1. Essence of Care and Links to Care Standards Jennifer Holmes

2. Care Standards  Developed for Regulated services as listed in Quality, Improvement and Regulation Order (2003)  Homes – nursing, residential and children’s  Day care centres, residential family centres  Agencies – domiciliary care, nursing, fostering and adoption  Independent health care – hospitals, hospices and clinics.

3. Content of Standards Article 23  Staff – numbers, type, training, management.  Provisions for securing welfare of residents/those provided with services  Record keeping  Incident reporting  Premises – fitness  Financial management  Complaint handling  Promotion and protection of health of service users  Control, restraint and discipline of children….

4. Focus of Care Standards  Person in receipt of service should be central in all aspects of planning, delivery, review and improvement of the service.  Standards and quality of service is dependent on managers and staff basing their practice on key values.

5. Values underpinning the standards  Dignity and respect  Privacy  Independence  Rights  Equality and diversity  Choice  Fulfillment  Confidentiality  Safety

6. Nursing Homes  Development of nursing care standards began with review of fundamentals of good quality care as described in Essence of Care.  Standards included for nutrition, skin care, promotion of continence and safety.

7. Care Standards  Consultation and patient involvement  Patients and carers actively involved in planning care  Using patient feedback, comments to improve service  Identify and respect rights of those using service  Identify and manage risk  Evaluate/audit practice  Staff training  Documentation  Treatment that is evidence based  Information available to patients, carers or representatives, staff

8. Care Standards vs. E of Care  Overall patient focused outcome  Many similarities between criteria and factors.  Essence of Care and Care standards complement one another, and although the care standards go further ( as required by legislation ) they have the same focus – Quality of care for those in receipt of service.

9. Nutrition Care standard 8 Nutritional needs of patients are met. Essence of Care Patients are enabled to consume food which meets their individual need.

10. Care standard - criteria 1. Screening carried out with patients on admission using a validated tool. 2. Nutritional screening is repeated monthly or more frequently depending on individual assessed need. 3. Nutritional information is available in accessible format for patients and their representative.

11. Essence of Care Factor 1 Screening and assessment to identify patients nutritional needs. Indicators  Components of screening  Assessment  Screening takes place within time frames  Triggers for reassessment.

12. Continence Care standard 10 Patients receive individual continence management and support. Essence of Care Patient’s bladder and bowel needs are met

13. Continence Care standard criterion 3 There is information on promotion of continence available for patients, their representative and staff. Essence of Care factor 1 Patients and or carers have free access to information about bowel and bladder care that has been adapted to meet individual patients needs or those of their carer.

14. Benefits  Focus is on patient and their care needs and outcomes – not professional plans/goals.  Minimum standards are the same for statutory and independent sector service providers.  Quality Agenda is regional and applies to all sectors.

15. Benefits (contd.)  Benchmark across different organisational boundaries.  Multi - professional working - understanding of roles and expertise, knowledge base and consistency of message, clear treatment pathways and protocols.

16. Quality and Improvement  Is everyone’s business  Patients and carers  Professionals  Managers and Proprietors  Registration and Inspection Units/HPSS Regulation and Improvement Authority.