Table of Contents
Introduction………………………………………………………………….2
Key Features of Work Practice Organisation
Key Factors which impact the Work Practice
Health, Safety & Welfare at Work: Employment & Equality
Internal and external policies and procedures
Introduction
The aim of this assignment is to submit a portfolio of work which will address the four following assessments points relating to the students Work Practice Organisation where he attended work placement.
Part (a) will include Key Features of Work Practice Organisation, size, structure, contribution to the local economy, management structure
Part (b) will include Key Factors which impact the Work Practice Organisation, globalization, communication, technology, sector related scientific breakthrough, Government policies, environment issues, diversity, resident privacy,
Part (c) will include Health, Safety and Welfare at Work: Employment and Equality, employer and employee obligations, Health and safety, working conditions
Part (d) will include Internal and external policies and procedures, recruitment, complaints procedures, fire safety, confidentiality, infection control, HIQA policies and equal opportunities
The methodology used will be independence research on the internet, tutor input and Creative Training Handbook on work practice
Key Features of Work Practice Organisation
The Secular Franciscan Order belongs to the Franciscan Family, it is a Catholic fraternity formed by the organic union whose members are moved by the Holy Spirit. The Franciscan order Established Assisi House Nursing Home in 1983. It was established to accommodate elderly women who had worked their lives in Dublin but did not have accommodation in later life. Assisi House is voluntary nursing home and is a registered charity that provides a family home environment to its residents (Franciscan Dublin, 2018)
This student did a 300 hour work placement two days a week over a five month period with a two week block period at the end of the placement.
The grounds for Assisi House where donated to the Franciscan Order by a local church in the 1980s. Assisi House is a double story building with accommodation which includes fifty single rooms; there is also a high dependency ward which can accommodate four residents. The nursing home has a day care centre and rehabilitation centres, dining area several sitting rooms. Oxygen bottles are safely secured in a designated area. Other services also include a Chapel, hair dressing several walking garden areas. There is also a library wireless free internet, all the rooms have cable t.v. and there are also music rooms where residents can reminisce to some of their favourite songs of the past.
Organisation size and structure and compare it to similar local organisations in the area, what sector are you in and how big is that sector in Ireland.
Similar Nursing Home in the area
Santa Sabina House is located directly next door to Assisi House. This is a smaller nursing home run by the Congregation of Dominican Sisters. They have 32 filly furnished state of the art nursing home. The build was also built to have a family home environment. It has a canteen, several sitting rooms a Chapel also available are hairdressing mornings and activity coordinating personal on some afternoons (Santa Sabina House. 2018)
Assisi House’s contribution to the Ireland
Assisi house makes the majority of its food for the residents from locally sourced businesses including local farmers markets. They employ several kitchen staff including chefs and bakers to create beautiful homemade dinners and desserts for the residents and nursing staff. Several of the professions are outsourced including hair pressing, activity coordinating.
All of the staff also live locally some own their homes while the majority of the staff rent locally either way the staff are generating revenue for the banks or for their landlords
The overall Irish Health Care Economy
The HSE is Ireland’s largest employer, it’s total number of employees including primary staff who they directly employ and secondary staff are employed by agencies who are funded and paid by the HSE. The number of employees has fallen from 111’770 in 2009 to 101,451 in recent years, that’s a drop of 10,000 staff. The biggest reduction in staff numbers was in general support staff, there numbers were reduced by one fifth of the total HSE workforce (The Journal. 2018).
Multi-disciplinary
The resident’s multi-disciplinary teams also include occupational therapist, physiotherapists, chiropodists, dentists, local doctors. All these professionals would live locally and the wages the make would help boost the local economy once they get paid for providing their services and then spend their earnings.
Improving Economy
The nurses who decided to take up employment in Ireland where offered a 1,500 euro relocation package grants which will help boost the economies beside the hospitals they end up working in. At the moment the minimum qualification to work for the HSE as a career is the QQI Level 5 Award in Healthcare Support he HSE are now starting to hire again in 2017 at a three day recruitment event the HSE managed to lure 190 nursing staff back from working overseas offering them permanent contracts. The Health Minister Simon Harris currently has over 1,000 job vacancies to fill (The Journal. 2018).
Global Economy
Ireland has to follow standards and policies set by the World Health Organisation their objective is to co-operate with Member States in Strengthening their policies providing financial support if necessary. They also provide health promotions with emphasis on sound evidence-bases approaches and strategies regarding planning, implementing and evaluations for countries to follow including Ireland (World Health Organization, 2018)
The Irish Healthcare Sector has many employees from around the world. For instance many Health Care Assistance and Nurses come from India and the Philippines these countries do not have Social Welfare entitlements like Ireland. Many of these foreign workers help support family members especially elderly parents in their native homes, the money they send home is spent by their families which in turn helps boosts their native home economy.
Mission Statement
Assisi House are committed to delivering a caring health care service, it aims to provide a home from home environment that fosters mutual respect for the dignity and fights of all it residents, and all care practices are aimed at reflecting a person centred approach. Assisi house’s aims to ensure that its residents and staff are happy and everyone feels safe and happy.
Assisi house continually focuses on improving and delivering the quality of hospitality and care and choices it offers residents. They understand the importance and value of the residents keeping their independence for as long as possible. Assisi house respects the residents privacy and encourage them and their families to choose how their care is planned and delivered
Assisi Aims
Assisi House see it residents as individuals and tries to give as much choice as it can in day to day living, it supports residents in maintain their independence. They hope that the residents will see the nursing home as an extension of their own homes and carry on their lifestyles as they did before knowing that they are cared for and supported by the staff.
Staff Are Committed To
Nursing Homes Ireland
Assisi House is a member of Nursing Homes Ireland. They are committed to their goals and shared vision. Nursing Homes Ireland are a single representative body of the voluntary and private Nursing Homes sector in Ireland and is a key part of the Irish Health Service. It is also Nursing Homes Irelands vision is to also insure that all residents of all Nursing Homes in Ireland will receive the same high quality care. Along side the Government and other key stakeholders Nursing Homes Ireland can influence important health decisions and policies which effect residents care services. Nursing Homes Ireland Mission Statement states that their Members are commited to the provision of high standards of support care and respect for older people who are residents in Nursing Homes within Ireland (Nursing Homes Ireland, 2018)
Organisation Structure
General Manager Stephen Wrenn
Director of Nursing Anna Joseph
Assisting Director of Nursing Sheila O’Brien
Nurses 8
Health Care Assistants 16
At Assisi House all new staff member recruits are presented with a hand book. In this hand book are the policies and procedures that staff members must abide to regard standards of equality. This booklet also provides each staff members with information regarding their role within the nursing home. If staff members fail to abide to the policies or procedures they will be reported to a senior member of staff and if necessary the General Manager will get involved and reprimand any non-compliant staff members
Assisi House is a charitable organisation which started out with the intention to provide affordable accommodation for it residents who donate the majority of their state pension which would not be editable amount to stay in a private nursing home. The nursing home is run in a professional manor which has a relaxed and calm atmosphere.
The Staff at Assisi House are trained to use the Roper-Logan-Tierney-Module which helps the staff understand the residents needs including their Physical, Social, Psychological and spiritual needs.
Assisi House practices person centred holistic care which is a way of thinking and doing things that puts individuals first. This personal centred holistic approach was developed by Dr Tom Kitwood at the university of Bradford, United Kingdom (RCNi Ltd, 2017).
Personal-centred care is not just about the nursing home providing the residents with information or whatever they want. It is about the nursing home considering the residents lifestyle, values, desires and seeing each resident as individuals and working together with them to develop a care plan for them. At Assisi House it is important that the staff are compassionate towards the residents and are trained to think about things from the residents point of view. The staff at Assisi House are also trained to assist the residents and not to do things for them regarding the Activities of Daily Living, in order to keep the residents as independent as possible residents are encouraged by staff members to do as much as possible for themselves (Health Innovation Networks, 2018).
Key Factors which impact the Work Practice
Assisi house has a residents committee it meets monthly, if any of the residents have any concerns about using the technologies they can being them up at these meetings
At Assisi House all the residents’ private living quarters have wi-fi access it is important for the residents to be able to use digital technology and to know how to go online and communicate whit family and friends via social media. The residents are encouraged to use the internet, and for the residents who are well capable and dependent they are encouraged to attend local computer courses which are organised by Age Action called Getting Started Computer Training Programmes (Age Action Ireland, 2018).
Since 2006 Age Action has trained over 32,000 elderly people in over 14 counties some of the residents at Assisi House availed of this service. Funding comes from government grants as well as the private secter. At these programs the residents at Assisi House can learn to use the internet, send emails and use skype for instance to communicate and stay in touch with their families especially if some family members are living overseas.
The Epi Care bracelet is worn by elderly residents at Assisi House who are at risk of having seizures, if the elderly person has a seizure the technology in the bracelet notifies the care team in the nursing station and members of staff can then go straight to the residents room to assist them (Tunstall, 2018).
VCare is an Electronic Care Plan used by Assisi House, this system helps to create person centred care plans for each of the residents in the nursing home and can be managed in an auditable process. Staff using this technology can update individual care plans and it can send reminders when individual care plans need to be reviewed (VCare International, 2018).
Some of the key features of VCare include
Technology relating to scientific recent breakthroughs have led to the development of a new blood test to predict if an individual is at risk of developing onset Alzheimer’s disease. This test means that anyone who shows a positive blood test for Alzheimer’s disease. This blood test is an early warning system and just a small drop of blood can give several decades of warning. Recently some resident at Assisi House have had this test after it was discussed and agreed upon by the residents and their families (Science Alert, 2018).
The Nursing Homes Support Scheme (NHSS)
Also known as the Fair Deal scheme is an initiative that provides financial support to any person who needs long-term nursing home care. Many of the residents at Assisi House have used the Nursing Homes Support Scheme.The scheme is operated by the Health Service Executive. With this scheme, individuals at Assisi House make a contribution towards the cost of their care and the State pays the balance (Citizens Information, 2016).
Approved private nursing homes, voluntary nursing homes and public nursing homes are covered with this scheme. Anyone who is resident in the State and is assessed and requires long-term nursing home care can apply for the scheme.
When applying for the scheme the residents at Assisi House care needs are assessed to confirm that long-term nursing home care is the most appropriate option. To see how much the resident will have to contribute towards their nursing home fees their financial situation will also be assessed. The HSE will pay the rest if their contribution is less than the amount of the fees (Citizens Information, 2016).
The Health Information and Quality Authority (HIQA)
The Health Information and Quality Authority was set up as an independent organisation. It has the legal power and responsibility for improving safety, quality and social care in Ireland including value of health. HIQA received its mandate and power in May 2007 under the Health Act 2007 (excluding mental health services).
The purpose for setting HIQA up was to help improve the quality and safety of Ireland’s health and social care services and in response for the regulations of nursing homes. The regulation of nursing homes involves using national standards, regulation and legislation to decide whether services are providing effective and safe care for the residents who live there. This is done through keeping a list or register of centres and inspecting and monitoring them on a regular basis to check that they are meeting the legislations and standards. By regulating these services HIQA can make sure that the quality of care provided to people living in these nursing homes are high, regardless of who is running the service (Health Information and Quality Authority, 2017)
Standards and Criteria,
The National Quality Standards for residential Care Settings for Older People have developed 32 standards and they are based on legislation. All the standards are grouped into seven different sections and are designed to reflect the dimensions of a quality service. Some of the standards include supplementary criteria that apply to units that specifically specialise in the care of people with dementia. There are sections on protection and the rights of older people, quality of life, health and social care needs, staffing, management and governance and the care environment (Health Information and Quality Authority, 2017)
Assisi house has a recycling programme that has been operating for some time now. Things like corrugated cardboard, newspapers, white office paper, mixed paper, glass bottles, aluminium can, steel cans, plastic, bottles, and jars are all recycled
Most of the residents welcome the opportunity to recycle and feel that the are doing there bit to improve the environment. Sharps and red bag waste require strict regulation for disposal which is done regularly (VCare International, 2018)
Equality and Diversity Policy
The residents at Assisi House are all of the Christian faith. However the staff on the other hand come from many different countries including Ireland, Eastern, Poland, Romania, France, Slovakia, India and the Philippines.
Assisi house promote equality and diversity and fairness throughout the nursing home. The nursing home aims to create a culture that respects and values each other’s differences that promotes diversity, dignity and equality for all. The management encourages individuals to maximise and develop their true potential.
Assisi House opposes all forms of unfair and unlawful discrimination on the grounds of marital status, gender, ethnic origin, race, nationality, colour, disability religion, age and sexual orientation for all if residents and staff members (Healthcare Homes, 2018).
Assisi House encourages families to be involved with the loved ones who are residents there. They understand that no matter how meaningful the relationships and interaction between staff are residents are that when families are involved in the care connection stays strong it can have a very positive effect with the elderly residents (Mariposa Training. 2018)
Assisi House also provides palliative care support for its residents by improving their quality of life and providing their families with information. The Palliative care team focuses on promoting comfort through relieving pain and other symptoms. The palliative care team aims to enhance the quality of life of those in care with life limiting progressive conditions and their families and addresses the needs for both the patients and their families (THE IRISH HOSPICE FOUNDATION, 2018)
Protecting residents from abuse
Legislation requires that all residents at Assisi House are protected from all forms of abuse, this includes the misuse of restraints. This legislation is available from the Health Act 2007 regarding the Care and Welfare of Residents in Designated Centres for Older People and National Quality Standards for Residential Care Settings for Older People (HIQA, 2018)
When the Irish economy took a down turn in 2008 many Irish graduate nurses where force to immigrate to find employment. In 2012 the HSE received Government approval to recruit 1,000 newly graduate nurses and midwives. However these new recruits only received 80% of their salary compared to an experienced staff nurse. The new recruits would now just earn 26,000 per annum
Many of these nurses immerageted to the UK where the basic Salary is £23,000 but they have the opportunity to make bonuses which can boost their wages up to £34,105 per annum (The Irish Times, 2018).
The recession also affected Assisi House the number of staff on shifts there are down to the minimum, for instance on the 12 hour night shift there is only one nurse and HCA on duty to cover the whole night shift. On the weekends the residents activities of daily living are kept to a minimum for instance a resident will only receive a shower if they really need one.
As a result of the housing crises in Dublin Assisi House provides accommodation for some overseas nurses, kitchen staff and grounds keepers to. The majority of the Irish staff members live locally and the overseas workers with families rent houses within 20 kilometers
Health, Safety & Welfare at Work: Employment & Equality (10 marks)
Obligations of employer and employee
The Health Service Authority (HSA) of Ireland is responsible for providing legislation to Assisi House regard health and safety in the work place, this information provided under the Safety, Health and Welfare at Work Act 2005.
The HSA function
Under Section 20 Assisi House is required to prepare a safety and health policy as part of the preparation to wright their safety statement which residents, employees and victory should follow (Health and Safety Authority, 2017a)
Under Section 8 of the Act Assisi house has a duty of care to everyone’s safety, health and welfare on the premises as far as reasonably possible.
Managements Responsibilities
The management of Assisi House are responsible for the safety and health of residents, staff and visitors while on their premises
Using the provided information from the HSA website Assisi House management can implement procedures and develop safety statements.
Communication
After the safety statement has been made available by management at Assisi House it is placed around the premises for every to see. The safety statement is written and explained in away by management so it is easily understood. Management at Assisi House at all levels can communicate powerful messages about the significance and importance of the safety and health objectives of the safety statement by leading by example. Management may use three methods of communication (1) written information provided in the statement, (2) face to face discussions with staff expressing the importance of the statement, (3) Visible behaviour allows management to observe good and bad work safety performances by the staff at Assisi House (Nitfast, 2015).
Training
Training is required under Section 19 of the 2005 Act, training should be provided at all levels of Assisi House including management; good training contributes to Assisi House’s health, safety and welfare culture. It is the duty of care of the Assisi House to provide training, and the duty of care of the employee to engage in the training provided by the company (HSA, 2017a)
During train managers and employees should be made aware of any possible hazards or risk that is associated with their duties with in the grounds of the nursing Home. When managers and employees have received adequate training under supervision they will acquire the necessary skills and knowledge to do their work safely (Nitfast, 2015).
To promote best practices at all times the management at Assisi House provide compulsory update training, this can help reinforce learning and address any deficits identified during the learning process (HSA, 2017).
Slips, trips and falls
One of the main causes of injury in health care are slips, trips and falls. Health and safety law requires any entries exits or isles in Assisi House to be safe. Access routes throughout the facility are kept free of non-necessary obstructions.
Floors are in good condition and not slippery. In order to maintain an appropriate level of safety and health within the nursing home employees practice good house-keeping practices across their departments by keeping their work areas clean as possible frequent cleaning them (HSA, 2017).
Identifying hazards and assessing risk
The workplace risk assessment at Assisi House includes a focus slips, trips and fall hazards to help protect the residents and staff members. When a hazard is identified by staff it is avoided if possible. If the risk cannot be avoided the trained staff members will implement controls measures to minimise the risk e.g. if cleaning staff are washing a corridor floor, their risk assessment instructions include that this task should be carry out when there is a low volume of traffic going through it.
When the cleaning staff at Assisi House wash right side of the corridor they place highly visible signage around the wet area but allow walking access on the left side. When the floor dries they change the signage over to the other side and repeat the process.
Warning signs do not always physically keep people of wet floors especially when many of the residents at Assisi House suffer with various forms of dementia. If a whole area needs to be washed cleaning staff may cordon of the whole area and eliminate access altogether. (HSA, 2017).
Employees Responsibilities
The Safety, Health and Welfare at Work Act 2005 clarifies and enhances the responsibilities of the employees and self-employed in relation to safety and health while carrying out their work at Assisi House
Employees at Assisi House must:
Protection of employment, Equality act 2004, Employment Equality Employment Act 1998, European communities, working visa
The Employment Equality Act 1998-2015 outlaw in an wide range of employment-related areas for Assisi House. These include
Assisi House operates different Shifts
Some of the HCA are on Social Welfare benefits these employees work less than 20 hours a week, these employees usually work a 6 hour morning shifts over three day a week.
Internal and external policies and procedures
Complaints procedure
Industrial Relations Act 1990 Code of Practice on Grievance and Disciplinary Procedures indicates that the handling of complaint at Assisi House can be addressed in a number of different stages when dealing with discipline and grievance. This can include in the first instance raising the issue with the supervisor to resolve the situation. An example of this could be if a HCA has an issue with another HCA a nurse who supervises both of them could help resolve the situation if the grievance was a miner one. If the supervisor cannot resolve the situation between the HCA’s then the matter will have to progressed through a number of steps involving more senior management.
The procedures for dealing with such issues at Assisi House must comply with the general principles of natural justice and fair procedures which include
Holidays
The Organisation of Working Time Act 1997 provides for a basic annual paid leave entitlement of 4 weeks, although an employee’s contract could give greater rights.
Assisi House follows the Organisation of Working Time Act 1997 which provides information for employees basic annual leave paid entitlements of four weeks. As many of the workforce are originally from overseas like India and Philippines over the years some employees have requested for beyond the four annual leave for instance if the where getting married at home, hover the extra leave that would be granted to them would be unpaid.Annual leave for part time workers is set 8% of hours worked throughout the year.
The Lowest rate of pay paid by Assisi House is 10 euro an hour, this is the rate that new HCA’s are paid once they have completed their work placement. New kitchen, cleaning staff with no previous experience also start of on this rate of pay then once they have gained normally one years’ experience they can apply for a raise (Citizens Information. 2018)
Smoking
All of the Residents at Assisi House have their own private rooms. As a result of many of the residents suffering with dementia smoking is not permitted within the grounds for safety reasons. Residents could start fires with cigarettes if they were not extinguished prpoerely putting their own and other people’s lives at risk.
Fire safety – how often are fire drills carried out
The legislation of the Fire Services Act of 1981 & 2003 rests with the management of Assisi House they are responsible for the duty of care regarding the Fire Safety of the Building and greater grounds. The Fire Authorities have various powers to inspect the property and to enforce fire prevention /safety measures if need be. This applies to every person who has control over the premises to which this section applies to which includes:
The Fire Safety for Assisi House rests with the management (Cannon Fire Safety Group, 2018)
Confidentiality
Before starting my placement at Assisi House in class the tutor informed the students about the importance of the residents rights to confidentiality. At the start of my placement when I was assigned to assist the experienced HCA we went through the rights of the residents to confidentiality by not discussing the residents care plans with other staff members who don not need to know like cleaners and kitchen staff.
The residents at Assisi House have the right to have privacy in their accommodation, personal intimate care, medical treatment, meeting family and friends, sending and receiving mail, using the telephone and have their clinical records kept private (Department of Health, 2018)
Infection control – what is the legislation and how is it carried out
Infection prevention and control legislation are of the up most importance in the health care sector Health Information and Quality Authority (HIQA) was established in 2007.it is an independent authority designed to deliver high-quality and safe care for people using the social and health care services in Ireland.
HIQA mandate extends across a specified range of private, public and sectos sevvices like voluntary organisations. HIQA reports directly to the Minister for Health including the Ministetfor Children and Youth Affairs. HIQA is responsible for developing standards, inspecting and reviewing health and social care services and supporting informad decisions on how services are delivered (HIQA, 2018).
Equal opportunities
The Employment Equality Act 1998 and 2004 was put in place to provide equal opportunities for all staff including the staff at Assisi House to protect their dignity at all times. All aspects of employment are covered under this legislation including recruitment and selection, conditions and dignity at work.
The legislation provides that anyone who is qualified to work in a position at Assisi House should have the right to do so regarding their marital status, race, family status, age, religion, sexual orientation disability, gender or membership of the travelling community
The legislation also lists that best recruitment practice at each stage of the selection and recruitment process can help to avoid unlawful discrimination with in Assisi House. This can also help to ensure that the most suitable person is appointed to the job that is advertises. (HSE, 2018).
Conclusion
After caring out this Work Practice Portfolio this student has learned that in Ireland a high standard of care is expected form nursing homes that operate here. Assisi house treats it residents with dignity and respect and during my 300 hour placement and completing this assignment I learned the importance of understand legislation that applies to the nursing home when it comes to following standards and applying them with the holistic care approach.
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