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    Concept of health and social care quality majorly put focus on the managing quality of health care services. Health care service is crucial factor to maintain and promote health care services in order to prevent disease, reducing premature death and disability. In order to establish this research study the selected organization namely The Royal United that has failed to provide quality service for their clients. Not providing proper quality related to health care service has created major issue for the healthcare standard of the selected hospital. This research will elaborate on several perspective qualities such as stakeholders’ perspective. Strategies to achieve and methodology to describe quality of services will have pertained in the current study.

    Part 1

    A) Several perspectives of quality

    1.1. Perspective of stakeholder in social care and health regarding quality

    External stakeholders of The Royal United hospital have their own perspective regarding quality standard of social and healthcare. As mentioned by Goodridge (2018, p. 385), the previous service user of the hospital has complained about the service quality of Royal United Hospital. As per my opinion, the stakeholders of social and healthcare services are employees, technicians, service user.

    Perspective of employees: Employees provides service for the service users have the liability and responsibility for maintaining quality of Royal United Hospital. Thus, it can be suggested that employees of this organization require performing more efficiently. 

    Perspective of service user: The organizational service user has their perspective related to the quality. In my opinion, the service user has their personal requirement related to the organizational service.
    Perspective of the legal body: In order to maintain quality standard of health care, this organization needed to put focus on the perspective of external legal bodies regarding clinical excellence to set benchmarks for social and health care. 
    Perspective of the technicians: As mentioned by Cameron (2014, p. 229), the organizational quality of service majorly depends on technical services. According to the researcher, this above-mentioned organization required proper management team to improve the quality of services. 
    In order to meet quality standard, the included things are eating, bathing and dressing of the patients.

    1.2. Role of the   external agencies for setting standard

    As commented by Healy (2016, p. 21), the major two external agencies related to social and health care are National Institute of clinical excellence and Care Quality Commission. Care Quality Commission is public body of UK that set conditions and standards related to social and health care services. This organization has major effect on the above-mentioned organization, as it fails to provide quality service for the patients. This external organization safeguards the services of healthcare industry by setting standard for the services users of hospitals. It has helped the Royal United hospital to set the standard, as their service quality was poor before. Additionally, this external agency regulates and supervises services of the social and healthcare and ensures right for individual patients. On the other hand, National Institute for Clinical Excellence provides guidelines and gives advice for health and social care on time basis. Additionally, this organization involves the standard for the health and social care services. This organization also helps the healthcare organization by providing information related to the industry.  

    1.3. Impact of poor service quality on social and healthcare stakeholders

    Poor service quality has major impact on the stakeholders in several ways. It has impact on both the organization and service users. Poor quality of service has effect on the organization in several manners. However, if quality of social and health care is not properly managed by the organization, as result it can create serious consequence for the organization. It may lead to inability to improve social and health well being of the service users, as the organization is responsible for commissioning and planning in order to meet the criteria of the service user. In my opinion, this will also affect the safety part of the service quality and will affect cost-effectiveness. Inappropriate quality has to lead the Royal United Hospital to poor healthcare effectiveness. Safety of the service user has not been guaranteed and as outcome patient has faced poor experience related to health care. According to Brett (2014, p. 641), external regulatory body has identified that the organization has not maintained the standard of health care. This influenced the health of the service user in several ways. As the organization has not fulfilled requirement of service users, it has affected the health of service users. The organization was using poor quality of health care service and the equipment that is being used for patient care has deteriorated the health condition of the patient. The trainers of healthcare professionals have not provided effective training, which has made the service quality of organization worse. 


    Range of sources of information

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    The data of this study has been collected from primary resources. Interview has been conducted for organizational manager, in order to know their view for quality improvement. In order to know the view of employees and patients, the survey has been conducted. This study has used both qualitative and quantitative technique in order to establish this research study. This method of data collection has helped the researcher to get proper information about health and social care service of Royal United Hospital. 

    Appropriate findings
    The research methods have helped the researcher to gather appropriate data about the organization. As this organization has faced difficulties related to their service quality, for that external agencies has sent them to notice to improve their quality of service. By the research methods, it has been found that the organization was not maintaining proper quality for their organization, for that governing body has sent notice to improve their service quality. 


    B)  Strategies to achieve quality

    2.1. Standard to measure quality
    Meaning of standard
    Why is important 
    Mention some of the agencies like CQC, NMC and Nice 
    Focus on CQC at least five  standards related to the case study 

    Health Service command of UK measures the service quality of social and health care. A system of organization cannot be operating effectively if the quality of service is not effectively measured. As above-mentioned organization has not maintained their service quality, for that this organization has faced several issues from regulatory bodies. Quality standard in health and social care services is major part. According to Glasby (2017, p. 17), the measurement of health care service includes structure measurement, process measurement, patient experience measurement, outcome measurement. In the part of structure measurement, this health service command evaluates infrastructure of healthcare management, for this research, it is a hospital. This measurement includes capability and facility of employees, policy, and structure.  Structure measurement helps the organization to see the quality care system. Process measurement provides specific services for the patients by following the guideline. However, it is not allowed in the Royal United hospital. Process measure captures true quality that provided by the organization. On the other hand, outcome measurement needs detail information about the service user. Patient Experience measurement provides feedback from the patient about the quality care of the organization. It helps to measure accessibility and clarity related information that an healthcare service provider provides. On the other hand, outcome measurement provides information related to medical records. This measurement looks at the effect of the health care that has been provided to the consumer. 

    2.2. Different approaches to implementing quality system 
    What is meant my approach 
    Mention different approaches such as bench marking, total quality management 
    Add case study 
    Quality standard that is existed in the healthcare service is changing based on global aspect. Changes Of quality in healthcare services are leading the above-mentioned organization to face difficulty. In my view, social and health care provider needs to follow proper approach in order to practice proper healthcare standard. According to Rosen et al. (2018, p. 433), the organization requires to follow care quality commission's approach in order to mitigate risk related to health care services. Healthcare organization needs to implement quality required planning. Government of the country requires setting procedure and policies in order to audit quality standard of healthcare organization. The healthcare organization needed to set benchmark to measure performance indicators. The organization needs to maintain the code of practice related to health care treatment.  Health care services majorly include human health-related activities, hospital-related activities, medical practice. These activities need to conduct by the organization and has relation with service quality they deliver. Quality in healthcare described as the completing right thing at right time. Approach for implementing quality system involves continuous growth for improvement. Proper quality improvement is essential for service development of healthcare organization.  The organization requires favoring the service user by providing assurance of quality and requires following healthcare regulation related documents. Adoption of total quality management will help the organization to improve their service quality, which was not good before the implementation. By adopting this system, organization can improve health care and will also able to satisfy the needs of the patients.  
    2.3. Barriers to delivering social care and health services
    The Royal United has faced several barriers to deliver quality service to the patient. The major barriers include external and internal barriers. External barriers in order to improve quality can involve health insurance, lack of financial and social support. On the other hand, internal barriers within healthcare organization can include lack of improved equipment and technology related to the system. This organizational management system was not proper for that they fail to improve their quality standard in the previous year. Reason behind the poor management system is financial problem within the organization. This organization has not adopted better technology system in order to improve social and health care services. The improper implementation of document procedure is one of the barriers for quality improvement of healthcare organization. Not giving proper salary to the employees can create barrier to provide health care services. Another barrier of the quality improvement includes lack of support and training system for the new employees. According to Foot et al. (2014, p. 77), the organization has not used sufficient amount of data in order to improve the quality of health care service, that has created barrier for the organization. In order to mitigate those barriers, organization requires maintaining proper training for the healthcare professional and requires to provide better leadership than before. Leadership related issue can create barrier for healthcare quality improvement. 
    Evolution of work and justified conclusion
    The Royal United hospital has faced problems related to organizational health care service, for that they needed to improve their quality of service. In order to improve the quality of service, this organization requires quality improvement measurement. Additionally, this organization requires implementing new approaches in order to improve their quality of service. Barriers need to be identified, in order to mitigate issues that have been faced by the organization. 

    This research study has elaborated several stakeholders related to health and social care services, which has included perspective of employees, technician, service user and legal bodies. Role of the external agencies such as Care Quality Commission and National Institute for clinical Excellence put emphasis on the research study.  Impact of poor quality service has described in the current context. Measurement of healthcare standard, different approaches, and potential barriers have been described in this study. Effectiveness of procedure, policies, and system has been elaborated related to health care services. Additionally, this research study has described the impact of service user in evaluation process.

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