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The author has been assigned the task of critically reviewing mechanisms used to monitor and audit the quality in care services with reference to their own practice experiences.

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The author has been assigned the task of critically reviewing mechanisms used to monitor and audit the quality in care services with reference to their own practice experiences. Part two of the assignment will describe in detail methods of utilising resources effectively to achieve maximum quality outcomes. Task 1 For professionals working with clients it may seem that quality of care has always been an issue of importance. Most work places will have some sort of quality assurance system in place and it is assumed that quality can therefore be measured. As definitions relating to quality tend to be less concrete, measuring quality is a complex matter. One mechanism used to monitor quality is the audit. The audit in healthcare is used to examine the outcomes resulting from the utilisation of resources, and it is not restricted simply to an examination of the quality of outcome; it could involve themes such as equity, acceptability and effectiveness. Audits can be carried out at a ward / team, departmental, Unit, District or regional level. Audits can be internal - organised by internal auditors of the organisation, or external - e.g. through Registration and Inspection Units. The audit will be discussed in depth later on in the task. There is a definite relationship between quality and the processes of management in the care sector. Quality Control refers to a methodology for ensuring that specific standards of care are attained. Based on methodologies adapted within the industrial sector where the processes of production, and the outcomes from production, are generally clearly defined. In health and care this clarity does not always exist, making effective quality control more complex. We can relate this process - outcome to Donabedian who developed a conceptual approach for the examination of how an organisation functions; Donabedian's approach examines Structure, Process and Outcome. This conceptualisation can be used to facilitate the examination of quality in a multidisciplinary setting as it provides a framework that allows for different interpretations by different service delivery agencies or organisations. ...read more.


All inspection reports will be published and made available to the public. Again like the NSF's auditing process these inspections will fully involve the providers and users of the service in the evaluation of the service provided. Two formal inspections take place - one announced and one unannounced. Units are given four to six weeks notice with request for completion of checklist / questionnaires in advance, as a starting point for engaging Units and managers in the process. The inspection is the evaluation of a service at a particular point in time, including: -The resources devoted to the provision of the service. -The processes involved in provision of the service. -The quality and quantity of service provisions. -The quality of life of the users. This is done through an inspection of the building by the 'Estate Services Officer', an inspection of the administrative records / management systems and finally an evaluation of service through interview with residents, relatives and staff. On completion of the inspection verbal feedback is given and includes both identification of good practice and where there are concerns in any structure or practice. The inspector also offers constructive advice on how improvements might be made. Agreed further action and timescales are negotiated. All discussions and observations are recorded and complied into a detailed written report. The value to staff and service users of the NSF in the quality control process, is knowing beyond doubt that their service fully complies with the NSF's standards. It is a chance to identify those areas causing concern and take action were it is needed and as a result an improved quality service is provided. Participants do not have to operate alone as it is a multi dimensional process involving different professionals and service users. The service users involvement throughout this process is imperative as it encourages motivation, increases empowerment and promotes a feeling of ownership. ...read more.


Service managers play a central role in promoting a positive ethos and in promoting teamwork throughout the service. They should encourage staff to develop initiative and leadership in relation to their own work. Service managers can establish, in discussion with colleagues, the core values and priorities of the service, supporting all staff in practising effectively within agreed parameters and standards, as described in service policies and guidelines. Everyone involved needs a thorough understanding of the overall concept of quality assurance and how it will affect him or her and their role in the quality programme. They should also gain some understanding of the value of the quality assurance programme to themselves, the client, other staff and the organisation as a whole. To ensure maximum use of information and at the same time maintain the trust and commitment of staff, the issue of who receives what information requires careful consideration. The circulation of detailed information needs careful negotiation with the clients. Confidentiality should be adhered to were appropriate for e.g. making service users satisfaction surveys anonymous. Above all the service should adhere to standards of practice that derive from policies operating within the law and legislation. These are set out in well-designed written policies and practice guidelines in relation to key aspects of service provision and are regularly monitored and reviewed. This will include 'the Code of Conduct' and 'Equality of Opportunity Policy'. Legislation that may be relevant to care services is: - Human Rights Act - Disability Discrimination Act - Mental Health Order To conclude, the author, has detailed various methods of using resources effectively to obtain maximum quality outcomes; but we have not yet discussed what that quality outcome may be. Any business or service whether in the industrial or care sector strives to satisfy the customer, to meet their needs. In the case of health and care practice, basic needs can be defined as: physical, psychological, spiritual and sociological. It is important that these needs are met in order for survival. How these needs are met will determine the quality of life a person has. ...read more.

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