Legislative Impact on Quality Care: Winterbourne View Case Study

Introduction

The laws and legislations in the health and social care settings are effective to maintain the quality standard in the care homes as well as follow the ethical code of conduct for maximising the professional intelligence and practitioner’s practice to serve the patients with care and support (Pandya-Wood, Barron and Elliott, 2017). The report provides a scope to demonstrate the legislations, organisational policies and practice in Winterbourne as well as identify the shortfalls in managing patient’s safety and care which in turn helps to acknowledge the existing practiced in Winterbourne and review the practice for better management and patient’s care. Through describing the existing policies and legislations in the care home, it is possible to acknowledge the relationship between the ethical code of conduct and professional standard of Winterbourne, where through following the existing rules and legislation as well as national policies of government, the organisation Winterbourne can manage their ethical practice and deliver high quality care and patient’s safety proficiently. The Winterbourne View was a private owned hospital, in south Gloucestershire, operates by Castle beck Care Limited, which had been opened in the year of 2006. It was designed with the accommodation of 24 patients in two separate wards and it was registered as a hospital prodding assessed, treatment, rehabilitation for the people with learning disabilities (McGregor, 2012).

Summarising legislations, organisational policies and practice

The purpose of health care polices and legislative framework is to standardise the daily activities in the hospital so that the service providers can support the service users with efficient treatment and quality care successfully. in this regard, there are certain legislations such as Health and Social Care Act 2012, care Act 2014, Equality Act 2010 and Freedom of Information Act 2000, as amended 2014 are effective to meet the standard of care in the health and social care settings, where the staff members and health care professionals try to empower the patients and maximise their values by delivering proper care and treatment. Nursing Homes Regulations 2005 and Mental Capacity Act 2005 are also effective to treat the patients with learning disabilities where the staff and professionals implement the act in the hospital so that they can manage ethical rules and manage the mental capacity while treating the patients with care (NHS, 2018). In addition to these, the organisational policies and practice of safety, competence scientific and ethical conduct is effective to manage the safety and security of the patients in the hospitals. Additionally, the Patient, Service User and Public Involvement, integrity, quality and transparency are also important organisational policies to create values for the patients in the health and social care settings, where all the patients are treated fairly ain which integrity of the care record and duty of care are ensured by the professionals. Hereby, all the above mentioned legislations and ethical code of conduct as well as organisational policies and practice are beneficial to maximise the professional standard and it in turn helps to improve patient’s safety where the nurses and doctors are trying to treat the patients with quality care and efficient treatment according to their health needs and personal preferences (World Health organisation, 2019).

Shortfalls in managing patient’s safety and care

The organisation Winterbourne view faced the problem in the year of 2011, where the behaviour of the staff sometimes made the family members of the patients worry where the patients are with learning disabilities ad autism. It is a major issue due to lack of lack of ethical code of conduct and improper implementation of the policies and practice in the organisation for which the organisation did not able to serve the patients with proper care and safety. As per the BBC news, the staff members in the Winterbourne view hurt and slap the patients, stayed in the hospital and it was a big controversy for the organisation where the government, National Health Service (NHS) and Care Quality Commission (CQC) took active initiative to investigate as this is related to injustice with the patients and their families. It has been also seen that, the staff members sat on the patients and stop them by chairs so that the patients cannot move (Flynn, 2012). Moreover, the patients were bullied and the patients are treated so rudely at the hospital for which the hospital is closed now and it is under investigation of the government and CQC. It is injustice for the patients where the staff and practitioners in the Winterbourne view failed to treat the patients with quality care and support. The rude behaviour and the ways of treating are crime in the health and social care context where the health care professionals in Winterbourne view failed to follow the ethical principles, guidance of CQC and NHS as well as rules and legislations in the health and social care settings. It has been found that, there were many patients in the Winterbourne view who had been hurt they felt lack of safety and security in the hospital. Some patients went for accidents and suicidal attempt as they tried to hurt themselves due to such injustice and rude behaviour. The patients complained to their families and friends and hospital managers and they did not believe the patient’s voice (Café, 2012).

Explaining the outcome of the shortfalls

The outcome of such incident in the Winterbourne view was dangerous as the hospital is closed now and it is under investigation of the government, NHS ad CQC. There were many patients who felt unsafe at the place and they try to infirm their family members and friend and the family members inform the managers and professionals at the Winterbourne view, but they did not believe that. It is a serious injustice for the patients with learning disabilities where the staff members did not treat them safely rather the patients were hurt and bullied at the hospital. The patient’s safety and safeguarding the patients were not there in the Winterbourne view for which the NHS and CQC took the responsibility of taking care of the people as they need proper treatment and quality care to overcome their trauma. Lack of management of the health and safety legislations and ethical code of conduct further created worse situation for the patients, where the patients were not feeling safe at the hospital., the staff members were not trained and they did not concern about the ethical practice of treating the patients with quality care and respect and integrity for which they face difficulties and they were also sent to jail for such misbehaviour and lack of quality and care and treating patients with learning disabilities (The Guardian, 2012).

Reviewing the ethical practice among the workers in Winterbourne view

It is necessary for the staff members in the health and social care settings to maintain all the ethical principles sop that it is possible to manage the patient’s safety and quality of care successfully so that they can maximise professional standard at the workplace. In this context, as per the ethical code of conduct, it is necessary to do all the responsibility of the nurses and staff members, where in Winterbourne view, the staff members were unskilled and they behave rudely with the patients. They were not at all knowledgeable to treat the patients with care where the patients are suffering from learning disabilities. Managing integrity and respecting all the patients is necessary as per the ethical code of conduct in the health and social care context. However, the staffs in Winterbourne view were not concerned about respecting the patients and treat them with integrity. The staff needed to give priority to the patients and understand their actual needs and preferences so that they can get proper support and quality care. Lack of support to the patients and lack of respect and integrity further deteriorated the quality of care on the Winterbourne view. The managers and the health care professionals in the Winterbourne view implemented the ethical code of conduct but as per the record, the staff members were not trained (Department of Health, n.d.). There was lack of training and development program for the staff for which the staff did not follow any ethical practice in the workplace. Moreover, maintaining justice with the patients in the hospital is another ethical principle but the staff continuously did injustice with the patients by hurting and slapping the patients, which is crime in the health and social care settings. Managing competencies and managing transparency and accountability are also necessary as per the ethical code of conduct, so that it is possible to manage human relations and treat all the patients with respect for people’s rights and dignity.

However, in the Winterbourne view, the staff were not handling the patients politely rather the patients were bullied and it is unethical behaviour for the patients with learning disabilities. Managing safety, health and wellbeing of the individuals is another ethical code of conduct, where the managers and professional in the Winterbourne view were concerned about managing health and safety of the patients, but the nurses and staff were not concerned about managing safety and security of the patients with learning disabilities (Department of Health, 2012). The nurses behaved rudely and teat the patients unethically where the patients were bullied, hurt physically and mentally as well as got slapped by the staff which are crime in the health and social care context. In order to resolve these ethical issues, the government of England took proper step with proper cooperation with NHS and CQC to handle the patients in Winterbourne view by efficient physical intervention as the patients need proper support and treatment form the proficient health and social care professions. The ethical code of conduct of justice, responsibility, integrity and respect and patient’s safety and security for the wellbeing of the people are effective in the country where the government, NSH and CQC are working collaboratively to treat the patients with quality care and standard treatment so that they can overcome their traumatic situation and get rid of the problems of learning disabilities (Bubb, 2014).

There was clear management failure in the v and the closed and punitive culture at the hospital had developed which needs to be resolved and the government in this regard took active initiative to mitigate the issue and save the patients with quality care and support. The government took the initiative to maintain the quality standard set by CQC as well as stronger accountability and corporate responsibility for the patients and private and care homes are effective to maximise safeguarding the people successfully. Moreover, the regulation of CQC is related to greater inspection of the service providers as well as building string relations with the service users and their families so that it is possible to improve patient’s involvement and empowerment so that the patients also can take active part in developing care plan for themselves. Improving quality standard and recruiting more trained staff at the hospital are also necessary step by the government of England where the ethical code of practice must be maintained by all the staff in the health and social care settings. National support and local planning with government led improvement team with proper cooperation of NHS further promotes quality standard by working as a partnership basis and ensure the adults with challenging behaviours get the support they need (NHS, 2017).

Analysing the impacts of the legislations and practice in Winterbourne

The impact of above mentioned ethical code of conduct in the health and social care settings are positive, where the staff members are trained well to treat the patients with quality care and effective treatment. The ethical code of conduct further provides a scope to improve patient’s safety and security at the hospital where the staff can manage the patients with respect and dignity so that human rights of the patients can be fulfilled. The patients are also treated well with latest treatment and quality acre and support so that the wellbeing of the people can be enhanced. The staff can cooperate with the doctors and professionals to manage the patients and improve their standard of living by delivering high quality treatment and care what the patients need. In addition to these, the legislations and organisational practice of managing patient’s data and information, cooperating with the patients and enhancing communication with them for empowering the people in the care plan are also beneficial for create values for the patients and cooperating with them for maximising their wellbeing by overcoming their learning disabilities (NHS, 2019).

Describing relationship between the legislations and professional standard of Winterbourne view with proper recommendations

There are key legislations and principles through which it is possible for the staff to manage the patient’s safety and security successfully in Winterbourne view. The Health and Social care Act 2012 is important where the NHS and Public Health England focus on implementing the law for resolving the issue of inequality where they try to safeguard the entire patient with equally in the country so that each of the patients can access quality care and proper treatment. In addition to these, the Equality Act 2010 is also another legislation through which the equality among the patients in accessing care can be managed where the staff members and clinical bodies are concerned about treating the people fairly by managing transparency and accountability as well as conducting all the responsibilities of the staff successfully. Social Value Act 2012 is another legislation through which it is possible to create values for the people by providing proper treatment and care and it would also be beneficial for the Winterbourne view to implement this act in order to maximise wellbeing of the individuals through delivering quality care and efficient treatment as per the needs and personal preferences of the patients with learning disabilities. Improving empowerment of the patients and managing the Human Rights of the people are also necessary for the professionals and staff members of Winterbourne view so that they can treat the patients equally and maximise their rights by respecting them and managing the dignity at the hospital. Moreover, it is necessary to follow the ethical code of conduct in order to maximise the professional standard in the Winterbourne view and in this regard, empowering the patients in the care plan and proper cooperation and communication are important. The staff members need to empower each patient and cooperate with them and enhance communication so that it is possible to acknowledge their actual needs and preferences successfully. In addition to these, the staff needs to resolve the above mentioned ethical issues and improve the quality standard, set by CQC and NHS in order to treat the patients fairly and give them appropriate treatment and support as per they need.

Conclusion

It can be concluded that, the ethical code of conduct as well as legislations and national policies of NHS and CQC and Government intervention are crucial for maximising the patient’s values in the hospital where the trained staff and professionals are trying to empower the service user and their families in order to develop effective care plan. Integrated working practice and partnership working further enhance the quality of care in the hospital where the staff and doctors are trying to create values for the patients by delivering quality care and treatment according to the health needs and personal preferences of the patients.

Legislations and ethical practice for health and social care practitioners

The ethical practice of working with others, partnership working practice and communication and cooperation are effective to improve the standard of professional at the hospital.

Minimising risk at the hospital and enhancing one performance through learning activities and conducting more research in health care settings are also necessary for the practitioners to support the patients with proper treatment and efficient care (Glasby, 2017).

Professional behaviour, organisational protocol of treating the patients fairly with respect and integrity as well as empowerment of the patients in the care plan are also beneficial for the practitioners to enhance the quality of care in the health and social care settings.

The legalisations such as, Health and Social Care Act 2012, Care Act 2014, Equality Act 2010, Freedom of Information Act 2000, Nursing Homes Regulations 2005 and Mental Capacity Act 2005 as well as the guidance of CQC and NHS are followed by the health and social care practitioners in order to enhance their performance and deliver high quality care and patients’ safety proficiently (Harriss, MacSween and Atkinson, 2017).

Relationship between key legislation and national policy relevant to health and care settings

The legislations and national policies with government intervention and the cooperation with the NHS and CQC are helpful and it has crucial impacts for the health and social care settings.

It is the responsibility of all the health and social care professionals to maintain all the legislations and rules in order to work fairly and maximise the aim of the health and social care organisation. In addition to these, the national health policies and practice further provides a scope to all the staff and health care professionals to follow proper guidelines to conduct their own roles and responsibilities at the hospital. Hereby, they can perform better with proper utilisation of the organisational resources and technology to serve the patients successfully (Colby and Dziegielewski, 2016).

The relationship between the legislative framework and national policy is helpful in the context of health and social care where the government is concerned about the above mentioned health policies and practice where the national policies are developed with the help of rules and legislations where the acts are effective for the care professionals to follow each of the criteria to serve the patients in a better way.

Ethical dilemmas in health and care settings

Lack of respect for anonymity and confidentiality and poor privacy are the ethical dilemmas for which the quality standard of the hospital is hampered. In addition to these, unskilled staffs, presence of non-clinical professionals and poor management is also other ethical issues for which the patients cannot get proper treatment and care at the hospitals.

The employees and professionals at the hospitals as well as the management team fail to handle the organisational protocol top maximise patients safely. On the other hand, lack of quality and lack of trust and loyalty further deteriorate the quality of the care at the hospitals due to inefficiency among the staff members and there is high presence of non-trained and non-clinical staff members.

Additionally, poor communication and non-cooperation are other ethical dilemma, for which the working in partnership cannot be built in the hospital where the staff and heath care professionals also fail to implement the above mentioned legislative framework at the hospital. This in turn raises issues in the quality care and delivering proper treatment to the patients.

Lack of informed consent, negligence and lack of duty of care and lack of transparency and accountability, equality are also serious ethical dilemmas in the organisation for which, the health and social care organisations face difficulties to serve the patients with better care and support (Hall et al., 2018).

Evaluating national system of government

National system of government focuses on quality standard of care where it is necessary to provide proper training to the staff members and develop organisational infrastructure so that they can provide best quality care and treatment to the patients. This in turn helps the health and social care practitioners to have proper infrastructure and technology to treat the patients and support the people with quality care. It is important for the national system and government to intervene in the process with cooperation of NHS and CQC so that the quality of care can be maintained well and the practitioners can deliver high quality efficient treatment and support to all the patients (NHS, 2019).

Legislation and policy to work safely and healthily in health and care settings

The legislations and policy framework in the health and social care context for managing safety and security of the employees are well established in order to have proper occupational safety and death act relevant to legislations. The program of managing health and safety at workplace further provides a scope to ensure all the employees that they are safe at the organisation and it is effective to reduce workplace hazards as well as protect lives and promote employee health. It is hereby necessary to follow the organisational practice to protect the employees as well as implement the legislations in order to provide safety of the workers at the health and social care settings. In this regard,

COSHH (Control of Substances Hazardous to Health) is effective to control the substance hazards at the hospital where the mangers ensure that there are no such substances hazardous to health for the employees (NHS, 2018).

The Health and Safety at Work Act 1974 is appropriate to protect human lives and it further ensures that the management team is concerned about the safety of the employees at the workplace.

Health And Safety (First aid regulations 1981) provides an opportunity to improve trust and loyalty among the employees, that they are safe and secured under proper supervisions.

Manual handling operations regulations 1992 provides clear and concise information about manual handling of the legislations for the safety and security of the employees at the workplace. Apart from the above legislations, there are policies and organisational protocol for managing safety and security of the employees.

The manager try to cover the hospital area under CCTV by implementing CCTV cameras at different points of the organisation and this is effective where the employees are under proper supervision of the senior management team.

Fire extinguisher at different places of the hospitals is there in order to control the situation in case of substances hazardous to health for the workers at the hospital.

Hand gloves are distributed among the employee in order to manage safety of them.

There is hand sensitisation at different places of the hospitals which is also effective for the nurses and staff members for infection control and being safe at the hospital.

There is proper control of infection by providing masks to the nurses so that they can feel free to serve better care to the patients by taking care of their own health.

There are emergency doors at the organisations in case of any unsafe situation and also fire alarm which raise concern in unfavourable circumstances in the hospitals.

Reference List

Colby, I. and Dziegielewski, S.F., 2016. Introduction to social work: The people’s profession. Lyceum Books.

Hall, M.A., Orentlicher, D., Bobinski, M.A., Bagley, N. and Cohen, I.G., 2018. Health care law and ethics. London: Wolters Kluwer Law & Business.

Harris, J. and White, V., 2018. A dictionary of social work and social care. London: Oxford University Press.

Harriss, D.J., MacSween, A. and Atkinson, G., 2017. Standards for ethics in sport and exercise science research: 2018 update. International journal of sports medicine, 38(14), pp.1126-1131.

Pandya-Wood, R., Barron, D.S. and Elliott, J., 2017. A framework for public involvement at the design stage of NHS health and social care research: time to develop ethically conscious standards. Research Involvement and Engagement, 3(1), p.6.