Home Care of Elderly Citizens - the United Kingdom Home Care Association Ltd - Research Proposal Example

Order Ref: 143069 6060 Order: Project Thesis Proposal 6th December 2006 Introduction The management and provision of social care in the United Kingdom is become more and more an "in vogue" system; that is consistently in the media spotlight. The fragile network of partnerships, networks and collaboratives that bring together these services are a necessity for the welfare of our social services that support a growing demographic time bomb elder social care provision. Home care of our elderly citizens is now becoming a more wider and constructive system of care, against a background of legislation, governance and professional standing of care personnel engaged in care occupations. In this respect, the umbrella group, United Kingdom Home Care Association Ltd (UKHCA); represents the growing Small Medium and Large (SME) organisations that are the ground force of social care. This umbrella group acts as advocate and activist against the growing weight of political change and governance for our future elder care. Therefore, I have decided to focus this study on the work of UKHCC, to explore three specific areas that are consistently in the media and of concern to both the recipients of care and the deliverer of care services in the UK. The aim of the study will be to provide coherent answers to the proposed research question: - With reference to the theoretical trends within social care; how can the UKHCC ensure the best prospects for home care provision" Within the context of this question we will focus the direction of the enquiry on three specific areas of elder care, currently in the focus of the news media:- The legislation that informs delivery of home care provision; The training and professional development of home care personnel; The concerns about the quality of care being delivered. My reason for considering this specific area of concern is that we are working in a demographic time bomb of care; as our elderly population grows, and our current elders continue to live beyond higher age trends; we are seeing a growing need to re-address, re-appraise and debate the future of care for ourselves and our elderly. At this stage it is important to discuss the work of UKHCC, to offer understanding to the wider concerns that will be explored by the research being proposed. Its own website describes its focus, which appropriately give reference to its remit: "United Kingdom Home Care Association Ltd (UKHCA) is the professional association of home care providers from the independent, voluntary, not-for-profit and statutory sectors. UKHCA helps organisations that provide social care, which may include nursing services, to people in their own homes, promoting high standards of care and providing representation with national and regional policy-makers and regulators. The Association represents over 1,500 members across the United Kingdom, in England, Wales, Scotland and Northern Ireland". www.ukhcc.org.uk (2006) Having now introduced the nature of the potential enquiry we can now move to briefly consider the current debate in literature that has informed the initial interest in this project subject and hypothesis proposed. Literature Review The culture of care has in recent years been debated and discussed within academic circles to the point where this debate now firmly focused on developing a wider theoretical understanding of this concept within the context of delivery. We shall consider briefly the three objectives within the context of current literature and academic debate. This will allow for an informed and guided focus for the potential research study that is being planned. Therefore to offer justice to the wealth of literature we would use the terms "care and home care" to be the context of our ensuring discussion that will offer a key conceptual analysis of the UKHCC, that will be the subjects of this, proposed study. This will afford firstly, an overview of: the legislation that informs delivery of home care provision in the SME's UKHCC represents; Secondly, the training and professional development of home care personnel and the incentives that UKHCC can offer to its membership within organisational constraints; and thirdly, the concerns about the quality of care being delivered in the care sector and how UKHCC as an umbrella organisation is able to inform and guide development. In recent years it has been a wider and growing concern amongst academics and care professionals that the sector is over legislated, bogged down in governance and directives that impinge and cause wider difficulties in the direction and delivery of care. In a recent study, Stephen O'Kell (2006) stated that his study found that: " the impact of the following legislation: Modernising Social Services (1998), Quality Strategy for Social Care (2000), NHS Plan (2000), National Service Framework for Older People (2001), Care Standards Act (2001) and the Health and Social Care Act (2001) It found that the large number of overlapping government initiatives currently being implemented are causing concern and confusion within the care sector". O'Kell (2006). Furthermore, it is also documented that recent trends and policies within social care governance and management structure require organisations to work together at strategic and operational levels with strategic and organisational plans to procure, present and plan services in the public interest. This includes purchasing services from charitable, voluntary and non-strategically commissioned services to work with and alongside mandated organisations to provide all aspect of social housing and care. Biggs (1993) deemed this emphasis "as a central plank in government attempts to engineer change in health and welfare services as evidence by the 1990 NHS & Community Care Act. (P. 151). Although this period was within the governance of the Conservative Government, we still have more far reaching changes that have impacted the structures of care and home care provisions. This includes devolved governance of parts of the United Kingdom that have impacted on the ways that social care is currently delivered. This is reflected in further studies that raise concerns for the future of care. UKHCC have on a number of occasions been part of the growing voice of concern, in a recent study, they cited that: " At the moment, the raft of legislation currently being implemented does not seem to have benefited care home residents, individual care homes, Registration and Inspection Units or commissioners of care. It will be interesting to see how well all the parties are able to work together over the next few years in order to improve the care services available to clients". Malcolm L. Johnson, Lesley Cullen and Demi Patsios (2006). The integration of organisations that provide key care services for frail elderly is currently a growth market for collaborative ventures between smaller SME organisations and the growing rise of advocacy organisations that represent the care recipients and those who provide care. Because of the legislative tangle, of overlapping governance there is a ongoing strategic management trend to re-evaluated, re-invent and appraised to ensure good collaborative endeavours are consistent and that the representation of the care providers by UKHCC are consistently voiced, heard and informed. This is clearly noted in academic circles in particular Davies (2004) states that such collaboration is here to stay and will be a continual area of significant growth as resources in particular financial constraints are seen more and more at the micro level of provision. The concerns for more professional and dedicated personnel within the sector, well trained and able to cope with the ever growing need for care; is of paramount importance for UKHCC. In this respect, they have secured funding for a limited number of care personnel to be trained to the National Occupational Standards; this has been obtained, through competitive means and retained to ensure that their members have some opportunities for staff development. Their website states that: "UKHCA can provide funding for up to 40% subsidy available for the following qualifications: NVQ4: 50 awards; NVQ2: 150 awards; Assessor: 50 awards. UKHCA has secured Skills for Care funding for the previous three years. We await the outcome of our bid for 2006-7 monies, which should be announced by the end of May 2006. This funding enables organisations who sign a partnership agreement with UKHCA to receive 75.00 for each induction course or NVQ unit completed" www.ukhcc.org.uk (2006). Considering the numbers engaged by UKHCC in membership, this is a very small number of training places for its membership. Training is a mandatory requirement within the care sector and as such is a growing expenditure for SME organisations. However, some are able to engage public funding through Government Schemes, like the Modern Apprenticeship Schemes, that allow those under 25 years of age to be trained for free whilst enjoying employment or employment trainee placements. However, as the care sector is in the main, staffed by personnel over this threshold cut off age, an unfair advantage is found in some SME organisations where many staff have to fund their own training to remain in the sector. This again is the reason why staff turnover is high and the skills gap is widening. Rabbi Julia Neuberger, director of the King's Fund, in a recent interview, informed the BBC that: " staff were no longer prepared to be exploited It has traditionally been women's work, and these are people who used to do it because that is what they could get. But increasingly the retail sector has been able to attract them, and the money has been better, and the work has been lighter. We think there is a real issue, particularly with an ageing population and an increased demand for these care and support workers. We think we are going to come to a crisis unless the government does something." BBC (2004). However, Government incentives, directives and programmes continue to be focused in an effort to up skill the workforce within the sector. This has been clearly due to the consistent and timely intervention of organisations like UKHCC on behalf of the care sector. This has resulted in the development of a council specifically for care training and skill development. "Skills for Care" is part of the new breed of Government Agencies that now provide a voice for specific sectors and offer support, guidance and incentives towards the skilling of the workforce. In a recent statement the Chief Executive stated that: "Our part of the Sector Skills Agreement will identify what skills are needed to ensure the adult social care workforce can provide the best possible care. It will address the skills needs of employers in both large and SME care organisations. I am confident this strategy is a significant step towards developing the skills of the social care and children's workforce to meet the needs of adults and children using services, as well as employers." "In addition to the Sector Skills Agreement, Skills for Care will also produce a Sector Learning Strategy specifying the broader qualification needs of the workforce. Skills for Care will make both plans available for consultation to ensure that they include feedback from the sector. A. Rowe Skills for Care (2006). Even though the shortfall of skills within the workforce are being addressed. Stephen O'Kell in his report: "The independent care homes sector: Implications of care staff shortages on service delivery" clearly maintains that " it does not detract from the fact that t takes time, effort and resources to recruit, induct, supervise, provide training and pay the salaries of all members of staff". He further maintained and raises concerns that employers must continue to invest in human resources as this " investment is essential if the employees are to provide high quality care and be successful members of the care team". O' Kell (2006). For this reason the continuing quality of care is essential if services are to be maintained, grown and developed to ensure that the older population is to be cared for in a manner that is befitting a caring society. Quality of care is also a growing area of concern for UKHCC who continue to maintain a voice for its membership. In this respect it focuses a growing concern on the bureaucratic governance of inspection that now informed and directs the quality of care provision in the UK. The raft of legislation provides guidance and governance for care provision and also for the focused and informative inspection of services being provided. But, as two recent academic reports concluded, they are woefully inadequate and cumbersome. This is born out in Kell's (2006) report in which he states: "A systematic approach should be used for the assessment of care quality. This should include setting standards, measuring performance, comparing performance with standards, and identifying the need for and implementing change". Kell (2006). Similar concerns are raised the Royal College of Nursing as apart of the Kell Report in that: " The Registered Homes Act (1984) provides the regulations covering registration and inspection. Some standards within the Act, for example, staffing levels and record keeping, are quite specific. Others are open to interpretation of what is "adequate" or "sufficient", for example, quality of care". "unless steps are taken to recognise the growing needs of elderly people living in residential care ... a scandal of major proportions is inevitable". Therefore, to be purposeful in itself needs to find solutions or preferred outcomes to this ongoing and widening debate for better on more constructive care provision for our elderly population. Addressing such problems are costly but, by widening the pool of organisational expertise society is more able to provide greater cohesion and resources to such problems at both the strategic level and the operational levels. This focused umbrella of expertise, found in the UKHCC, allows for the convergence of individual organisational goals to formulate better-informed goals, strategies and a one-voice approach, leading to the potential development of consensual inter-organisational focused strategies and operational planning. At this stage it is worth mentioning that such umbrella organisations like UKHCC are in themselves collaborative and there are a number of organisational theoretics that can be cited and/or considered as mandatory to the success of these groups. However, these do not fall within the scope of this research study, but are worthy on note to show coherence to the materials being explored. Organisational methodologies that impact and ensure good collaboration are exhaustive, but, considering these, we should briefly consider the complexity of organisational structures; boundaries; dynamics; power basis; trust and formulated evaluating processes that will impact on any collaborative arrangement. Bearing this in mind, we can consider the work of Handy (1993) in which he provides theoretical structures to the study of organisations and also that of Penning (1981) who categorised the notion of interdependence within organisation that would clearly impact on any further study within the context of this project. And importantly, the work of Cropper (1996) who discussed the potential dangers and values of the inter-organisational relationship that collaborating organisations can create within the structures and constructs of a collaborative. Having now provided a brief overview of the complex framework of academic and theoretical debate we move to consider the potential methodology that will inform the finding of any potential study. Methodology Firstly, the consideration between qualitative and quantitative research approaches and in deciding this, given the timescale, which method would prove more successful in the gathering of appropriate research data. Notably, quantitative methods of analysis are frequently noted for deductive research methods in which hypothesis are tested. In this respect if a survey method was adopted for this study, for example a questionnaire, it would provide raw numerical data for analysis, but it would not prove the answers to why the organisations have been successful in collaborating, unless it was balanced with another method, for example, a series of short unstructured interviews with key personnel. Therefore, it was considered more appropriate to use qualitative methods. Given the nature of the study qualitative methods, would ensure both "a richer, more vital, and greater depth [whilst more] likely to present a true picture " Haralambos & Holborn (1995). With consideration of the differences and problems associated with quantitative and qualitative approaches, serious consideration would be given to using purely a qualitative method, using structured interviews with social care professional that are within the membership of UKHCC alongside supportive documentation from the UKHCC for the data collection. The method would also involve correspondence with leading academics involved in the current study of umbrella groups. Examination of published and unpublished literature and where possible a short series of audio recorded unstructured interviews, with UKHCC members, with transcription and analysis of the raw data contrasted within the context of the literature. Final an informed choice of the actual method of collecting research data will inform the conceptual analysis of UKHCC that will impact on the success of knowing how the organisations work has been successful. However, it is also noted and not ruled out that other potential qualitative methods can be utilised, for example: observational case studies; analysis of an element of an organisations work at either the macro or micro perspective. Notwithstanding the aspect of chosen methodology, it is imperative that the method is strong enough and robust to target, glean and focus the data that will inform and create the raw data necessary to answer with consistent comparison and contrast with the academic and theoretical literature that informs the contextual analysis of organisational management trends, in this organisational study. Timescale and Resources Schedule ITEM DATE ACTIVITY 1 7/07 Approval of Research Proposal by Tutor(s) 2 7/07 Meeting/arrangements to discuss the project with UKHCC 3 7/07 Research academic literature and contact such sources 4 9/07 Tutor Meeting to discuss preliminary findings research to remain Focused 5 9/07 Meeting with UKHCC personnel 6 10/07 Meeting with a group of UKHCC members with UKHCC approval 7 10.07 Finalise the academic research 8 11/07 Meet with Tutor 9 11/07 Prepare the first draft of the literature review 10 01/08 Submit the literature review for tutor comments 11 01/08 Re-draft the literature review 12 01/08 Transcribe and write the findings informed by the literature review 13 01/08 Tutor meeting 14 02/08 Write the Methodology and Introduction 15 02/08 Present the Methodology and Introduction to Tutor 16 02/08 Re-draft the Methodology and Introduction 17 03/08 Review the drafts and where necessary re-write the materials 18 03/08 Write up the findings 19 03/08 Meet with Tutor 20 03/08 Write up the conclusion 21 03/08 Ensure grammatical, spelling and punctuation are correct. 22 04/08 Meeting with Tutor 23 04/08 Write thank you letters to those professionals who have kindly assisted the research 24 04/08 Present the study to the tutor in accordance with the required regulations for submission. Bibliography Biggs s. (1993) "User participation and interprofessional collaboration in community care J. of Interprofessional Care (vol 7: No 2 pp. 151-159) Baldwin M. (2000) Care Management and Community Care: Social Work Discretion and the Construction of Policy Cropper S. (1996) "Collaborative working and the issue of sustainability" in Huxham c (ed) (1996) Creating Collaborative Advantage Sage London. Pp 80-100. " Davies. B. (2004) "integration of health and social services for frail older people in England: implications of service and care management productivities for prioritising policy effort" Cited on: Read More