Patricia Duff and Rosemary Hurtley
This paper seeks to describe a method of assessing and achieving a person‐centred culture of care, developed for care homes. It considers the results of a pilot study adapted for…
Abstract
Purpose
This paper seeks to describe a method of assessing and achieving a person‐centred culture of care, developed for care homes. It considers the results of a pilot study adapted for domiciliary services and comments on the results of the evaluation.
Design/methodology/approach
A case study describes the development of a framework and audit of a culture of care, from which practice development and quality improvement work flows, from an in‐depth 360 ° feedback exercise. Data were garnered from clients, relatives, staff and managers, and triangulated with observation and documentary review.
Findings
The audit results provide a route map for action planning towards continuous sustained improvement. Examples of specific actions taken demonstrate the positive benefits to the clients, families, staff and management with value added business and efficiency improvements.
Practical implications
This paper raises important practice development issues both inside and outside the agency's responsibility. Use of the tool would enable cultural and interface issues affecting the client experience along with possible causes to help collaborative ways of working and integration of health and social care.
Social implications
The 360 Standard Framework (SF) (Domiciliary Settings (DS)) will help organisations provide evidence for a journey towards excellence and give the public confidence that the client experience is at the heart of the business.
Originality/value
The 360 SF is the first triangulated, diagnostic, assessment framework that measures the care culture based on the triangulated relationships for relationship activated care in DS.
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Patricia Duff OBE and Rosemary Hurtley
This paper aims to highlight the benefits of the 360 SF diagnostic audit for assessing person centeredness of a domiciliary agency and to highlight the challenges they face with…
Abstract
Purpose
This paper aims to highlight the benefits of the 360 SF diagnostic audit for assessing person centeredness of a domiciliary agency and to highlight the challenges they face with some suggested actions. These are exemplars of what is raised in policy and recent reports relating to personalisation, dignity and integration of health and social care and have wider implications for all agencies as they strive to resolve issues for the client.
Design/methodology/approach
The approach is a case study describing results of the audit in relation to challenges that include practice development needs, inter agency co‐ordination, collaboration and co‐operation for the achievement of relationship based person centered outcomes in quality improvement work. The pilot study involved data gathered from the clients, relatives and staff, which were analyzed resulting in findings, conclusions and suggestions for ongoing improvement from which action plans were devised and implemented.
Findings
The audit results provide examples of the primary interface relationship and co‐ordination challenges, highlighting leaning needs for staff delivering person centred care in domiciliary settings.
Practical implications
This paper raises important practice development issues both inside and outside the agency's responsibility. Use of the tool would support cultural and interface relationship issues affecting the client experience and highlight ways to assist the achievement of collaborative ways of working needed for the integration of health and social care.
Social implications
The 360 SF (DS) can help organisations provide evidence to CQC and the public for their performance and identify the close interface relationships and their effectiveness in delivering co‐ordinated and integrated health and social care.
Originality/value
The 360 SF DOM has highlighted with evidence the challenges of the systemic culture at the interface, in particular the nature and quality of collaboration, communication and practice development needs across the organisational divide to deliver person centred care and support.
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While the future funding of social care currently has perhaps the highest public profile in the need to reform social care, not far behind is the agenda to transform social care…
Abstract
While the future funding of social care currently has perhaps the highest public profile in the need to reform social care, not far behind is the agenda to transform social care from its prevailing rigid and service‐centred culture to one that is personalised. The core driver used by the government to achieve personalisation is to give people ‘choice and control’ through the provision of personal budgets. This is the allocation of sums of money ‘up front’ to allow people to choose and commission their own support systems. The new coalition government has signalled its wish to not only endorse this approach, but to accelerate its implementation. However, there is growing evidence that while this will work very well for people and those around them with the will, the skills and the time to make a success of it, for most it will not result in real change. This is especially the case for older people. This article explores this issue, but carries the message that personalisation can and should be made a reality for all service users and all older people. However, it will require a commitment to a transformational change programme within councils that goes beyond simply achieving well against the former government's performance indicator of numbers with personal budgets.
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Julienne Meyer, Hazel Heath, Cheryl Holman and Tom Owen
This paper highlights the need for researchers to work across disciplinary boundaries in order to capture the complexity that care practitioners have to engage with everyday in…
Abstract
This paper highlights the need for researchers to work across disciplinary boundaries in order to capture the complexity that care practitioners have to engage with everyday in care home settings. Drawing on findings from a literature review on the complexity of loss in continuing care institutions for older people, the case is made for less victim blaming and more appreciative approaches to research. The way this thinking informed the development of a further literature review on quality of life in care homes (My Home Life) is discussed. Findings from this second study are shared by illustrating key messages with quotes from older residents, relatives and staff living, visiting and working in care homes. These best practice messages focus on: transition into a care home; working to help residents maintain their identity; creating community within care homes; shared decision‐making; health and health services; end‐of‐life care; keeping the workforce fit for purpose, and promoting positive culture. The importance of collaborative working in both research and practice is discussed. The paper is likely to be of interest to all those concerned with improving and developing evidence‐based practice in the care home sector, including users and service providers, managers, commissioners and inspectors, policy‐makers, researchers and teachers.