the data who it will be used. 3. Whether data will be transferred internationally. 4. Period to be stored. 5. The right to access, rectify or erase. 6. The right to withdrawn consent. 7. The right to complain. Companies must report breach pf security . The impact of GDPR is time consuming , some of the service users got anxious over the changes and filling more forms in.(1.1, 1.2).
2. Discuss at length (analyse), conflicts you have experienced as a Domiciliary manager. Since I have been a manager of the domiciliary care service, my schedule involves working long hours with being on call and in the office setting. I think that conflicts revolve around social isolation with loneliness as I spend most days in the office alone. On the other hand, it’s rewarding, and I enjoy my job. One of the service users was allocated a 15 minutes slot for toileting needs the individual uses a stand aid for transfers x2 carers to assist. The carers had expressed concerns about going over the ladies 15 mins call time on more than one occasion, so I monitored the times logged for toileting needs. I contacted the lady’s social worker regarding the time allowed and expressed concerns going over the call time. The social worker had asked reasons why? I explained the lady need time to have her bowels opened.
With only having 15 mins we seem to be rushing her and seems were not allowing her any privacy to use the toilet, I mentioned the time to be taken into consideration to transfer the lady with the equipment from the chair to the commode then take her to the toilet and back to transfer back , I also explained the lady’s health needs and it’s not good to be rushing her, as this could escalate in conflict with the carers. Social worker then said she needs this evidencing, I scanned the lady’s daily notes and emailed them for evidence that the lady was going over the allocated time, the social worker sends the evident to the funding bodies to require increase in time, the lady did receive. I have experienced a disagreement when going to assess a new package of care, the disagreement was between the social worker and the husband of the service user they were disagreeing on the allocated times of the calls – the social worker had sent me the length of times to be allocated , so I asked if they were right due to the husband said they weren’t, social worker said they were and the pair disagreed for a while I was accompanied with my work colleague, I said do you mind if we look at your package of care notes that you have in place now as that should state the length of time the calls are. The husband was right, after leaving the meeting I spoke with my colleague regarding being in that environment and the social workers wasn’t very professional, nor did she apologize for being in the wrong. Due to the budget cut the issue with funding is challenging, some of the budget allocated to the service user may be too low to make a meaningful impact. (1.3).
3.Discuss your charges:
How are they calculated. Presious Healthcare ltd calculates the cost of wages, salaries and the running cost of the business then will see financially what the hourly rate can be.
Explain and justify your charges. Presious HealthCare’s charges are at present the minimum rate of fee that the public funds pay, as when we started are business we were sub contacting for a year and when the rate of pay for the carers went up the company wasn’t going to compromise to a reasonable rate of pay. We had meeting and as managers weighed up the pros and cons and decided there was more reasons to leave the subcontract work and go alone. After giving the work back to the subcontractor most of the service users contacted the Adult Social care to remain with Presious Healthcare as their provider.
Quality as above the service users we work with was happy to follow us and wasn’t happy to go back to the old provides, I think that speaks for its self, I as manager am continuing to promote high standards of work to gain high expectation from my CQC report.
Comparison with other agencies. Presious Healthcare Ltd has only been operating for just over a year we work well in partnership with other agencies. Adult Social Care contact us if their preferred supplier can’t accommodate that service user.
Based on funding. Local authorities have encouraged clients to manage their own budgets called direct payments, given wider choice to some, but causes disadvantages to other, if the individual doesn’t have capacity to make choices Most of are fees are paid by the public funds (social services), some of our service users get direct payment and will pay us , other have company’s like Penndel’s Trust to support with their payments, the charges are based on the length of time required to do the tasks the service user needs. (2.5).
4.Discuss how you encourage practitioners to report changes in need. I will liaise with the practitioners , once I have consent from the service user to address issues regarding their Health , I will ask the receptionist to send a message to the practitioner regarding the service user . The Practitioner will contact me usually the same day.
When I had concerns about a service users behaviour? after monitoring using the (ABI)chart/investigating , highlighting the issues , the conclusion :may have been contributed to him not having all his prescribed medication. I make arrangements for medication to be sent directly to the service users home and Presious Healthcare carers to administrate his medication, due to the Next of kin forgotten to collect the script which lead to the service user missing medication dosages.
After speaking to a gentleman’s practitioner, the social worker, next of kin and the service user . I had a duty of care to the service user to safeguard him. so put the above guidelines in place.
Why is this important? To Ensure that Presious Healthcare Ltd has the right information regarding the service user Health and wellbeing to minimise the risk to themselves and others around . As above this individual also has M.S and Dementia which can make his behaviour unpredictable , making his mood switch quickly, presenting a risk to staff. It’s essential that staff are aware of potential triggers to minimise any risk. The staff are allowed to have their phones on them in case of emergencies. We have a phone policy to comply with.(4.3)
5. Discuss challenges associated with managing emergencies.
We face challenges with recruiting the right staff, ensuring the right person fit for the job, the rate of pay may be an issue as most care pay is minimum wage , with the individuals first language not being English can be a challenge when trying to provide continuity of care its important in the change of workforce. Last year we had heavy snow due to the weather conditions , the Describe changes in service user needs , I,e from walking with a frame assisted by 1 carer needing support with assistance to wash back to keep their independence, people’s health can change quite quickly. Form being independent to having a stroke for instance, after having a stroke the individual may need 2x carers and use of equipment due to mobility issues. This individual may require 2 carers for all personal care also due to unable to move and assistance for all personal care . In due course the increase of man force will be needed. By auditing the records and with staff meetings ,feedback from staff I can identify if the service users need are being meet . Team member sickness the other team members will help to cover shift that require covering at the last minute , myself and the other member of management will be on call so shifts will be covered. How do you plan for these unforeseen circumstances? When we recruit we ask availability of work hours , we will put the shifts out to the carers, what extra shift are left to cover and they will phone back to let us know there availability ,we may change a few shift to accommodate the cover of sickness. Some of the carers work a rolling rota. With having a small amount of service users the shifts get covered, the staff are reliable. (5.1)
6.Discussion the actions you take if do not comply with agreed ways of working
As a manager I may have to address concerns that may present a risk to patient safety and need to be proactive to addressing issues. I will have to provide all evidence , it is important to identify what standard or organisational rules have been breached. As working in partnership the concerns should be addressed with the main practitioner of the surgery. Follow local conduct procedure that applies to the surgery in question.
Clear lines of responsibility for considering and investigating particular concerns. NHS England should be the first contact where concerns relate to an individual professional. CQC should be notified where there are concerns across a practice that may affect patient care. The GMC’s Employer Liaison Service should be notified where there are concerns about a practitioners fitness to practise or where concerns about patient safety or public confidence in the profession remain following intervention from NHS England or CQC.