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Fundamentals of Care - NHS Wales

Fundamentalsof CareFundamentalsof CareGuidance for Health and Social care Staff Guidance for Health and Social care Staff improving the quality of fundamentalaspects of health and social care for adultsImproving the quality of fundamentalaspects of health and social care for adultsGuidance for Health and Social care StaffImproving the quality of fundamental aspects of healthand social care for adultsFundamentals of care This version of the Fundamentals of care is aimed at staff of all grades who provide care and the organisations that employ them. These organisationsinclude all providers of health and social Aim of Fundamentals of Care32. Using the Guide43. Introduction to the Practice Indicators64.

Fundamentals of Care is a Welsh Assembly Government initiative included in the Plan for Wales as part of “Improving Health and Care Services”. The initiative grew out of the following: Inconsistency of quality across service settings and areas. Emphasis, until recently, on service efficiency and cost, rather than quality of care.

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Transcription of Fundamentals of Care - NHS Wales

1 Fundamentalsof CareFundamentalsof CareGuidance for Health and Social care Staff Guidance for Health and Social care Staff improving the quality of fundamentalaspects of health and social care for adultsImproving the quality of fundamentalaspects of health and social care for adultsGuidance for Health and Social care StaffImproving the quality of fundamental aspects of healthand social care for adultsFundamentals of care This version of the Fundamentals of care is aimed at staff of all grades who provide care and the organisations that employ them. These organisationsinclude all providers of health and social Aim of Fundamentals of Care32. Using the Guide43. Introduction to the Practice Indicators64.

2 Practice Indicators71. Communication and information72. Respecting people 143. Ensuring safety194. Promoting independence255. Relationships306. Rest and sleep 357. Ensuring comfort, alleviating pain388. Personal hygiene, appearance and foot care429. Eating and drinking4610. Oral health and hygiene5011. Toilet needs5512. Preventing pressure sores595. Monitoring the use of the Practice Indicators636. Useful contacts65 Appendices:66A1. Steering Group membership66A2. Contributors to redrafting67 ContentsThe twelve aspects of care described in the document draw together, for the first time, guidance on the quality of care service users may expect from health and social careproviders in know, from talking with service users, that they are as much affected by the general experience of their care as by its outcome.

3 I also recognise that the experience of care is oftenvariable and dependent on the type of service accessed and geography. These indicators willhelp ensure that such inequities are addressed across Wales . They relate to a range of settings,from a person s own home, to care homes and hospitals and to all organisations dedicated todelivering care , in the health, social or independent and organisations providing health and social care within Wales , should use theseindicators to develop and improve the services they deliver. It is only by constant referenceand review that we can raise the quality of much is being achieved already, but more remains to be done, so that the more vulnerablemembers of our society are helped to enjoy a better, healthier and happier future.

4 I am pleased to commend this document to you. Jane Hutt AMMinister for Health & Social ServicesForeword by Jane Hutt AM, Ministerfor Health and Social ServicesFundamentals of care is a Welsh Assembly government initiative included in the Plan forWales as part of improving Health and care services . The initiative grew out of the following: Inconsistency of quality across service settings and areas. Emphasis, until recently, on service efficiency and cost, rather than quality of care . Common themes in complaints and compliments. Increasing expectations of service users. Developing partnerships with service users and between organisations. Lack of clarity for service users on what they should expect.

5 Increasing focus on regulation and performance. Awareness of Essence of care , DOH, of care therefore aims to improve the quality of aspects of health and socialcare for adults. The indicators will be integrated with educational, commissioning and performance management frameworks for the NHS, Social services and the care Standards Inspectorate, asappropriate. They therefore reflect an integrated whole systems approach, making them relevant to multi-disciplinary environments across organisational Aim of Fundamentals of Care3 The first reaction to these indicators may bethat they are nothing new. This is true. Indeedit would be surprising if material did notalready exist on the key subjects addressed,for example, the Essence of care in England,DOH, 2001.

6 What is different is that theseindicators are applicable to the whole ofWales, across the full range of health andsocial care settings. To achieve this, this document draws together a composite set ofindicators from a range of statutory, mandatory and professional requirements andnational policies. These include (amongstothers): National Minimum Standards,National Service Frameworks, NationalInstitute of Clinical Excellence documents,Occupational Standards and ProfessionalCodes of Conduct. Additional indicators havebeen included where gaps have been identified from a literature search and extensive consultation. Using the Fundamentals of care alongside other guidelines and standardsFundamentals of care views the service-useras the most significant stakeholder in thedevelopment and promotion of best practiceand quality services .

7 On a personal basis therelationship between the service-user andcare provider is fundamental. The relationship between the person giving careand the person receiving care should be apartnership. Everyone is an individual andshould be treated according to their needsand wishes. Service-users should receive thehighest quality of care and service providershave a responsibility to provide a wider level, practice and services aregoverned by legislation and regulations. Theyare also influenced by standards and guidance. In this broader contextFundamentals of care seeks to stimulateimprovements in quality and the way careproviders respond to and meet the needs ofservice-users. Fundamentals of care is alsodesigned to enable service-users to assess forthemselves whether the care they receive isappropriate to their personal example each section suggests an indicator to which care providers shouldaspire.

8 The indicators are referenced to therelevant care Standard Regulations. Thisapproach will help both the service providerand the service-user. The service provider canutilise Fundamentals of care for self auditand quality control purposes and establishhow each indicator relates to care StandardRegulations. In turn service-users in private,voluntary and local authority sector provisionare better able to understand how the CareStandards Act shapes the services they of service providers in theprivate and voluntary sectorFundamentals of care does not impose anynew requirements, obligations or standardsupon domiciliary, care homes or independenthealthcare providers. Providers of these services are registered and regulated by theNational Assembly through the CareStandards Inspectorate for Wales (CSIW).

9 Fundamentals of care will supplement butnot replace the Regulations and NationalMinimum Standards issued by the NationalAssembly and enforced by CSIW. It is anticipated that all care providers, anxious tomaintain and develop quality personal careservices, will incorporate Fundamentals ofCare within training and staff developmentprogrammes as a basic foundation for theprovision of quality services . Both Health andSocial services may also incorporate theseindicators into commissioning, contractual orservice-specification Using the Guide4 Expectations of the National HealthServiceWithin the Health services Fundamentals ofCare will be used to drive up and improvethe consistency, quality and delivery of a baseline Fundamentals of care shouldbe used to establish targets for the consistentimprovement of services and the provision ofcare regardless of setting.

10 It is recommendedthat individual staff and organisations identifythose indicators from the cross-references thatshould already be complied with. For theother indicators there is a responsibility toensure they are integrated into educationaland monitoring systems. All indicators are tobe met and compliance systematically monitored, whether this be through clinicalsupervision, peer review, audit or operationalperformance NHS may also wish to use the indicatorswhen commissioning from private of Local Authority SocialService DepartmentsSocial services may use Fundamentals ofCare as a nationally recognised frameworkand where appropriate audit existing domiciliary and residential care servicesagainst the relevant indicators.