Quality Assurance

Chocolate Quality (Street) Imagine you are the owner of a new sweet company, CadTree. Your new chocolate range is not selling as well as it should, and you think that this might be due to the quality of the chocolates. How can you make sure that all your chocolates are of the highest quality?

Quality Assurance In H. & S. C. Discuss the following points: What is quality assurance? Do is it needed? Who will carry it out? How might they do this?

Glossary Terms Standards – the level of service required. Governance – the organisation and delivery of services so they meet the required standard. Quality control – the systems put in place by health and social care organisations to ensure that services are of a high quality.

Standards Standards are being developed through NSFs for different areas. Targets are nationally set but on a local level they may be agreed to target issues of concern.

Quality Assurance Mechanisms Improving information and consultation with service users – users involved in service development, increased availability of information through leaflets and websites. Involving service users in the NHS and social care – legal duty to consult the public on changes to NHS services and by the local council. PALS – Patient Advice and Liaison Service- resolves problems, gives out information and directs people to advocacy or complaints services.

Patients’ Forums – all trusts have one Patients’ Forums – all trusts have one. Made up of volunteers who have the power to inspect all patients facilities. Monitor services from the patients’ perspective and pass information onto monitoring bodies. Patient choice – a new initiative which allows patients to chose the hospital they wish. Patients’ Charters – gives information on the most appropriate treatment and how to make a complaint.

Performance Measures in the NHS League tables started in 2002. Trusts were awarded starts for performance – was not a true reflection of quality so have been abolished. Healthcare commission started in 2004. Monitors performance in the NHS and assesses whether standards have been met.

Performance Measures in Social Care Commission for social care inspection set up in 2004. The commission currently inspects children’s social services – this is being transferred to OFSTED as they will be merging with education departments to form Children’s Trusts. Responsibilities on p.32. Young people leaving social services will be given a leaving care plan to help them adjust.

Monitoring in the NHS Overview and scrutiny committees – run by councils with social service responsibilities. Review health and social care in their area. Internal monitoring – each NHS organisation has it’s own systems – must produce an annual report on service quality and how they deal with complaints/ risk management.

Registration in Social Care CSCI assesses whether those wishing to offer services are fit to do so. They will assess: Fitness of premises. Fitness of persons. Fitness of services and facilities. E.g. someone wishing to open a care home would have to be registered in order to do so. CSCI also inspects premises not registered with them e.g. local council fostering/ adoption services and educational boarding services.

Inspection in Social Care At least 10% of staff interviewed. At least four residents spoken to. Paperwork checked e.g. care plans, fire books, staff records, accident books. Will observe how staff behave with service users and how meal times are managed. Not just about safety – how can service users keep their independence/ individuality/ make own decisions etc.?

OFSTED Four main roles: Registration. Inspection. Investigation. Enforcement.

Evaluating Quality of Service Hospital trusts must survey all patients who have been an in-patient for at least one night. Covers: Emergency and planned admissions. The environment and facilities. Care and treatment, especially pain relief. Doctors and nurses. Adequacy of patient information. Discharge. Overall impression. The response rate can be low and different people will have different standards.

Monitoring Service User’s Views in Social Care People may be nervous about criticising the care they receive e.g. if they live in a home. Older people may not feel as comfortable talking to younger people. Issues of confidentiality – people nervous about being identified.

Rewarding Good Practice The Charter Mark Investors in people (IIP)

Developing Procedures for Complaint Designated manager in every NHS Trust. Complaints studied carefully. Records of complaints and their outcomes are kept. Quarterly report provided to the board meeting. Most trusts give staff opportunities to raise issues about the services. Independent Complaints Advocacy Service can act on behalf of service users and give advice. Social care users may go through other advocacy services e.g. Age Concern.

Raising Training Levels In social care… CSCI give guidance on required qualification levels and numbers of staff on duty. This is checked at inspection. All staff should have an individual training program and most providers will give ongoing training. In the NHS… ongoing training essential! Doctors and nurses have individual learning plan and doctors are revalidated annually. Registered general nurses can train to become nurse practitioners.