This report focused on the stakeholders’ perspective in managing quality and the roles of the agencies when setting right standards, and assesses policies and procedures concerning quality management. Also evaluated the implementation of quality systems and methods concerning internal and external perspectives. In addition, evaluate the impact of engaging service users when implementing and evaluating quality and suggestions on improvement of quality.
This report reflects CQC inspection of Russell House that was done on the 9/05/2017 and on the 26/06/2017 was published which focused on standards of the government and the agencies responsible for implementation. Russell House which is a care home for individuals with epilepsy and accommodates twenty service users, hence the report was on quality management and the systems in place.
According to Freema (1983) explains that stakeholders are groups or people who are affected through achievement or success of organisation and can influence the aims of the organisation. The stakeholders experience the impact and effect of the organisation’s decisions that are made. There are internal and external stakeholders, Internal stakeholders include service users, organisations and staff. While external stakeholders include regulators, inspectors and various agencies like NICE and CQC.
Service Users Quality: This is considered in different ways concerning their expectations and experience. According to Sixma et al (1998) the important approach is whereby to explore the experience and the need of the service users, by listening to their views on quality from their experience of dignity and respect. Also, the care provided to them and the environment they live in whether it is favourable. Service users’ quality assessment is connected to their relationship with staff and when their needs are met adequately.
The service users’ perspective is based on their expectations but not standards as in the case study, service users’ expectations were met. When they were asked during the visit of CQC, they said that the level of quality and care provided to them was of quality, staff were empathetic, their request was attended to and there was good respect towards the service users by the staff.
Staff: staff perspective of quality is in relation to the expectation of adequate facilities and adequate working condition to do their role in a proper manner. In addition, employees are concerned about their rate of pay, salary and working hours hence determine the perspective of quality. According to ASQ (2017) staff consider empowerment and fear of working a good environment and to continue with improvement through training staff as part of staff perception of quality expectation. In the case study of RHC, there was quality to some extent as staff were happy with the work, however not with the level of staffing. The staff who were brought from agencies were not having adequate skills that the permanent students had, therefore pressure was increased on permanent staff because they find them in the situation of doing more work. Therefore, there is a need to improve on staff recruitment to resolve this problem.
CQC quality perspective ensures regulations and set standards are practiced and standards from different agencies that include: CQC, NICE, NMC and sectors Skills Council. CQC considers quality from perception of services implemented and ensure them to be effective, safe, high quality and improvement which is continuous (CQC, 2015). Quality is accurate, have adequate budget for quality services, good record keeping and correct documentation. Therefore, in the case study CQC perspectives were partly implemented, however in some cases staff were ignorant about service users’ needs hence not meeting quality perspective. Therefore, there is a need for continuous monitoring of quality of services by CQC.
According to Health, Social services and public safety (2014) external agencies are referred to regulators that work for government, influence performance of the organisations to ensure they comply with legal standards including quality. They provide warning notices, termination when an organisation fails to comply with regulations, encourage and provide advice to organisations.
There are different external agencies like: NICE, CQC, NMC, Health Commissioner of midwifery and CCG.
The role of three of the above will be explained as below:
NICE (2015) it’s the role of NICE to provide advice and information for improvement of health and social care services. They also set up standards to enable improvement for the outcome of the people and the public using NHS services and it is through provision of guidance, advice and information and establish advice and direction for health and social care workers. Coulter et al (2013) suggest that they produce standards of quality measurement for commissioners, health and social care officers, to improve health and social care service delivery.
For example: In the case study of RHC, NICE standard includes the administration of medication, because it was reported that allergies due to medication were not reported by staff, hence non-compliance with the standards. However, the manager made improvement by taking immediate action hence the residents’ needs were met as it is NICE standard.
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