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Working in Partnership in Health in Social Care

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Working in partnership in health and social care is a collaboration of health care services that provide care in the health and social care sector. These can be Corporal, Organisations, Agency, Community service providers with shared interest. For effective service to be provided across the health care sector there must be a collaboration of shared information. Working in partnership encourages social care to be examined and improved. Without collaboration of professional major problems could arise with collaboration major problems can be discussed and addressed. Failure’s such as Victoria Climbie which was a tragic failure of working in partnership has cause reviews over the years to bring improvement not only in services but working in partnership. Working in partnership has also improved the action response time to an emergency situation since the Victoria Climbie incident The way in which this is addressed and monitored is through monitoring boards such as the (CQC) Care Quality Commission. A company such as this is capable of Auditing, reviewing and evaluating the services that are being provided.

Through CQC examination it will be possible to see whether the targets are being hit, whether reports being filed and documents. CQC not only make it possible for the mistakes to be highlighted but also what works and what has been improved and what needs improvement. Working in partnerships has 6 philosophies that centre on the service users care which are use the Health and Social Care services which are provided and the professional that work in partnership. The philosophies promote empowerment; Power sharing, Respect, Choice, Making informal decisions and independence. Working in Partnership collaboration gives empowerment to share ideas and respecting each power in their division of the Health and Social care sector as well as the collaboration of service user and the professional. Working together as professionals can also make informal decisions easier to come to agreement about because of shared responsibility.

This then go onto promote empowerment for the service user as they get the chance to be heard about the care that they are receiving making them feel confident. Through being given the choice and the respect to decide independently about the care that might choose to have. “In Healthcare the terms ‘inter – disciplinary’ or ‘multi – disciplinary’ are often used to refer to a term of individuals with different background training (e.g. nursing, medicine, occupational therapy, health visiting, social work) who all share a common objective but who make a different but complementary contribution. (Thus differing from inter agency collaboration or ad hoc collaboration between professionals” (Marshall el al 1979: 12), (Leathard, A; ‘Going inter-professional, working together for health and welfare’ p6,(1994)

Using the model of partnership in “Victoria Climbie” case there was an overview of how the case was handled from the beginning. There should been have been several intra agency collaborations as well as inter professional collaborations. These would have included GP, Midwife, Community Services, Social Services, Case Manager, Directors these are just some of the main focus professionals that would have been immediately involved with this case. In Victoria Climbie case there were failures, this could bring you to the conclusion that there are dangerous flaws in the basic model of partnership working. With all models and strategies there will be need for improvement, development, reviews and evaluations. Even with the most effective Model of Partnership working and collaboration there will always be a new situation that arises that a team of professionals as a whole might not be aware of how to handle. But through working in partnership and using their individual training back ground the problem can be solve effectively and efficiently.

Improvements came about after the serious Case reviews of the cases such as Victoria Climbie and Baby P. From theses reviews it came about that changes were trigged in the law and Working practice strategy. The Children Act (2004) Every Child Matters now includes the introduction of the Children commissioner, Local Safeguarding Children Boards and Legislative Policies and procedures within the Acts such as the Safeguarding of Vulnerable Adults and Children policy were re-evaluated. The need for improvement and review and evaluation can been seen evidently from the Children Act (1989).there were major changes even then when the concept of ‘significant harm’, the concept of ‘parental responsibilities’ instead of ‘rights’ was brought in to the Act.

Referring to the Adult A / Victoria Climbie Serious Case reviews the seriousness of it would have led to the structure documented below and from that improvement would be sorted to come about. “SCRs are conducted by the Local Safeguarding Children Board (LSCB) for the area in which the child is living, or, if the child has died, the area in which the child was normally resident. The decision to conduct a review is made by the LSCB Chair, and the matter then normally passes to the LSCB Sub-Committee responsible for SCRs. The Sub-Committee then sets up a SCR Panel to manage the review process. The Panel normally comprises representatives from the local authority children’s social care department, health and education services, the police and any other relevant agencies”. (www.ecm.gov.uk.10/04/14.03.57am).

The benefits of the SCR evaluation of the Serious Case Reviews of Adult A/ Victoria brought about multi agency working with the local body of the health and social sector. Multi-agency working may have provided benefits there could have been tailor-made support in the most efficient way. Some of the benefits could have included early intervention and identification of any issues and intervention needed to control and support both of these cases. There could have been quicker access to the needs of theses dysfunctional families and the Vulnerable Children that maybe it could be said suffered at the hand of dysfunctional systems that failed to act and protect at the earliest stage of abuse and neglect. When looking at these cases and there reviews it can be seen that there would have been a big benefit in having easier quicker access to expertise services and professional in collaboration of working partnership. Could there have been earlier prevention?

It could be said in the case of Victoria C and Baby P. It may be said that in giving the parents more support and monitoring the family home and care of the children in question this would have been a big impact on prevention cause of harm to the victims. With the professional talking to one another such as the GP reporting and sending evaluations to the social services young person’s services and even specialist being brought into to evaluate the child and the parents to see irregularities behaviour pattern. Prevention could have been promoted and followed if these working in partnership policies were in place. A better quality of service could have been given having better trained staff who were equipped to handle and evaluate situations. Being able pick up on irregular behaviour and having regular child safety training and specialist training for those that might come across cases such as these in the case of Adult A and /Victoria. This would have reduced the need for longer term or more specialist service easing up on the service user’s waiting list and getting quicker service users appointments and service user’s evaluation

On the site of the (Victoria Climbie Foundation) a comment was made reference, “SCR into tragic death of Daniel Pelka raises more questions than answers”. “The release of the Serious Case Review (SCR) report today, into the tragic death of Daniel Pelka highlights some key issues for VCF – The Victoria ClimbiĂ© Foundation UK, not least the transparency of the council-led review and thus accountability following publication of the report”. What we hope the report will help us to understand, is whether Daniel’s death could have been prevented, and whether the process was independent enough. Daniel was not a hidden child, thus within the current system, his death should, and could have been prevented. “VCF continues to work together with all statutory agencies to facilitate effective coordination and engagement with the community. Our work within the community to raise awareness of child abuse in the context of the legal framework, and aspects of culture or faith, has demonstrated a greater willingness within communities to speak out about child abuse”. “The recent reporting of this tragic case has brought the usual shock and reaction to the recurring tragedies that continue to happen, despite improvements to the child protection system. We have also seen increasing calls for mandatory reporting of child abuse by those working with children and families”. (www.VCF.Org.Uk) Sep 17, 2013, Under: VCF Comments…

Legislation and policy in the Health and Social Care sector has had improvements such as the Care Standards and Every Child Matters policies been reviewed and collaborated through working partnerships. Yet it can be said in reality that there shall always be a new situation or complication that has not been come across, which the legislation and policies and the collaborative agencies and professional must in some way aware and be in preparation for. Development of the model of partnerships in different Areas within the Health and Social Care sector is partly tackled by thinking ahead. Studying scenarios that have similar case structure and failing based on previous SCR’s reviews can help in the improvement of timescales and staff monitoring and staff support. As well as the biggest factor some may say the safety and the care of those requiring care. Can this be part of the working in collaborative strategy? Can developing and sharing information of past cases scenario help to develop protective pre-active plans to protect and guard from past failure in the Case studies that have been evaluated and analyse in this report of Vc/Dp. All of the above questions would have been asked reviewed and evaluated promoting positive steps in planning and developing effective working partnerships.

Examples of Health and Social Care models of partnership are: Health care working partnership between the service user and the health service providers. The service user opinions and values and voice must be at the forefront of the care provided and given. The local council and the healthcare providers working in collaboration with information sharing agreements in place to better understand the service users requirements in there care and their needs. The confidentiality Act is brought into place as is Data protection. There is information that can be shared but then there are Organisational policy’s that have confidentiality agreements that in fact follow the guide lines of the law Confidentiality Act but also has some extra additions such as the Drug Act and the Terrorist Act, The Hosing Act and safe harm or risk of harm to other that I case of any of the above it will be reported to the correct authority and then there can be included the information sharing contract Document which the service user should be explained and help understand before they sign and agree to the contract that you state whom you wish to share you information with. is as well as being able to red flag any activity that breaks the laws within the ‘Children Act’ (2004) or any such Act that runs in accordance with protecting the service user from harm and providing the best effective care at the highest standard. There can be many different outcomes of Partnership Working.

This can be for service users, professional and organisations. There are different issues that may arise from different opinions, failure in service providing by staff employed by the employers. This can be because of slacking in the training levels and the refreshment in policies and expected levels of care providing. There is also the level of management involvement in evaluating and monitoring the staffing levels and care provided. There could also be a indifference in the way in which a professional provide care and the inter partnership being affected by delays in agreements being made. Professional can have power level dilemmas, years of experience and using example a doctor who has been so for 20 years taking advice from a social worker who has been so for 3 years. This kind of power struggle can cause effect on the service user as there can be delays even wrong decisions because of the communication levels not being met. Communication is a big part of successful working in partnership. Bad communication can cause failure in service providing and can cause sufferance on the service user. Whereas good communication can speed up levels of service providing, the client can get clear descriptive care and can also communicate their opinions and wishes in the care they receive.

Dysfunctional systems of organisations such as social services failures in the Victoria Climbe case and non- communication between health services, management and professional can have serious effects such as death as so it happened in the Vitoria Climbie case which was investigate. Failures in staff communication and staff not following care levels and policy can affect the service provide. Going to the case study of the “Mid Stafford NHS Trust” there is a clear description of a serious failure within the Safford Hospital were Bailey who mother died in there care in 2007. After an investigation the hospital was found to have had reports of staff leaving patients to urinate on themselves and patient resulting in drinking water from flower vases. This is a clear description of abuse from staff who had obviously had not been vetted through the right pathway of employment some could say this is unknown but if training and management training had maybe been provide these incident may not have happen.

The result of the investigate cause there to be a heavy fine of £11,000 which was distributed between the families of those that suffered abuse at the hands of the staff of the Safford Hospital. All of this could have been prevented if there had been some changes such as changing the structure of the way the staff are interviewed and employed checking qualifications and evidence. DBS checking along with references. If the candidate doesn’t have all of the training providing that training will strengthen the service provider in providing good care. Refresh training courses which are compulsory to take would give staff the knowledge they need to stay updated and give them the tools they need not to fail the service user. Many changes have come about and this has improved the level of working in partnership.

Now there are more organisations working together. Such as social service, Child protection services and the police as well as 3rd sector organisation such as charities and Health services all working in partnership to help the better of the client to protect and work together with that service user. This has proven to work better than past structure. With barriers such as Skills: No training in partnership skills, Lack of knowledge of other professions, Roles: Different employment conditions, Power and Hierarchy. Structures: Poor engagement of local people and service users. As well as some others as Resources, Environment, Culture. A lack in Agreed Outcomes is very detrimental to the service the service user receives. Decision-Making Mechanisms

Actions will be blocked when members lack delegated authority and have to refer to their parent organisations for decisions; Failure to acknowledge the complexity of achieving change through public sector partnership (or, conversely, over-complicating analysis of situations) – become an excuse for lack of action. (Armistead & Pettigrew, 2004, Maguire and Truscott, 2006, Marks, 2007; Smith, 1995) Poor practice and dysfunctional service providing, poor communication and skills are all barriers with working in partnership. Thereafter, partnerships will need to identify those factors which they can and cannot control and take action on aspects within their power. There are 11 sets of Good Practice Standards, some of these are: each of the local authorities have joined and established multi-agency partnership which to lead to ‘Safeguarding Adults’ work. Each partner organisation’s executive body recognises that having Accountability for and ownership of ‘Safeguarding Adults’ work improved. Every person’s right to live a life free from abuse and neglect is clear statement in The ‘Safeguarding Adults’ policy. This message is actively promoted to the public by the Local Strategic Partnership.

Each partner agency has a clear, well-publicised policy of Zero-Tolerance of abuse within the organisation. These are 4 examples of the 11. Through changes such as the Coordination of Good Practice and safe guarding Adults Coordination role would consist of advising and supporting the partnership. Implementing the ‘Safe Guarding Adults’ work with their organisation. Overviewing the development of local Safe Guarding Adults. Collate Monitoring and providing quality assurance information. Implementation of the ‘Safeguarding Adults’ procedures to all by providing information and advice. Safe Guarding manager receiving the information and advice to stay at the standard level set at legislative and policy standards as well as local standards. Partnerships will need to plan and commission there work. Joint training and information strategies being shared between partnerships, the work being done in partnership will need to be managed by a director. In some cases in some areas it would include the management of a ‘Safeguarding Adults’ Unit which would include dedicating Lead Safeguarding Managers. Conclusion

As Working in Partner follow these Good practice which when put together makes a strong solid structure to follow and guidelines that are simplified, with the improvement strategy care providing and service has strengthen its safe guarding policies. The service provided that each service provide should and want to provide will safe guard the service user if these guide lines are followed

(Marshall el al 1979: 12), (Leathard, A; ‘Going inter-professional, working together for health and welfare’ p6,(1994 Leathard, A. (1994). Going inter-professional, working together for health and welfare. London: Routledge. (Armistead & Pettigrew, 2004; Audit Commission, 1998; Improvement Network; Maguire and Truscott, 2006; Marks, 2007; Smith, 1995) (www.VCF.Org.Uk) Sep 17, 2013, Under: VCF Comments…

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