National Service Framework for Older People - Essay Example

Are national service frameworks and quality standards necessary for improving services, and is there any evidence that they are working Introduction National Service Framework for Older People has been established to look at the problems older people face in receiving care in order to deliver higher quality services.(www.dh.gov.uk) The key standards that underpin the Framework are outlined. These include plans to eradicate age discrimination and to support person-centred care with newly integrated services. A new layer of intermediate care is being developed at home or in care settings, while general hospital care should be delivered by the appropriate hospital staff. The NHS is also to take action on stroke prevention, in the promotion of health and active life and a reduction in the number of falls for older people. Integrated mental health services are to be provided for older people. The process of translating these nationally supported standards into local delivery is outlined. (www.dh.gov.uk). Quality Standard for Health Care was launched in February 2004 and puts the quality at the forefront of the agenda for the NHS and for private and voluntary providers of NHS care. It shows the quality of health organizations, including NHS Foundation Trusts, and private and voluntary providers of NHS care, will be expected to meet in terms of safety, clinical and cost effectiveness, governance, patient focus, accessible and responsive care, care environment and amenities, and public health. (www.dh.gov.uk). The Quality Standard will be a key part in the assessment in the performance as assessed by the Healthcare Commision of all health care organizations. The above mentioned characteristics of NSF and QS will be used to prove that they are doing something to improve their services. Articles and useful websites will be used to strengthen our claim that NSF and QS are doing something. The aims of NSF will be presented to further understand the importance and role of NSF not just only on elderly but to everybody as well. Home Care for Old Age Using the Donabedian framework we will assess the effectivity of the framework by choosing an organization. The paper will assess whether the organization are meeting the national standard. Donabedian framework includes the structure, process and outcome. The organization to be assessed is located in Nottingham Street Melton Mowbray Leicestershire. 1st Choice Abbey Homecare was rated excellent by the Commission for Social Care Inspection (CSCI). CSCI are non government organization that inspect and report on care services and councils. It is an independent but setup by Governmentto improve social care and stamp out bad practice. Abbey Care Home was founded in March 2000 by Jayne LEE, who through remarkable dedication has established her agency with the support of five managers and a team of highly respected professional care workers. The head office is based in Reading and has direct communications for referrals from Social Services, Direct Payments service users and the private sector. Abbey Home Care offers all year round support. The type of service is care home with nursing (private) with 97 residents. The home care is comfortable for the adult they have 87 single rooms. They can have their own GP if required, pets are allowed but with arrangements, strictly no smoking. Internal access includes lift and wheelchair access. External access includes easy accessible local shops, near public transport, minibus or other transport. To help the old age patient feel comfortable the home care create a garden for residents, communication accessories such as own phone point in the room, television set in the rooms to make the patient feel comfortable. The home provides well maintained and pleasant accommodation and grounds. The home was very clean and tidy on the day of inspection. Staff at the home was friendly and approachable. People spoken to confirmed that staff is kind and respectful. The Abbey Care is structured the way the patient wants it to be. It is comfortable, easily accessible, communications are open and staffs are friendly. In order to have a person centered care the home care should listened to the views of users and carers about the services they need and want. The said attitude is being promoted within NSF. Within NHS a comprehensive programme of trust based survey of patient is available. It measures the patients experience in the process of care rendered to them. Abbey Home Care and facilities seems to have fitted on the standard created by NSF. In the inspection done by the Commission for Social Care Inspection (CSCI) on Abbey Home Care the following observation was given: 1. Based on the standard - The care needs requirements of service users and their personal or family carers when appropriate, are individually assessed before they are offered a personal dormiciliary care service. According to CSCI, quality in this outcome area is good. The care and support needs of service users are assessed appropriately. 2. Considering the two standards for inspection - a) service users feel that they are treated with respect and valued as a person, and their right to privacy is upheld. b) The agency's policy and procedures on medication and health related activities protect service users and assists them to maintain responsibility for their own medication and to remain in their own home, even if they are unable to administer their medication themselves. The CSCI observation, quality in this outcome is good, Service users feel that they are treated with respect and valued as a person, and their right to privacy is upheld. 3. In relation to these three standards under Protection - a) The health, safety and welfare of service users and care and support staff is promoted and protected, except for employment agencies solely introducing workers. b) The risk of accidents and harm happening to Service Users and staff in the provision of the personal care, is minimised, except for employment agencies solely introducing workers. c) Service users are protected from abuse, neglect and self-harm, except for employment agencies solely introducing workers. CSCI finds the quality in these outcomes is good. Service users and care staff are protected in relation to health, safety and the risk of accidents by the agency's policies and procedures. The procedures for protecting vulnerable adults are robust. 4. Assessment done based on the following standards: a) The well being, Health and security of services users is protected by the agency's policies and procedures on recruitment and selection of staff. b) Service users know that staff is appropriately trained to meet their personal care needs, except for employment agencies solely introducing workers. c) Service users know and benefit from having staffs who are supervised and whose performance is appraised regularly, except for employment agencies solely introducing workers. The CSCI assess the Abbey home care as good in these areas. Service users are protected by the recruitment practices, training provision and supervision of staff. 5. Assessment of standard on organization and running of the business; Service users receive a consistent, well managed and planned service. And the Service users and their relatives or representatives are confident that their complaints will be listened to, taken seriously and acted upon. The assessment is good. The main service users receive a consistent service and their complaints are acted upon. Evidence On the above standard the rating and assessment is done using the evidence. In User Focused Services Standard (1), the documentation was done for 6 service users. All new service users receive a personal visit by staff qualified to undertake assessments. Information is obtained which informs the initial care plan. The agency's own quality assurance systems have concluded that this practice is also valued by service users. Having staff which are linguistic provide care staff who could communicate with the service users in their preferred language. Personal care and support needs are reviewed frequently. Care staff surveys and discussion with staff are given appropriate information prior to seeing new service users. The evidence in standard in personal care (2) was provided from previous inspection information, which confirmed that the agency's policies and practices on the handling of medication are robust and protect service users. Management confirmed that only staff appropriately trained assist service users with medication. It was evident from the results of care worker surveys that sufficient time is allowed in the care plan to undertake the care and support needs of the service user. Evidence in the Protection standards (3), the company has a comprehensive policy covering health and safety matters. Procedures are designed to protect both service users and staff. The responsibility for health and safety was clear and understood the importance of following procedures. The agency has implemented a programme of assessing risks to all service users. The users have risk assessments undertaken and the agency is striving to refine their risk assessment tool to ensure it is user friendly and effective. All the staff undertakes protection of vulnerable adults training and it was acknowledged that updates were needed to be implemented soon. Evidence in National Standard in Managers and staff (4), six staff files were seen. There was evidence that all new staff had undergone appropriate checks and documentation on the files such as copy passports etc. supported this. The use of recruitment checklists and interview records is seen as good practice. Training courses are undertaken by the staff to ensure that the above measures are followed. There was evidence from staff files that written records of these meetings are maintained. In the National Standard in organization and running in business (5), the evidence from service user surveys that the consistency of the service had reduced particularly at weekends and in the evenings since the last inspection. The manager felt that this could be explained by the expansion of the business and the reliance on a manual system of work allocation. Proof of Work The following are works that prove that the agency is working based on the National Standards. The improvements done by the agency are based on the previous inspection done by the CSCI: 1. Since the last inspection there have been 14 complaints received by the service one of which was sent to the Commission for Social Care Inspection. Records seen were comprehensive and well maintained. The agency adopts an informal system of analyzing complaints and is confident that patterns would be identified. 2. Upon receiving the results of staff training audit facilitated by Skills for Care a structured training programme will be implemented and monitored. The staff receive a regular one to one supervision and there was evidence from staff files that written records of these meetings are maintained. Some staff surveys indicated that they had not received supervision. The manager intends to raise this at next staff meeting to clarity. 3. The agency has implemented a new assessment risk program. This was formulated because of the previous feedback done by the CSCI. All new service users have risk assessments undertaken and the agency is striving to refine their risk assessment tool to ensure it is user friendly and effective. 4. The agency was able to provide care staff who could communicate with the service users in their preferred language. All 11 service user surveys confirmed that care staff understands their needs and that changes are acted upon by the agency without delay. NSF and Quality Standard The following are the NSF standard for old age people: 1. Rooting Out Age Discrimination - this ensure that old age people will be treated equally and can access or receive health and social care services due to their age. Health providers should create service that will listen to them and respect them. 2. Person Centered Care Standard - indicates the importance of the Unified Assessment and Care Management system in identifying and meeting individual's holistic needs. This also includes the personal and professional behaviour of staff and on a whole system infrastructure in which integrated health and social care services are planned and delivered. 3. The standard on promoting Health and Wellbeing in older age - focusing on helping the to stay healthy. Emphasize on the helping people to stay healthy and independent for as long as possible. It calls for initiatives to address the social, economic and environmental determinants of health through Community strategies and Health, Social Care and Well Being Strategies; availability of integrated health promotion activities of specific benefit for older people, reflected in the Healthy Ageing Action Plan, support for individuals to take more responsibility for their own health and wellbeing and access to mainstream health promotion and disease prevention programmes. 4. Challenging Dependency - wherever possible, those needs should be managed within a community setting, in or near the persons own home, enabling people to maintain their independence and avoiding the need for inappropriate hospital or care admission. 5. The standard on Intermediate Care - aims to develop a co-ordinated and integrated range of services that respond to more intense needs, which if not met within a community setting could lead to hospital or care home admission. It also provides appropriate care environments to enable more timely transfer of care from acute hospital settings and support for people in regaining their independence. 6. The Standard on Stroke, applies to all adults, and aims to reduce the incidence of stroke through lifestyle advice for all and specific advice and monitoring for those at high risk. It also aims to ensure that people who have had a stroke receive the best possible care in the immediate as well as longer term to maximize their chances of survival and recovery. 7. The Standard on fall and Fractures also places emphasis on helping to prevent falls from occurring in the first place, and also on the prevention and treatment of osteoporosis which can greatly exacerbate the effects of fall. The standard aims to ensure that the resultant fractures are treated promptly and effectively. Conclusion Based on the above evidence as well as the report done by the CSCI, the National Standard Framework has been working toward perfection in servicing the people especially old age people. Abbey Care home has been adopting the quality standard to pass the yearly inspection of the CSCI. All home care is being inspected to ensure that they are operating on the way that the NSF has set them to be. The framework has been revised many times to ensure that the services are given to the fullest. The NSF and QS are important in improving their services. It is best to review these standards and framework and assess the need of the people to come up with standards that will be helpful to them. The question on do NSF work the answer would be yes. The continuous reviews done on the standard and framework are signs that the group are working for the welfare of all the people in need of their service. Annual inspection or as needed on home cares are done to evaluate their services rendered. The NSF and QS are working very hard to be of service to the people. Reference: National Service Framework for Older People in Wales, 2006 http://www.wales.nhs.uk/sites3/home.cfmorgid=439 McQuestion, M. 2006, Quality of Care, http://ocw.jhsph.edu/courses/immunizationPrograms/PDFs/Lecture7.pdf www.csci.org.uk CSCI, Inspector Newman, S., 2006 Inspection Report Dormiciliary Care Agency, Abbey Home Care Agency, www.csci.org.uk Read More