Managing Quality in Health and Social Care

Programme

Edexcel BTEC Levels 4 and 5 Higher Nationals in Health and Social Care

Unit Title: Managing Quality in Health and Social Care

Unit No. 27
Code: K/601/1670

Date Issued:

14th of Sept, 2015.

Student Name


Student ID No.: 

 


Date of final submission:

6th of December 2015

Tutor: MQ Teaching Team

 

Internal Verifier Name: IV Team




Assignment
Brief – Managing Quality in Health and Social Care
 
Rules and regulations:

Plagiarism is presenting somebody else’s work as your own. It includes: copying information directly from the Web or books without referencing the material; submitting joint coursework as an individual effort; copying another student’s coursework; stealing coursework from another student and submitting it as your own work.  Suspected plagiarism will be investigated and if found to have occurred will be dealt with according to the procedures set down by the College. Please see your student handbook for further details of what is / isn’t plagiarism.

Coursework Regulations  

1                     Submission of coursework must be undertaken according to the relevant procedure – whether online or paper-based.  Lecturers will give information as to which procedure must be followed, and details of submission procedures and penalty fees can be obtained from Academic Administration or the general student handbook.
2                     All coursework must be submitted to the Academic Admin Office and a receipt must be obtained. Under no circumstances can other College staff accept them. Please check the Academic Admin Office opening hours.
3                     Late coursework will be accepted by Academic Admin Office and marked according to the guidelines given in your Student Handbook for this year.
4                     If you need an extension (even for one day) for a valid reason, you must request one. Collect a coursework extension request form from the Academic Admin Office. Then take the form to your lecturer, along with evidence to back up your request. The completed form must be accompanied by evidence such as a medical certificate in the event of you being sick. The completed form must then be returned to Academic Admin for processing. This is the only way to get an extension.
5                     General guidelines for submission of coursework:
a)       All work must be word-processed and must be of “good” standard.
b)       Document margins shall not be more than 2.5cm or less than 1.5cm
c)       Font size in the range of 11 to 14 points distributed to including headings and body text. Preferred typeface to be of a common standard such as Arial or Times New Roman for the main text.
d)       Any computer files generated such as program code (software), graphic files that form part of the course work must be submitted either online with the documentation or on a CD for paper submissions.
e)       The copy of the course work submitted may not be returned to you after marking and you are advised to have your personal copy for your reference.
f)        All work completed, including any software constructed may not be used for any purpose other than the purpose of intended study without prior written permission from St Patrick’s International College.



 Unit Descriptors

• Aim
The aim of this unit is to help learners develop an understanding of different perspectives on health and social care service quality and how it is evaluated in order to empower and involve users of services.
• Unit abstract
Quality is an essential component of health and social care services and a concept with many different interpretations and perspectives. It is important to both users of health and social care services and external stakeholders. In this unit learners will gain knowledge of these differing perspectives and consider ways in which health and care service quality may be improved.
Improvement of service quality requires both the empowerment and involvement of users of services, as well as addressing the requirements of external regulatory bodies. Learners will explore the requirements of external regulators and contrast them with the expectations of those who use services. Learners will also gain knowledge of some of the methods that can be used to assess different quality perspectives, and develop the ability to evaluate these methods against service objectives.
Health and social care is a high contact service industry, and learners will be introduced to some of the concepts of managing service quality with an aim of achieving continuous improvement and exceeding minimum standards.
• Learning outcomes
On successful completion of this unit a learner will:
1 Understand differing perspectives of quality in relation to health and social care services
2 Understand strategies for achieving quality in health and social care services
3 Be able to evaluate systems, policies and procedures in health and social care services
4 Understand methodologies for evaluating health and social care service quality.




Unit content
1 Understand differing perspectives of quality in relation to health and social care services
Quality perspectives: perspectives of external bodies e.g. conformance; perspectives of staff; perspectives of those who use services e.g. Servqual – Zeithaml, Parasuraman and Berry; technical quality; functional quality; quality assurance; quality control; quality audit; quality management
Stakeholders: external agencies eg Care Quality Commission; Supporting People; National Institute for Clinical Excellence; Health Service Commissioners; local authorities; users of services eg direct users of services, families, carers; professionals; managers; support workers
2. Understand strategies for achieving quality in health and social care services
Standards: minimum standards; best practice; benchmarks; performance indicators; charters; codes of practice; legislation eg local, national, European
Implementing quality: planning, policies and procedures; target setting; audit; monitoring; review; resources (financial, equipment, personnel, accommodation); communication; information; adapting to change
Barriers: external (inter-agency interactions, legislation, social policy); internal (risks, resources, organisational structures, interactions between people)
3. Be able to evaluate systems, policies and procedures in health and social care services
Evaluating quality: different quality methods and systems eg Total Quality Management, Continuous Quality Improvement; concepts; preventing problems; management leadership, control of processes, involvement of people; quality circles
Health and care organisation: services eg an NHS trust, a local authority social care service, a private health or social care service, a not-for-profit health and care service
Improving quality: methods eg customer service, empowering users of services, functional quality, putting people first, valuing front-line staff, internally generated standards that exceed minimum requirements

4 Understand methodologies for evaluating health and social care service quality
Methods for assessing service quality: methods eg questionnaires, focus groups, structured and semi-structured interviews, panels, complaints procedures, road shows
Perspectives: external eg requirements of inspection agencies (minimum standards); internal eg organisational standards; continuous improvement Involving users of services: mechanisms eg consultation, panels, empowerment, user managed services.


Guidance
Links
This unit has links with, for example:
• Unit 1: Communicating in Health and Social Care Organisations
• Unit 2: Principles of Health and Social Care Practice
• Unit 3: Health and Safety in the Health and Social Care Workplace.
This unit also has links with the National Occupational Standards in Health and Social Care. See Annexe B for mapping.
This unit also has links with the National Occupational Standards in Leadership and Management for Care Services. See Annexe C for mapping.

Essential requirements
Learners will need access to information about local standards and targets for health and social care services.
It is strongly recommended that learners have the use of an authentic health or social care setting for the assessment of learning outcome 3. However, if this is not appropriate for the learner’s role and responsibilities or if there are concerns about access to a particular setting, a simulated scenario with appropriate supporting documents (policies etc) may be used. Learners must consult with their tutor about the aspect of service chosen to ensure that there will be sufficient evidence to meet the assessment criteria fully.
Employer engagement and vocational contexts Engagement with health and social care employers would be beneficial for both learners who are employees and those on work placement in settings, especially if the setting can be used as a case study for assessment purposes. The broad assessment requirements of the unit should be shared with the employer.


























Learning Outcomes
Assessment requirements

To achieve each outcome a learner must demonstrate the ability to:
LO1 Understand differing perspectives of quality in relation to health and social care services
1.1
Explain perspectives that stakeholders in health and social care have regarding quality

1.2

Analyse the role of external agencies in setting standards

1.3
Assess the impact of poor service quality on health and social care stakeholders

LO2 Understand strategies for achieving quality in health and social care services
2.1
Explain the standards that exist in health and social care for measuring quality

2.2
Evaluate different approaches to implementing quality systems

2.3
Analyse potential barriers to delivery of quality health and social care services


LO3 Be able to evaluate systems, policies and procedures in health and social care services
3.1
Evaluate the effectiveness of systems, policies and procedures used in a health and social care setting in achieving quality in the service(s) offered.

3.2
Analyse other factors that influence the achievement of quality in the health and social care service

3.3
Suggest ways in which the health and social care service could improve its quality

LO4 Understand methodologies for evaluating health and social care service quality.
4.1
Evaluate methods for evaluating health and social care service quality with regard to external and internal perspectives


4.2
Discuss the impact that involving users of services in the
Evaluation process has on service quality.

Text Box: NOTICE

Please note that it is now college policy to limit grades on work that is submitted late or very late to a pass grade only, even if the work merits a higher grade. This is to ensure that students do not take advantage of a late submission, in order to improve on their academic performance. Students who present evidence of extenuating circumstances will be exempt from this regulation.

Academic Administration will not issue extension forms to students unless they have written evidence from an official source which confirms the student’s inability to submit assignments on time. This could be a doctor’s note specifying dates of sickness; Council letters regarding accommodation; hospital notes, etc. They must show dates coinciding with or just before the submission due date. Please DO NOT ask academic administration for an extension form unless you have verifiable evidence.
Outcomes and assessment requirements






Merit Descriptors
Indicative characteristics/evidence needed
Contextualised Indicative characteristics (All the characteristics need to be achieved)
M1

Identify and apply
strategies to find
appropriate solutions

Complex problems with more than one variable have been explored and an effective approach to study and research has been applied.
Submits work by the agreed due date.
AND

Has explored health or social care factors and analysed different concepts of quality in relation to Royal United Hospital.
(Opportunities to meet in section 1) and
Submit report by the agreed due date outlined in the assignment brief.
1.1,1.2,1.3
M2
Select/design and apply appropriate methods/
techniques

A range of sources of information has been used.
Has used a range of sources of information in the exploration of strategies for achieving quality throughout the assignment. (Opportunities to meet in section 1,2,3 and 4)
1.1,1.2,1.3,2.1,2.2,2.3,3.1,3.2,3.3,4.1 4.2
M3
Present and
communicate
appropriate findings


The appropriate structure and approach has been used.
Has used appropriate Report structure and various approaches in the evaluation of systems, policies and procedures in a specific health or social care setting in relation to achieving quality systems. (Opportunities to meet in section 1,2,3 and 4)
1.1,1.2,1.3,2.1,2.2,2.3,3.1,3.2,3.3,4.1 4.2


Distinction Descriptors
Indicative characteristics
Contextualised Indicative characteristics (All the characteristics need to be achieved)
D1
Use critical reflection to evaluate own work and justify valid conclusions

Conclusions have been arrived at through synthesis of ideas and have been justified/ self-criticism of approach has taken place.

Has clearly justified or given a self-criticism of the approaches taken when evaluating the methods, approaches and effectiveness of quality service, systems, policies and procedure in health and social care setting. (Opportunities to meet in section 2,3 and 4)

2.2,3.1,4.1
D2
Take responsibility for managing and organising activities

Substantial activities, projects or investigations have been planned, managed and organised/the important of interdependence has been recognised and achieved.

Has substantialy investigated and explored strategies for achieving quality in health and social care setting (given case study or work experience) and recognised the importance of interdependence. (Opportunities to meet in section LO3 and LO4).



3.1,3.2,3.3,4.1,4.2
D3

Demonstrate
convergent/lateral/creative thinking
Problems have been solved/ self-evaluation has taken place/innovation and creative thinking have been applied

Has recommended problem-solving initiatives for poor quality of care services/ has applied innovation and creative thinking to improve quality in a health and social care setting.
(Opportunities to meet in section 3)

3.3



Summary of grades
In order to achieve a pass
Learners will have meet the assessment requirements for all learning outcomes and associated assessment criteria.
In order to achieve a merit
Learners will have to submit a REPORT on or before 31/07//2015, and meet the Pass and all merit grade descriptors (M1,M2,M3)
In order to achieve a distinction
Learners will have to submit a report on or before 31/07/2015 that meets the Pass, Merit and requirements for distinction descriptors D1, D2 and for D3.


NB: A copy of a REPORT format will be made available to students.
Case Study

Royal United Hospital Bath NHS Trust: CQC Quality report
 Date of inspection visit: 5-6 and 14 December 2013                  Date of publication: February 2014
Summary of findings
 The Royal United Hospital Bath NHS Trust (RUH Bath) provides acute treatment and care for a population of around 500,000 people in Bath and the surrounding towns and villages of North East Somerset, North and West Wiltshire, Somerset (Mendip) and South Gloucestershire. The trust provided 595 beds and a comprehensive range of acute services, including medicine and surgery, services for women and children, accident and emergency services, and diagnostic and clinical support services. The trust had an annual budget of around £230 million and employed 4,600 staff.
The trust had faced significant challenges in the past year, particularly over the last winter period of December 2012 to March 2013:
There was a high demand for trust services and the trust did not have sufficient capacity to cope with emergency admissions. The trust had three periods of ‘black escalation’ in January, February and March 2013. Patients were waiting in the corridors of the accident and emergency (A&E) department for treatment. The day surgery unit was being used for overnight stays. The trust received £2.35 million of NHS winter pressures funding to improve services.

·         The NHS patient safety indicators on falls, catheter and urinary tract infections, blood clots and pressure sores were above the national average and incident report rates were low compared with other trusts.
·         Elective surgical procedures were being cancelled and patients had long waiting times for surgery; this was worse than other trusts.
·         The staff survey results identified that the level of staff engagement was in the bottom 20% of trusts.
·         Patient complaints and concerns increased during this time.
·         The trust was not meeting standards and there were compliance actions following several CQC inspections for respecting and involving service users, care and welfare, safeguarding, and assessing and monitoring the quality of service provision.
·         We served a Warning Notice after our inspection in June 2013 because the trust did not meet standards for Regulation 20 (1) (a) and (2) (a) (b) (Records) of the Health and Social Care Act 2008.

The trust also had positive areas of practice:
ü  Surgical procedures were safe and the trust had not had a ‘never event’ for 18 months.
ü  Infection control rates were similar to those of other trusts.
ü  Overall mortality rates were similar to those of other trusts. The hospital standardised mortality ratio (HSMR) is a measure for deaths in hospital for specific conditions and procedures. This was significantly lower than other trusts and there was no difference between weekday and weekend mortality.
ü  The trust participated in national clinical audit and could demonstrate many areas where national guidelines were adhered to.
ü  The trust was supportive of innovation in services, for example, in dementia and end of life care.
ü  Patient feedback from surveys and NHS Choices was largely positive.

From this inspection, the trust has demonstrated that it could lead significant change effectively. It had been open and transparent with partners about challenges and funding had been used to support innovative changes. It had engaged the national Emergency Care Intensive Support Team (ECIST) to change services in both the trust and across the local health and social care community to improve the management of patient admissions and discharge. The changes had significantly improved how the trust managed the demand for its services and ensured that patients received good quality and safe care. Staff told us there had been a tangible shift in culture over the past few months from a corporate to a patient focus, and the trust was in a better position to manage winter pressures and unexpected demand for services.
Patients received safe and effective care. Surgical services were safe, for example, and infection rates were similar to those of other trusts. Patients were being treated according to national guidelines and clinical outcomes for them were good. Patients told us staff were caring and that they were treated with dignity and respect. Services were more responsive to patients’ needs and the trust had made changes to improve how it handled and responded to complaints. The trust was making progress in providing a seven-day service, and new models of care in A&E, medicine and surgery had meant patients were receiving quick and effective treatment and their length of stay in hospital was reduced. The environment on two wards, Combe Ward and the neonatal unit, had been redesigned and refurbished to reduce anxiety and improve the comfort of patients with dementia and of children and parents, respectively.
The CQC standards identified in the Warning Notice, and all but one of the compliance actions from our inspection in June 2013, had now been met. The Warning Notice has now been lifted.
We also identified a number of areas where the trust needed to improve. Staffing levels were safe but needed to improve in some areas, particularly in the critical care and neonatal units. Incident reporting had improved but information was not shared effectively so that staff could learn from mistakes. Patients were safeguarded, but more staff need appropriate safeguarding training to protect children, and some staff needed a clearer understanding about the rights to independence of patients who are at risk of wandering. Staff were caring, but at busy times in busy areas, such as admission and short stay wards, patients’ care needs were not always being met. Patients still had long waiting times for some planned surgery and outpatient appointments, and there were discharge delays for some patients with complex needs. The trust needed to engage with staff in lower pay bands who spend much of their time with patients and in patient areas, such as cleaners, who told us they did not feel valued or listened to. The trust was well-led but it needed to further improve how it assessed and monitored its quality and safety procedures. We identified actions for the trust to take to improve its services.

Full report summary and the main report on RUH is available on RUH report and policy documents


Description of the problem to be solved:

The CQC report identified some improvements and a need to further improve how the hospital assessed and monitored its quality and safety procedures. As a health and social care practitioner (Quality Manager) you are required to provide a report explaining the systems, policies and actions that can be taken to tackle the identified shortfalls.

Assignment

Based on the Case Study above you are required to provide a Report of approximately 3,000 words. (The word count is set here as a guide.) You should refer to the assessment criteria and the relevant unit content, when preparing your evidence of assessment. The report should address the following four tasks below which relate to the learning outcomes.

Section 1
In section1 of your report you are required to show an Explanation of perspectives that stakeholders in health and social care have regarding quality; Analysis of the role of external agencies in setting standards and Assessment of the impact of poor service quality on health and social care stakeholders. You need to refer to the case study provided to cover all the assessment criteria. (1.1, 1.2, 1.3 and also opportunities to meet M1, M2 and M3).

Section 2
In section 2 of your report, you need to show that you understand strategies for achieving quality in health and social care services. This will be achieved by analysing potential barriers to delivery of quality service; evaluating different approaches to implementing quality systems and finally explaining the standards that exist for measuring quality at The Royal United Hospital. (2.1, 2.2, 2.3 and also opportunities to meet M2, M3 and D1)

Section 3
In section 3 of your report, you are required to evaluate systems, policies and procedures in The Royal United Hospital. You are required to Evaluate the effectiveness of systems, policies and procedures used in The Royal United Hospital in achieving quality in the service(s) offered. You should also analyse other factors that influence the achievement of quality, and lastly suggest ways in which quality could be improved.

NB: You must identify the specific systems, policies and procedures that you are evaluating in this section. This can include any systems, policies and procedures mentioned in the CQC REPORT or /and other policies as seen on stponline folder named ‘RUH CQC Report and Policy documents’.
 (3.1, 3.2, 3.3 and also opportunities to meet M2, M3, D1, D2 and D3)




Section 4
In section 4 of your report, you are required to evaluate methods for evaluating quality with regards to external and internal perspectives and discuss the impact that involving users of services in the evaluation process has on service quality. (4.1 and 4.2 and also opportunities to meet M2, M3 AND D1)



Formative Submission

Formative assessment will take place to advise you on your progress within the term (during the 4th week) and the ways in which you could improve before the final (summative) submission. The feedback is for your benefit and is not part of your final grade for the unit.  Formative feedback may, however, not be as detailed as the final feedback you receive, and may be in verbal and/or written form (at the lecturer’s discretion).  You will be asked to submit your work for formative feedback in electronic or hard copy form to which you will receive verbal and/or written feedback.



Final (Summative) Submission


You need to submit the report covering all the 4 sections which relate to all the assessment requirements in this unit via www.stponline.co.uk on or before 31th July 2015.

Example feedback form:
   
Feedback
Strengths: Note: Summative Submission will be made via stponline.co.uk and the deadline for summative feedback will be provided on Stponline.
Areas for Improvement



Grade Awarded:
Lecturer Signature:                                                                                         Date:


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