B (Roles of organisations in the health and social care sector)

Question 1

examples of healthcare

Answer 1

GP services, physiotherapy, school nurse, dentistry, nursing, pharmacists, dermatology, paramedics, radiographers, gynaecologists

Question 2

examples of integrated services

Answer 2

health visitors, day care, midwives, A+E nurses, psychiatrists.

Question 3

examples of social care

Answer 3

respite care, sheltered housing, training centres, safeguarding, day centres, residential care, and parenting support.

Question 4

the public sector

Answer 4

funded by taxes and national insurance. The majority of hc free at point of access, but some charge (prescriptions, dentistry, eye care etc). Some social care means tested. Social care for children is completely free. local auth manages own sc. NHS AND SocialCare England are managed by DHSC.

Question 5

primary health care

Answer 5

first point of access, accessed directly by the service user when required. Eg GP, school nurses, walk-ins/out-of-hours, paramedics.

Question 6

secondary health care

Answer 6

secondary point of access, usually requiring a referral from primary services. Includes A&E, mental health services, dieticians, phlebotomists.

Question 7

tertiary health care

Answer 7

specialist and complex, referrals made by secondary care services. Includes SLT, Forensic Mental Health (Young offenders), and palliative care.

Question 8

The NHS

Answer 8

Started caring for SUs in 1948 alongside the Welfare state. Free at the point of use for UK residents (65 million), serving over 1 million ever 36 hours. employing over 1.5 million.

Question 9

NHS foundation trusts

Answer 9

managing the majority of hospitals. Have been in use since 2004. Financed by gov but make own decisions to meet needs of the local area. Some trusts had their status removed due to poor care/financial difficulties.

Managed by a board of governors, allowing them to get different viewpoints. Decision-making is more appropriate in relation to meeting the needs/wishes of local communities.

Question 10

mental health services

Answer 10

sometimes provided by a local GP/health centre. More specialist services normally provided by Mental Health Foundation trusts (run by a community with a board of governors) Patients, families, friends local orgs, and residents can become embers of the Foundation. Governors are elected to take responsibility for the quality and range of care provided.

Question 11

community health foundation trusts

Answer 11

Work with GPs and local auth SC depts to provide care and support for children and adults. The services enable SUs to live as independently as possible. Includes adult/community nursing, health visiting/school nursing, allied health professionals, palliative care, urgent care centres, and specialist services.

Question 12

adult social care

Answer 12

for 18y/o+ with care needs (disabilities, mental health issues, the elderly, impairments). Keeping people independent as much as possible, and safeguarding vulnerabilities. Responsibility of local auth social services department.
Can provide domiciliary care, day centres, sheltered housing schemes, residential care, nursing homes, respite care or short-term residential care, training centres, mental health community groups, and social workers.

Question 13

children’s services

Answer 13

free of charge to support vulnerable children, their families and young carers. Local council children’s services must work closely w. other providers, or exist w/in on integrated service. Aims to ensure safeguarding is maintain for all children. Provides day care for 5y/o>, after-school support, practical help and assistance for those with impairments, social workers,, children’s centres, fostering and adoption, children’s homes, and respite care.

Question 14

GP services

Answer 14

role - to make inital diagnosis and refer individuals to secondary providers for investigation/treatment. Typically now involved in MDTs, to provide holistic care. Funded by DHSC, by run by CCGS. Funding received depends on ages, gender, morbidity and mortality, amount of people in residential/nursing care, patient turnover, and birth rate. Get more funding from NHS England if have a good CQC report, providing additional services, seniority of GP’s, and requiring more support for cost of premises/equipment.

Question 15

the voluntary sector

Answer 15

important for provision and research, Pre-welfare state, only providers of hsc for those who couldn’t afford it. originally set up to meet the needs of particular groups, and now responding increasingly to needs, working ss pressure groups and conducting research. Charities/not-for-profit orgs. Differ in size. usually in SC. funded by donations from individuals, organs, or findings from local auth/DHSC

Question 16

voluntary health and social care services

Answer 16

‘3rd party services’ - managed independently from DHSC. Local auth may pay for the voluntary groups to provide care on their behalf. (mixed economy of care). key features- registered charities, not for personal profit, use volunteers and paid professionals, managed independently.

Question 17

informal carers

Answer 17

part of voluntary sector. 1/8 adults providing informal care. “a personal who provides some kind of regular care for the sick, disabled or elderly living in their own or another private home” provide vital tole in filling gaps unmet by statutory hsc. increasing number = linked to increasing ageing pop. unqualified and unpaid. entitled to benefits (carers allowance = 16< providing 36+ hours a week)

Question 18

the private sector

Answer 18

profit-making, managed by commercial companies. need to make a profit to stay in business. funded by direct payments or insurance. work in HC and SC. may provide care on behalf of the State.

Eg private education/childcare.nursey, hospitals/GPs/dentists/opticians/screening, maternity services, domiciliary care, residential/nursing homes, and rehabilitation

Question 19

settings - hospitals

Answer 19

healthcare setting, treatment given by specialised staff and equipment, accessed typically from a referral from a GP or via A&E. Can choose which hospital they attend, which team of consultants they see, and what happens in their treatment.

Question 20

hospice care

Answer 20

hospice care can be either palliative or respite. Palliative = end-of-life., active, holistic care that aims to relieve pain and symptoms. Respite = provide a break for main carers. Support offered during illness and for bereavement. Offered in hospices, day services, care homes, own homes.

Question 21

residential care

Answer 21

for any vulnerable person who may have issues w. living safely/independently. A staffed home. Care homes = personal care, meals, daily living. Nursing homes = health needs, personal care, food, support with daily living, usually long term.

Question 22

settings - daycare/ day centres

Answer 22

short term, non-residential services for specific groups (tailored to needs). Meet PIES needs, and promote independence and stimulation.

Question 23

settings - domiciliary care

Answer 23

w/i SU’s home. Regular visits from a care assistant, or live-in. Lenth/focus will be based on needs. General = promotion of independence, help with personal care and living, and providing social/emotional support.

Question 24

settings - in the workplace

Answer 24

counselling, first aid, health insurance coverage, and risk assessments. May also provide a range of aids, such as disabled toilets, lifts/ramps. Occupational health risks.

Question 25

barriers - referral

Answer 25

Self referral - contact provider personally.
third party - done on behalf due to vulnerability
professional - referral from practitioner for further support

Question 26

barriers - community care assessment

Answer 26

local auth = duty of care to carry out community care assessment for vulnerable adults. Gives advice and better access to services. SU needs reassurance and info about helpful services, simple devices and adaptations , a higher level of care, or support for their carer.

Question 27

barriers - carer’s assessment

Answer 27

informal carer giving support to a vulnerable person = allows a carer’s assessment to see how much additional support may be needed. When done, Adult social care must provide a written copy of the report with needs identified and actions agreed to meet needs.

Question 28

barriers - national eligibility criteria

Answer 28

• a physical/mental impairment AND
  inability to consistently meet daily ‘outcomes’ (activities) (2+)
  
  • toilet needs
  • appropriate dress
  • prepare and eat food
  • wash self and clothes
  • use local facilities and amenities
  • move around home easily
  • access work, education, or training
  • keep accommodation safe and clean
  • carry out caring responsibilities
  • maintain r/ships and avoid isolation

Question 29

barriers - contributing to care after an assessment

Answer 29

sc not usually free of charge = means testing. financial assessment one by local auth. to take into account regular income and saving
- pensions, benefits, income from employment (if relevant)
decides if contributing and if so, how much. personal budget (from private sector) can help. Local auth has to ensure care plan is monitored and reassessed. no help if more than £23,250 in savings/income.

Question 30

barriers- sc provided free of charge by local auth for all SUs.

Answer 30

care equipment (including assessment, toileting/bathroom/food/cooking/beds/chairs/dressing devices & adaptations)
minor adaptations
help after hospital discharge

Question 31

barriers - specific needs/preferences

Answer 31

affects vulnerable people, teenagers who fall b/w adult and child care, anyone from a community/culture that could affect their treatment.

Question 32

barriers- geographical

Answer 32

costs to travel could be high ( issue for students, pensioners, minimum wages)
inconvenient locations - specialist services not available everywhere. lack of/inconsistent public transport.

Question 33

barriers - scarce resources

Answer 33

long waiting lists can put people off - may feel like they will never get seen so no point asking for help. lack of beds and staff means delayed /cancelled /rescheduled appointments. restricted opening times. lack of places in residential homes

Question 34

barriers - finances

Answer 34

costs and difficulties w. childcare to attend services or procedures.
lost of wages to attend. Not every service is free of charge. may not want to use savings/pensions for support.

Question 35

barriers -communication and sensory issues

Answer 35

difficulty with communication with providers due to discrimination, disabilities and impairments, emotional barriers, isolation and stigma

Question 36

barriers - social, cultural and psychological needs

Answer 36

phobias - unpleasant treatments,
unwillingness to seek help, embarrassment, shame. previous negative experiences, being a man. Religion/culture - care may be considered to be responsibility of family/community.

Question 37

barriers - learning needs

Answer 37

lack of understanding of condition and services available. info provided may not be adapted for people with l.disabilities. lack of advocacy services. more likely to suffer from psychological barriers when accessing services.

Question 38

barriers - physical needs

Answer 38

access to the setting may not accommodate wheelchair users or those with limited mobility. may also be made worse by geographical and financial issues,

Question 39

ways orgs represent needs of SUs - voluntary orgs and charities

Answer 39

represent SUs by contacting and liaising w. officially agencies. Can help with complaints, providing support, info, and adaptations. Usually specialised to meet needs of service users.

Question 40

representing interests of SUs
- charities - pressure groups

Answer 40

try to influence public opinion and gov decisions. contact members of parliament to raise awareness.

NSPPC- children’s act 1998 and 2014
Smoking groups - banning of smoking in public placed

Question 41

representing interests of service users
- patient participation groups

Answer 41

many CCGS run patient participant groups to meet the legal duty to involve public in decisions. they represent needs and interests of those with particular needs, provide feedback, provide volunteers, and take part in research. improve services and help with complaints.National Association for Patient Participation help GPs

Question 42

representing interests of SUs
- advocacy

Answer 42

representing a vulnerable SU. May be self/citizen/peer/professional/crisis/carer/statutory. speak on behalf, put interests and needs forward. relay info. help to empower SU and raise self esteem

Question 43

Representing of SUs
- stages of advocacy

Answer 43

1. Vulnerable SU is told about advocacy in a way they understand.
2. informed choice (should be 100% in control)
3. meeting with advocate and asking for consent. yes = r/ship builds
4. sharing of complaints, concerns, opinions to build up info
5. advocate attends meetings and represents SU (w. or w/o present), challenging any decisions

Question 44

representing SU’s - complaints policies

Answer 44

all settings must have formal complaints policies and procedures, regularly reviewed. must ensure SUs are aware of the policy and how to access it. usually on settings website. procedure and outcomes always checked by CQC. Right to have complaints dealt w. efficiently and timely, have it formally investigated, be informed of the outcome.

Question 45

representing interests of SUs
- organisations to complain to

Answer 45

HC - PALS, ombudsman, managers, CQC, NMC, GMC, HCPC, C.A.B
SC - managers, Ombudsman, CQC,/OFSTED, C.A.B
Education - OFSTED, governing body, head teacher/manager, C.A.B

Question 46

representing interests of SUs
- whistleblowing

Answer 46

reporting poor/unsafe practices done by another member of staff, to management or a governing body. ensures quality of care. common to NMC, GMC,HCPC. ALL settings as a MUST. legal protection for staff. important for protection from neglect/abuse/safeguarding. discrimination/poor quality care/ineffective working practices

Question 47

roles of regulators and inspectors
- the process

Answer 47

(registration with regulator)
identify scope and purpose of check
gather views of Sus
gather views of staff
observe
review records
look at complaints
look at documents & policies
review and come to judgement
feedback at a meeting with team&staff
publish findings and ratings
setting publishes rating
take action

Question 48

roles of regulators and inspectors
- CQC

Answer 48

For Health and adult social care
. aims to ensure services are high quality, safe, effective and compassionate. independent. works with settings to investigate complaints. Focuses on Safety, effectiveness, Caring, Responsive, Well-led.

Question 49

inspection and regulation
- CQC standards

Answer 49

person-centred care, dignity and respect, consent, safety, safeguarding, food and drink, premises and equipment, complaints, good governance, staffing, first and proper staff, duty of candour, display of ratings,

Question 50

inspection and regulation - OFSTED

Answer 50

Education and training, children’s social care. Focus on quality of education, personal development of SUs, behaviour and attitudes (both staff and SUs), leadership and management.

Question 51

regulation and inspection -
ratings

Answer 51

Outstanding//Good/Requires Improvement //Inadequate.

depending on the grade, time b/w inspections will be different. RI/I closely monitored and inspected (every year-ish) until they are G/O

Question 52

regulation and inspection
- NMC

Answer 52

regulating all nurses, midwives and nursing associates in all settings. Require registration to practice and revalidation to continue. involvement in training and initial education. provides CPD courses. settings standards via the Code of Conduct.

Question 53

regulation and inspection - RCN

Answer 53

Union for nurses in all sectors. Aims to maintain high standards through education and research, support diversity, and ensure accountability.

Question 54

regulation and inspection - GMC

Answer 54

gov. body of doctors, including GPS, surgeons and consultants. Oversee training and education,registering all doctors and deciding who is qualified to practice, setting standards and ensuring they are met, revalidating, taking action to address shortfalls in standards of treatment, investigating

Question 55

investigation and regulation - HCPC

Answer 55

For therapists, social workers, paramedics, dieticians, radiologists, etc. Requires registration, revalidation, meeting of codes of conduct,

Question 56

regulation and inspection - how services are improved

Answer 56

CPD (continuing prof. development)
investigating issues
suspending staff (temp. or permanently)
- staff are suitable and competent to practise.

Question 57

investigation and regulation - accountability to professional bodies

Answer 57

awareness and follow codes of conducts at all time. follow relevant legislation at all times. ensure revalidation is completed. follow complaints and whistleblowing procedures.

Question 58

responsibilities of orgs towards staff - NOS

Answer 58

standards and examples of best practice applying to all HSC settings. introduced in 2012. met by both professional and non-professional staff. Includes relevant training, mentoring newly experienced staff, identifying skills through pre-employment checks, quality assurance from gov bodies to identify gaps in skills in the workforce, publishing policies and procedures to all staff, performance management systems, and revalidation. can be used for performance criteria as part of staff appraisal

Question 59

responsibilities of orgs towards staff - training of practitioners

Answer 59

regulations and legislation mean providers must be registered and have sufficient no. of suitably qualified staff to meet SU needs constantly, may be specific ratios to meet, .all staff must understand how to meet NOS and undertake CPD (revalidation). Care Cert 2014 for new, unregistered non-professional staff, meaning they meet a range of basic standards (accountability, promoting/uphold care values always, working collaboratively, communicate effectively, respect confidentiality, uphold /promote equality, and strive to improve are (cpd). 15 standards, online tests,

Question 60

responsibilities of orgs towards staff - CPD (continuous professional development)

Answer 60

should be ongoing. necessary for revalidation (at least 50 hours), of face-to-face/online/on-the-job training. helps to improve care given.

Question 61

responsibilities of orgs towards staff - codes of practice and conduct

Answer 61

set of guidelines, based on legal requirements, set by gov bodies. explain how to act when at work and outside. standards should be embedded in daily practice but staff should be aware there are regular updates. 6 main areas - the essential guide to best practice, informing staff of rights and resp, outlining the expected behaviour and attitudes, how to achieve high quality, safe, compassionate care, ensuring safety.

Question 62

responsibilities of orgs towards staff - safeguarding of staff

Answer 62

• safeguarding training (updated)
• membership of gov body
• union membership
• PPE
• violent/ antisocial behaviour policy
• whistleblowing and complaints
• lone working policies
• regular h&s training
• clear line management and reporting structure
• thorough risk assessments
• settings to keep in touch with employees, (handover,email,phones)
• panic buttons, controlled access to settings
• CPD