Describe about the Optimising Nutrition in Residential Aged Care.
The residential care in the USA contains the society’s most vulnerable people. These people have experienced family loss, violence, suffered abuse, before they entered into residential care. Residential care homes came into existence since the sixteen century. Children in this care facility mainly have a vulnerable background. Their past plays a role in their social and emotional stability after they enter into residential care. According to Gordon et al. (2013) in UK, 10000 children in the residential setting are purchased and provided by welfare agencies every night.
The essay describes the active management in day care and residential settings and fundamental aspects related to it. It demonstrates the equality and diversity issues about efficient management of care setting. Next to this, the importance of working within a multi-disciplinary network will be highlighted as well reflect on the team role in the multi-agency environment. Later, it will discuss the role played by the Health Care Trusts, Local Government in maintaining the contract of registration to provide care services. In this context, the essay will explore the approaches to achieve such contract and the statutory requirements that need to be fulfilled.
Effective management is essential in a residential care setting. Effective management includes centralizing the interests of residents in any activity. According to Munn-Giddings et al. (2013), the care services provided to the young people or in children’s homes require identifying as to what is personally important to them to obtain the desired goals.
The care in the residential setting focuses mainly on the “quality of life”. It takes various factors into consideration such as social contacts, evaluation of individuals, staff knowledge and resident activities. This is required to eliminate gaps in care especially the psycho-social aspects. The management should incorporate at its heart the person-centered plan (Marventano et al. 2015).
According to Sainero et al. (2014) effective management includes taking responsibility for various day to day challenges such as:
Executing proper workforce planning and ensuring that the services comply with Acts and standards and identifying gaps in care, eliminating risk factors (health record, age, offense, etc.). It also includes ensuring that all the residents have “person-centered plan” that is made meet the desired outcome that is to help them in getting social and mental stability. Monitor the decision-making capacity of the clients and to maintain the balance between fulfilling the care services and enabling the individual to make choices. It includes safeguarding their rights by prevention of abuse by professionals and any other threats.
Effective Management influences the initiatives of quality improvement (Edlich et al. 2014). There are several challenges which arise due to changes in the ill health of people or children, their disabilities, and changes in the lifestyle of older people. Ensuring the privacy, dignity, respect, freedom of decision-making of the clients is the biggest challenge of residential care. It ‘s hard to balance maintaining the independence of the people in making personal choices and managing risks. Aftercare is affected when negative attitude from staff such as verbal abuse, neglect of care, lack of facility to launch complain in the Institute and source of entertainment say, internet services or television. A particular approach may not solve all the problems. It is necessary to address these challenges with strategic management ensuring that it does not affect the safety and freedom of the service users (Eekelaar and Dingwall 2013).
Care providers sometimes may need to find the creative solution for handling situation which they perceive to be risky. For example, if Mr. X 85 years old and has a desire to go out for an evening walk alone, then it is better to provide him with a camera and ask him to photograph to know where he is going. It is a win-win situation for both the client and carer. The client would have dissatisfied due to miscommunication if he was denied to go out alone or if accompanied by a nurse. Creative measures are required in case of older people with memory loss (Chor et al. 2012).
Risk assessment in care planning includes implementation of safe activities and exercising “duty of care” by a maintaining balance between people during dilemma and in decision- making (Eekelaar and Dingwall 2013). It also requires ensuring clear policies in processes. Coulourides Kogan et al. (2016) believe that the residents and the staff are benefited from the care providers who are protective of their safety and rights and maintain effective communication. Clients are satisfied only when carers maintain the trust in the relationship (Doyle and Cronin 2016). This will be discussed further at a residential care home to evaluate the concepts related to identity, right, inequality knowledge, and other aspects such as legislations.
The “Clara Court” in UK, Maidenhead is a care facility that makes a significant contribution to healthcare. It is well furnished with 76 rooms and offers a range of care requirements. The registered care services provided by Clara Court are Dementia and specialist care services are Alzheimer’s and Parkinson’s disease. The core of the residential care services is the integration of “equality and diversity” into their policy development, employment practices and service delivery. It implements the guidelines of “The Equality Act 2010”. It works best to eliminate unfair discrimination, promote good relations and equality of opportunity. It promotes diversity by creating the culture where individuals have valued as well as their differences and given opportunities to thrive and contribute (Careuk.com, 2016). Maintaining the client’s dignity and respect is an integral part of their services for which it strictly follows “Dignity Resource Guide.” Its dignified care includes a provision of privacy, communication, autonomy, end of life care, eating and nutrition, pain control and social inclusion. It is in compliance with “Mental Capacity Act 2005”, “Disability Discrimination Act 1995 and 2005”, “Sex Discrimination Act 1975. The residents have the freedom of expression, thought, and religion. It protects the “Right to respect for private and family life” of the inhabitants. It is in compliance with the Care Act 2014. There is no discrimination here related to sex. Physical and verbal abuse, whistleblowing are restricted and punishable (Careuk.com, 2016).
Residential care services comprise of the multidisciplinary network. It includes people of different professional background working together and has a common goal. The essence of the multidisciplinary team lies in its ability to maximize the effectiveness of the services. Graham et al. (2013) believe that it is essential to provide holistic care to the patients across the boundaries of “primary, secondary and tertiary care” and throughout their “disease trajectory.”
However, a multidisciplinary team does not function merely by getting together members of a different profession. Instead, a proper team is required where its members have shared values and goals and know to respect the competencies of the other members of the team, their perspectives and views (Bennett et al. 2015). According to Harrington, (2015) teamwork is the critical ingredient required to deliver residential care practice. Blake et al. (2015) believe that teamwork is crucial for young people as well as staff in the experience of residential care as it is critical to the quality of attention and staff morale. The members of a multidisciplinary team must clearly negotiate the care planning and delivery for effective patient outcomes. The role of each member should be well defined to ensure optimum functioning of the team. Van Malderen et al. (2013) believes that working in the team requires respect and trust between team members; the best use of the skill mix within the team; agreed clinical governance structures; agreed on systems and protocols for communication and interaction between team members (Oates 2013).
Multidisciplinary teams provide many benefits to the patients as well as the health professionals in the team (Munn-Giddings and Winter 2013). It involves enhanced clinical outcomes and increased satisfaction for clients. It also includes efficient utilization of resources and improved job satisfaction for team members. It ensures continuity of care and enhances the ability to take the holistic and compressive view of the needs of the service users (Agarwal et al. 2016). The other benefit includes the availability of mutual support, range of skills and education. According to Sainero et al. (2014) working in a community, multidisciplinary teams makes available the functions to the service users such as continuing and long-term proactive care for people with health problems and those needing care. There must be 24-hour access to support, information, intervention and treatment during a crisis. The requests for help from primary care are responded in an organized way (Eekelaar and Dingwall 2013).
The local government plays a role in policy making. The terms “social inclusion agenda” and “well-being” are relevant in policy relevance. Both The Children’s Act 1989 and the Children Living Care Act 2000 ensure that the younger people have their rights protected once they are out of the care system (Marventano et al. 2015). The National Institute for Health and Care Excellence (NICE), which is an independent organization, provides advice and guidance for improvement of health and social care. The Department of Health 2014 formulates standards that are fundamental in nature and mandates it to be followed by social care providers (Doyle and Cronin 2016). It emphasizes on the significance of “person-centred care” and provision of health improving activities as well as mental stimulation (Munn-Giddings and Winter 2013).
To commission care services, the residential care settings, contract of registration is essential that contain all the clauses and criteria that are to be meet (Doyle and Cronin 2016). The members of the “Department’s Public Health Contract Advisory Group” were mainly responsible for developing the contract. The Advisory Group consists of representatives of local government, commissioners, public health professionals and representatives of the VCSE sector (Gordon et al. 2013).
The wider registration requirements are mentioned in “Health and Social Care Act 2008 (the ‘Act’).” The care homes must work by this Act and other regulations. The service provider and the care services must register with Care Quality Commission (CQC) and “the Care & Social Services Inspectorate Wales (CSSIW)” (Oates 2013). The care services meet the “National Minimum Care Standards” that is applicable for the particular services. The care services must meet all the legal requirements related to food and hygiene, health and safety, as well as meet the standards of local government agencies (Gordon et al. 2013). Legal requirements related to sex discrimination, race relations, equal opportunities, employment, disability discrimination, human rights and data protection are needed to be satisfied (Eekelaar and Dingwall 2013). The care service centers are eligible to receive contract only after meeting above discussed criteria. Additionally, financial management should be sound enough with a sizeable budget for the purchase of furniture, protective clothing, food, stationery, medical supplies, cleaning materials, and other requirements of residents (Marventano et al. 2015). A resident home cannot run successfully without strong economic stability.
The service providers are required to comply with the criteria provided by “Directions and the Local Involvement Network” and must acknowledge themselves as independent providers (Doyle and Cronin 2016). The local authorities have to abide by the contract to commission the services and satisfy their function about public health whether or not it is under section 2B. It includes: Tobacco and smoking control services, health check assessments, initiatives on nutrition, alcohol and drug misuse services and public health services for children and young people aged 5-19 (including Healthy Child Programme 5-19) (Coulourides Kogan et al. 2016).
The residential home mainly functions with the goal of providing residents with a safe living environment, independence and choice irrespective of age. The essential functions of effective management that is the roles and the responsibilities taken by the registered manager make the residential home successful in its goals (Munn-Giddings and Winter 2013). Residential care supports the achievement of an individual’s outcomes towards a positive and secure future as a “fully participating citizen”. It can provide an environment for adapting to the changes in capacity and ability in the later stages of life. A registered manager is a key person to make the resident home a positive and a happy place to live.
References
Agarwal, E., Marshall, S., Miller, M. and Isenring, E., 2016. Optimising nutrition in residential aged care: a narrative review. Maturitas.
Bennett, M.K., Ward, E.C., Scarinci, N.A. and Waite, M.C., 2015. Service providers’ perceptions of working in residential aged care: a qualitative cross-sectional analysis. Ageing and Society, 35(09), pp.1989-2010.
Blake, A., Sparrow, N. and Field, S., 2015. Care Quality Commission.InnovAiT: Education and inspiration for general practice, 8(7), pp.431-435.
Careuk.com. (2016). Clara Court. [online] Available at: https://www.careuk.com/care-homes/clara-court-maidenhead [Accessed 30 Jun. 2016].
Chor, K.H.B., McClelland, G.M., Weiner, D.A., Jordan, N. and Lyons, J.S., 2012. Predicting outcomes of children in residential treatment: A comparison of a decision support algorithm and a multidisciplinary team decision model.Children and Youth Services Review, 34(12), pp.2345-2352.
Coulourides Kogan, A., Wilber, K. and Mosqueda, L., 2016. Moving Toward Implementation of Personâ€ÂCentered Care for Older Adults in Communityâ€ÂBased Medical and Social Service Settings:“You Only Get Things Done When Working in Concert with Clients”. Journal of the American Geriatrics Society, 64(1), pp.e8-e14.
Doyle, S. and Cronin, I., 2016. Mooncoin Residential Care Centre, Polerone Road, Mooncoin, via Waterford, Kilkenny.
Edlich, R.F., Garrison, J.A. and Nearents, J.E., 2014. Compliance of the Americans With Disability Act. Journal of Emergency Medicine, 46(3), pp.387-389.
Eekelaar, J. and Dingwall, R., 2013. The Reform of Child Care Law: A Practical Guide to the Children Act 1989. Routledge.
Gordon, A.L., Franklin, M., Bradshaw, L., Logan, P., Elliott, R. and Gladman, J.R., 2013. Health status of UK care home residents: a cohort study. Age and ageing, p.aft077.
Graham, F., Sinnott, K.A., Snell, D.L., Martin, R. and Freeman, C., 2013. A more “normal” life: Residents’, family, staff, and managers’ experience of active support at a residential facility for people with physical and intellectual impairments. Journal of Intellectual and Developmental Disability, 38(3), pp.256-264.
Harrington, M., 2015. A designated centre for people with disabilities operated by St Aidan’s Day Care Centre Limited, Wexford.
Mahadevan, R. and Houston, R., 2015. Supporting Social Service Delivery through Medicaid Accountable Care Organizations: Early State Efforts.Center for Health Care Strategies. February.
Marventano, S., Prietoâ€ÂFlores, M.E., Sanzâ€ÂBarbero, B., Martínâ€ÂGarcía, S., Fernandezâ€ÂMayoralas, G., Rojoâ€ÂPerez, F., Martinezâ€ÂMartin, P. and Forjaz, M.J., 2015. Quality of life in older people with dementia: A multilevel study of individual attributes and residential care center characteristics. Geriatrics & gerontology international, 15(1), pp.104-110.
Munn-Giddings, C. and Winter, R., 2013. A handbook for action research in health and social care. Routledge.
Oates, R.K., 2013. The spectrum of child abuse: Assessment, treatment and prevention. Routledge.
Sainero, A., Bravo, A. and del Valle, J.F., 2014. Examining Needs and Referrals to Mental Health Services for Children in Residential Care in Spain An Empirical Study in an Autonomous Community. Journal of Emotional and Behavioral Disorders, 22(1), pp.16-26.
Van Malderen, L., Mets, T. and Gorus, E., 2013. Interventions to enhance the Quality of Life of older people in residential long-term care: a systematic review. Ageing research reviews, 12(1), pp.141-150.
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