The clear aim of this essay is to discuss key aspects relating to the efficient management of health and social care settings; demonstrate an understanding of issues pertaining to equality and diversity. Furthermore, to summarise the importance of working within a multi-disciplinary network and the overall importance of team work and lastly, to establish the requirement to achieve and maintain a contract of registration with the health authority to provide a care service.
According to Longest, Rakich, & Darr (2000) state that, “management is defined as the process…occurring within organisations for the purpose of accomplishing predetermined objectives through humans and other resources”. Thompson, Buchbinder and Shanks (2010, p.2-3) then go on to emphasize that “managers are needed to make certain that organisational tasks are carried out in the best way possible to achieve organisational goals and that appropriate resources, including financial and human resources, are adequate to support the organisation”. From this, it is possible to ascertain that a role and responsibility of management, within a healthcare setting, is to accomplish goals and to ensure the efficient running of the organisation.
Firstly to be an effective manager, Thompson, Buchbinder, & Shanks (2010 p.8) propose “the individual manager must be able to effectively manage him or herself. This means managing time, information, space, and materials; being responsive and following through with peers…and keeping a current understanding of management techniques and substantive issues of healthcare management”. In order for a manager to carry out roles such as planning, problem-solving, and decision-making, Katz (1974) identified key skills: conceptual skills, technical skills, and interpersonal skills. “Conceptual skills are those skills that involve the ability to critically analyze and solve complex problems”…”Technical skills are those skills that reflect expertise or ability to perform a specific work task”…”Interpersonal skills are those skills that enable a manager to communicate with and work well with other individuals, regardless of whether they are peers, supervisors, or subordinates” (Ross, Wenzel, & Mitlyng, 2002).
Another skill needed by an effective manager is sound decision-making. Marquis and Huston (2009 p.1) state that “decision making is often thought to be synonymous with management…decision-making, then, is both the innermost leadership activity and the core of management”. Furthermore, problem-solving skills tie into decision-making, as they describe problem-solving as a “systematic process that focuses on analyzing a difficult situation” (Marquis and Huston, 2009, p.2).
Under the Health and Social Care Act 2008, all regulated activities are required to have a registered manager who must register with the Care Quality Commission (CQC). After registration, a registered manager has a role in enabling and monitoring compliance with essential standards across the regulated activities (Care Quality Commission, 2013a).
The Registered Manager of a care home is responsible to the regulatory body for the social care provision being managed by him/her. For efficient management of care or residential home a registered manager must promote good communication with residents and their families and collaborate with other health care professionals (Chambers and Tyrer 2002, Chambers 2003a, Social Care Association 2011); put into effect systems and processes that support individual choice and control; ensuring that there is nothing that could be excluding service users or promoting discrimination; safeguarding service users from abuse (Social Care Association 2011) and support residents and families to be involved and express views (Chambers and Tyrer 2002, Chambers 2003a). Also, ensuring that sufficient number of suitably qualified, skilled and experience person are employed. Furthermore, to supervise organisational structure, provision and quality assurance (Owen et al. 2012a, Owen et al. 2012b); develop and keep in existence operational policies, procedures and guidelines relating to the multiple agencies with which care homes are engaged (Owen et al. 2012a, Owen et al. 2012b).
It is important to stress that there are many skills needed to perform the role of an effective manager, and thus only a few have been selected here. Highlighted above are what are believed to be the most important skills needed to ensure the efficient running of an organisation within a healthcare setting: these skills have been backed up by relevant references.
Most organisations either in further education or work-based learning provision now embedding equality and diversity into everyday practice. Not because it is a good thing, but a requirement and they have moral and legal obligation to do so.
The consequences of not embracing equality and diversity can result in damaging litigation and ruined organisation profile and reputation (Birmingham and Solihull Mental Health Foundation Trust, 2015).
Equality means treating everyone fairly and given a fair chance to access opportunities. It is not about treating everyone the same way as they may have different needs and preferences. Equality Act 2010 came into force on 1 October 2010. The new Act strengthens the current legislation to provide a new discrimination law which protects individuals from unfair treatment and promotes a fair and more equal society (Legislation.gov.uk, 2016).
Diversity means ‘difference’ it is about treating people as individuals and recognising individual or group differences. Sometimes these two terms ‘equality and diversity’ are used interchangeably but they are not the same (Birmingham and Solihull Mental Health Foundation Trust, 2015).
One of the ways in which organisation have reacted to the issue of diversity in recent years has been development of flexible working practices and services. For example, an employer allows an employee to work a flexible working pattern to accommodate child care arrangements, or a GP surgery opening at the weekends to accommodate those working full time during the week. These approaches identify that in order to provide accessible services and promote inclusive working environment organisation need to react differently to both individuals and to groups (Londondeanery, 2012).
In addition, is the issue of gender pay gap which saw increasing public attention in 2015. Research finds that male workers are paid on average 19% more than female counterparts in almost all area of the workforce.
Last July United Kingdom (UK) government responded to the consultation, ‘Closing the Gender Pay Gap’ and introduced a requirement for the public sector and larger companies to publish information on gender pay differences (Gov.UK, 2016).
Under the law of equality, no employee should be paid more or less than any one of their colleagues that are performing the same task due to their gender, religion, age, sexuality or any other discriminatory reason.
In the UK, all workers must be treated equally and have the same set of opportunities regardless of their ‘protected characteristics’. Even, the general single equality stated that all organisations, when exercising their duties to have due regard to the need to eliminate discrimination, harassment and victimisation and promote good relations between those who share or have different protected characteristics (Legislation.gov.uk, 2016). For example, Bexley College where I study promote equality through teaching and learning. They provide student support and guidance that reflects the diversity’s of students’ needs. I will say they are only one of its kind institutions that proactively committed to creating a stimul
ating teaching and learning environment that values diversity, mutual respect, fairness and inclusion.
The importance of a multidisciplinary team in health care setting cannot be overemphasised. The multidisciplinary team is made up staff from different professional background with different areas of expertise. These teams are able to respond to clients who require the help of more than one kind of professional (Drinkwater, 2008). Multidisciplinary teams pass on many benefits to service users and other health professionals working in the team. Such as holistic view of the service user’s needs, continuity of care, the availability of range of skills, and mutual support and education (Ovretveit, 1993).
According to Moss (1994), multidisciplinary team working enables service users to have 24-hour access to information and support, intervention and treatment before and during a crisis, ongoing proactive care for those with long-term illness and receiving services that are planned and co-ordinated.
Borrill et al. (n.d. p.12) lists several strategies for maintaining and enhancing effective multi-disciplinary working relationships. These include team composition and processes, effective communication, information sharing, decision-making, and problem-solving. These strategies are significant within healthcare if professionals are to achieve positive results.
Equally, when health care professionals collaborate they tend to be more efficient, effective, utilise resources better; more responsive to changes as they occur and patients are more satisfied with their care (Stewart el at., 2003). Nevertheless, there are barriers to integrated working such as lack of understanding and clarity of other’s roles; imbalance of power and poor communication (stewart el at., 2003). Also, organisational boundaries often resulted in staff feeling pressured, and collaboration working led to unrealistic expectations being placed on staff (Coxton, 2005).
Health care is often provided by ‘’teams’, however,’ a team is a group of people with different skills who are committed to a common goals or purpose for which they hold themselves accountable (Katzenbach and Smith, 1992).
Teamwork is when two or more health professionals interact or in relationship and work interdependently to provide care for patients. Teams usually have a shared goals and values, they communicate well between themselves and had a clear vision of where they were going and what they wanted to achieve within agreed timescales (Borrill and West, 2002).
Additionally, Borrill et al (2001) established that teamwork improves quality of care, patient safety, reducing staff shortages, burnout and stress among healthcare professional. He also stated that teamwork can drastically reduce workloads and patient morbidity; increase job satisfaction and retention; improve patient satisfaction. According to (Wedderburn-Tate, 1999) good leadership is the main prerequisite for effective team work.
However, there are disadvantages of team working. For example, it might take long time to nurture the team and individual team member, and to provide continuous support for the team. Also, a team may lose sight of the organisation’s aim and become isolated (Mullins, 2010). Nevertheless, team working in health and social care is crucial for the delivery of quality service to patients.
The Care Act 2014 sets out Local authorities’ statutory responsibilities for public health services. The general duty of local authority is promoting individual well-being, promoting the integration of care and support with health services, providing information and advice, promoting diversity and quality in provision of services. In addition, to the above responsibilities, local authority social services current duties are to provide welfare services such as residential accommodation for those in need of care, because of age, illness or disability, which they cannot otherwise obtain (Legislation.gov.uk, 2016).
Further, Health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulations 2015 introduced a single registration system that applies to health and adult social care services. This legislation wants all providers that carry on defined regulated activities to be registered with the Care Quality Commission (CQC).
The Care Quality Commission is the independent regulator of health and adult social care in England. They monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety. A service provider can be an individual, a partnership or an organisation – examples of organisations are companies, charities, NHS trusts and local authorities (Care Quality Commission, 2016).
The aim of registration is to ensure that patients can expect services to meet essential standards of quality, to protect their safety and to respect their dignity and rights anywhere care is delivered. There is no ‘joining’ fee when providers or registered managers apply to be registered. However, providers will be required to pay an annual registration fee once they are registered (Care Quality Commission, 2016).
The new service provider must provide the following documents as part of their application: Statement of purpose which describes aims and objectives; contact details; the different needs of service users; service’s legal entity and the places where services will be provided. Enhanced DBS certificate countersigned by the CQC provided at the interview; Employment history (CV) provided at interview or may be sent in prior to interview. Also, evidence of necessary qualification (such as health and social care professional qualifications and location evidence for example: Location details including number of places or beds, Building regulations completion certificate, Fire safety certificate, Purchase or transfer of existing location(s), Food safety registration with Environmental Health (Care Quality Commission, 2016).
In addition, from April 2015 there are new fundamental standards that all providers must meet including new fit and proper person for directors for example; provider must ensure directors are of good character, physically and mentally fit, have skills and experience for the role, and necessary qualification. Furthermore, the provider must demonstrate that they have good recruitment policy, disciplinary and dismissal policies, management appraisal and processes in place (Care Quality Commission, 2016).
In conclusion, a healthcare setting as with many organisations aims to produce success for the organisation. To thus produce this success, it is vital that the role and responsibilities and the qualities of an efficient manager are met, as it is the manager who holds the responsibility for the quality of care in his/her home. A healthcare setting could perhaps be viewed as a puzzle in which each part must be fitted correctly in order to achieve positive results. It is significant that the road to success starts with the manager, leading to recruitment if necessary, then to collaboration among professionals. These are the stages which will lead the organisation to success and at each stage there must be thorough efficiency.