The aim of this essay is to focus on management and how managers operate within the context of health and social care. As well the processes in which they operate when making decisions in relation to the needs of client, the importance of policy and practice. Attention will also be made to the way decisions are made within health and social care. In terms of this, a case study of the areas that will be a focus point is ‘contextual factor’ ‘policy making’ and case study. To address the problem the paper will cover the following spectrum, definition of the main problem in the case study, management roles, contextual factor, policy making in health and social care, objective goals and finally how management make decisions.
The term contextual factor is define as a frame work, the process in which a work is carry out, Working together with the frame work also identify it as an important characteristics within the environment . It is related to the effectiveness and includes limited to physical and structural setting of the community and the environment. For example, resources available in the community and the social contest.
What is policy making in the health care?
Policies allow for the implementation of services to companies that address public issues, including the Government State of affairs, private organisation and other companies regulation, it also include decision making and actions taken. These structures help with management technique and strengthen the tool in improving health care, which formulate part of the decision making policy. ‘Health care Policy is a network of interrelated decisions which together form an approach or strategy in relation to practical issues concerning health care delivery’ (Barker 2000).
Management plays an important role in making sure all members of the team perform and working together, to make the job vibrant by communicating and making the best decision possible for service users, (Quality care commission 2011). Managers are responsible for taking action which makes it possible for individuals to make their best contributions in groups for objective achievements (Hunter 2007).
Managers are also expected to ensure and implement the service to a company, for example the National Health Services (NHS) team within the NHS included a hole house of professional people include, polices making many Doctors and Nurses who play a key role management role leading their team of people who managers. Each team member working together to achieve gold set that need to be accomplishes (NHS 2011).
The aim is to identify, assist and address the problems associated with Mrs B, and decision making. Organization that are involved in making decision in regards to Mrs B case, team members involved with Mrs B, support the social service. The fundamental factor in good management team is all about communication which is very important when making decision all departments coming together to implement a service that needed to into put practice (Department of health 2007).
In the case of Mrs. B a 75 year old lady, she was taken into St. Luke’s hospital due to a fall at home. Due to the fall Mrs B. suffered a broken hip, and needed an operation. The operation was successful and Mrs. B. was giving the all clear and wanted to return home for a full recover.
The discharged nurse decided that it would be best for her to move into a nursing home to recover and to receive the care she need. However she refused and wanted to go home because she has being living in her home for over 35 years. She has been living alone since her husband pass away two years ago and has no children or relatives. As a result she will require home support due to the nature of her home; changes need to be made to meet her current needs.
However, looking at Mrs. B case file an assignment needs to be carried out for her in order to decide whether or not she can cope at home. That assessment will enable the management and other team members to put the right care in place. Mrs B involvement with such decision will promote her independence and can make a significant difference in her well being (Department of Health 2007).
Mrs B problem areas:
• Mrs B. need to receive home care
• Her home need to be adapted for her e.g. stairs lift.
Nevertheless, these problems need to be analyse to meet her needs and care planning must involve Mrs B. Care must be carefully consider within the community where she live and the assessments need to put into place (CQC, 2010). The manager’s duties are to provide the best care possible for Mrs. B.
According to the Quality Care System (QCS) policy and procedure, client should always be involved in their care planning. Health care policy is implemented as a network to make decisions that together form an approach or strategy in relation. to practical issues concerning health care delivery. Management is very important in improving health care needs, it is an important part in decision making and a better management technique (cited in Coral Barker Pg.9).
According to the management theory, policy and practice are put in place to solve a given problem. Identifying these types of needs also occurs during problem definition. Sometimes, additional data will be needed to clarify a perceived problem before it can be addressed through policy. In Ukraine, a policy development group identified a number of issues that impeded implementation of the (2001–2005) National Reproductive Health Program. Some issues were sufficiently clear to develop policies, while others included a number of questions about the efficiency of the health system, (Mostipan et al., 2004). A complex problem, which requires multiple policies to address it, will also need multiple data sources to support it
As a manager, the client well being is crucial when making decisions in relation to health care. In order for this to take place there is a team involve in this decision making process. For example social services, doctors, nurse’s and family members of service users may apply. The manager also has another important part to play in the client care planning, it is their responsibility to carry out considering health care assessment in order to decide the best possible care for an individual and to address their primarily care needs. Outside the requirement is not this is an assessment for the client to find out from the client what care best for the client needs. Doing so this gives the client right in having a say in her care planning. The council will make every effort to accommodate the client to have care or live in supported accommodation (Department of Health. 2007).
Referring to the case study, it is very important to making sure the environment is conducive to Mrs, B needs. Giving her the more autonomy to choose where to live and with who if possible is supported by the Human Right Act 2001. Therefore Mrs. B cannot be force to do anything she refused. In accordance with the CQC (2011) this will strengthen the effect and quality of care given (Department of Heath 2011). However, part of management process is discus the risk choice and support that is available to client in accordance to guideline with policy and practices, for example people suffering from mental ill health have the right to exercise their choice (Mental Health act 2001). However, client care must always be person centred looking at the care package that has being assessed by the management team. The process of client care as described by the local authority (Lewis et al 1995) points out that this will help smooth running for the service user and the management teams. Management also aim to meet the needs and expectation of service users.
According to the assessment criteria set by the CQC, there is a process in which clients social care assessment team take into consideration. These guidelines are implemented to improve client quality of life for example quality of environment, management and leadership. The quality statements are framed so that, as far as possible they are outcome statement which attempt to impel the provider and the inspector to assess quality and outcome, (William 2007) certain criteria is to ensure that everyone is treated equally. In addition assessment of needs and the services that flows from it meet certain criteria. This process is in place to deliver quality of care, patient to receive the best care possible (Dh.2001).
According to the Department of Health (1997), evidence has shown that patient involvement in their care was central to current government thinking. Patient Involvement in guideline development should be no exception. Patients’ knowledge understanding and experience of their illness make them ideally placed to contribute in their care and development process. (Cited in evidence-based 2002 p. 192)
Cast and adaptation: planning home care service for Mrs. B need to look at the finances support to assist with restructuring of her accommodation in order for it to be more adaptable for the client to be able to live comfortable in her own home.
As a manager dealing with such case should at all times put clients need first and working with the best outcomes suitable for the client’s needs. The manager roles are to support Mrs. B with best decisions that meet her needs, to be able to make, and to offer the best advice in caring for her at home. As a Manager, dealing with Mrs. B case the policy and procedure need to take into account her consideration. What Mrs B. needs and what is best for her, taking into account the right of the client under the Human Right Act (1998).
Another option that need to be consider involved weighing up and analysing options for achieving goals for example the cost and benefit available into place the care that Mrs. B need, the main aim is to provide the care that client needs in order to live a long, independent and comfortable life as long as possible. Under the Human Right Act 1998, underpinning all decision and activities surrounding a person choice about their daily living (Department of Health 2007). These decisions help managers to implement and make choices in order to make the right decision and fair and evaluation process where necessary.
Complying with the policy making within health care when making decision on behalf of the client this should be in line with the regulations stated that client had the right to be needs assist, managers duties also is to point out the risk associated with the situation and should also offered a trial period (Human right act 1998).
Moreover, manager need to remember the code and conduct when make decision within health and social care by respecting client needs, treated with respect and dignity and fairness (Barker 2000).
According to Douglas McGregor 1906- 1964), management theories have an explanation how this is worked in theory, theory x Autocratic and Theory Y objective setting. “Theory X” gives an unhelpful view of human behaviour and management that he well thought-out to have subject management theory from Fayol onwards – especially Taylorism. This theory also assumes that people are undeveloped and need direction and guidance how to control due because they are unable of taking responsibility. They are also view as being, “Theory Y”, the opposite of “Theory X”, argues that people want to fulfil themselves by seeking self-respect, self-development, and self-fulfilment at work as in life in general. The six basic assumptions for ‘Theory Y’, work is as natural as play or rest, the average human being does not inherently dislike work, whether work is a source of pleasure or a punishment (to be avoided) depends on nature of the work and its management. Second, effort at work need not depend on threat of punishment, if committed to objectives then self-direction and self-control rather than external controls. Thirdly, commitment to objectives is a function of the rewards associated with their achievement. Satisfaction of ego and self-actualization needs can direct towards the objectives of the organization. Fourth, the average human being learns, under proper conditions, to not only accept responsibility but also seek. Finally, the high degrees of imagination, cleverness and creativity are not limited to a narrow group but are widely distributed in the population. Under the conditions of modern industrial life, the intellectual potentials of the average human being only partly utilized. (Sited in management theory and practice 2007)
According to Care Quality Commission (CQC) policy and procedure 2008, the process by which manager’s make their involved taking into consideration the best interested for the clients these decision included assessing the client mental ability. In the case of a client suffering from mental illness who is incapable of making decision in their best interested in this situation this is the managers duties to make such decision on behalf of the client of the client for the management team to make that decision on the behalf of the client best interested (CQC 2008).
However, in the case of Mrs. B. Manager needs take into consideration that Mrs. B is capable to make the decision in her best interest. As stated Mrs. B has rights, rights to make decision where she would like live. In order for the client to receive the best care possible, management need to understand that Mrs. B. need to have that need of independence and feel comfortable in her own environment which is very important for recuperation. The support need to focus on Mrs. B needs and not impose force upon her. However, the managers’ duty is to inform Mrs B about the potential risk associated with her being home on her own at times (Department of Health 2007).
In term of addressing, the problem management need to discuss the options available to Mrs. B before discharge from hospital. Mrs. B need to be provided with a hospital bed which will be much adaptable for her, taking into consideration her mobility needs, for example inability to climbed the stairs in her home. She might also need a wheel chair to move around, as well the physiotherapy to help her regain her confidence to walk again. Therefore her home needs to be adapted for her so the carers have accessibility in assisting her with wheel chair accessible. Prior to her accident Mrs. B had no problem getting around and lived independently on her own after her husband passed away. The management team need to work closely together to achieve the best outcome for Mrs. B care needs (Care service Management 2007).
Moreover, the joining team should be able to put in place and arrange the prompt prevision of aids and adaptations. These are needed to enable safe discharge therefore a major adaption is needed and might not be available. It nevertheless remains the duty of the management to make prevision for the patient need (Community Care Discharge Act 2003). In accordance with the community care discharge act 2003, it stated that all assessment needs to be made priory to discharge as part of the community care assignment act. This included covering services need to allow patient to move in to the right place that is best suite.
Under the local authorities act under there is a statuary duty within the NHS Community Care Act (1999) to carry out assessment of needs to demonstrated an individual eligibility for service. In the case of Mrs. B., she able to pay for her care need and has the right to be assisted (REF). Management need to respect service needed, the individual wishes and need which is central in decision making. All these need to be centre on the client planning and progress. Person centred planning is an approach which help to identify what is important to a person from their own perceptive as long as they are of sound mind person centre approaches is a focus point in decision making (Department of Health 2007).
In conclusion, focusing on management and the implementation that needed to be made, policies are in place to assure that decisions are made equally and in a fair way to all service users. This is important to evaluate in the case of and the effect of other programmes it is important to put the needs of service users first and to be acknowledged at all time. In the case study, the management and teams work together to achieve goals, and objective in this case client are aware of what is best for her and needed the help and support in order for her to live in a familiar environment where she is comfortable. The Maine achievement is the client well-being after reviewing Mrs. B, case the social worker and the team have made all the necessary arrangement and her wish were fully acknowledged with little concern about her health, the care and support she need were all in place for Mrs B,to receive home care service.