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Health and social care management

Question 1

1.1 Factors to be considered when planning the recruitment of individuals to work in health and social care.

The first factor to be considered when planning employment is the overall aim of the recruitment with a particular focus on what the organisation wants to achieve (Chen et al, 2004). For example, whilst some recruitment may be to replace an existing worker due to retirement or career advancement, other recruitment may be due to the creation of a new job role (Buchan and Dal Poz, 2002). In the latter case, the organisation needs to have a clear understanding of the skill set, competence, education and experience levels of the individual they want to recruit (Thornley, 2000).

From this, the organisation then needs to consider the availability of workers, that fulfil the job requirements, that either already work for the organisation (internal recruitment) or who reside within the area (external recruitment) (Dussault and Franceschini, 2006). If such workers are not available, the organisation must then consider the financial implications associated with either training individuals to the required levels or offering remuneration and relocation incentives to encourage skilled workers in from other areas (Dussault and Franceschini, 2006). Once these decisions have been made, the organisation then needs to consider how to attract the right candidates for the available roles (O’Brien et al, 2009). Advertisement of jobs in areas where there are adequate skilled workers in the local area is commonly carried out in local newspapers and in the local Job Centre, however, where this local skilled workforce is not available, the organisation may consider utilising the power of the internet, recruitment agencies or job fairs to ensure they attract suitably skilled workers (Compton et al, 2009).

1.2 Legislative and policy framework that influence the selection, recruitment and employment of individuals.

There are a number of legislative Acts that control the selection and recruitment of individuals within the UK. These Acts include the Employment Rights Act 1996, the Equality Act 2010 and the Race Relations (Amendment) Act 2000 (Bewley, 2006). Each of these Acts is designed to minimise any discrimination of individuals on the grounds of gender, sexual orientation, race, disability, religion or beliefs within the selection, recruitment and employment process (Harcourt et al, 2005). These Acts are reinforced by a number of government employment and recruitment policies, such asImproving opportunities for older people (DWP, 2014), Making the labour market more flexible, efficient and fair (DWP, 2013) and Helping employers make safer recruiting decisions (Home Office, 2013).

In addition to these government policies, the health and social care organisation will also have their own policy to control recruitment; these policies will often contain anti-discrimination elements. For example, the General Social Care Council (2010) issued a Code of Practice for employers of social care workers. This code of practice is designed to complement the legislative framework that has been developed by the Government and forms part of the wider package of requirements for the employment and recruitment of social care staff. Within this policy, employers are tasked with ensuring that individuals are suitable to enter the workforce and that written rules and procedures are in place to ensure that discrimination and exploitation are avoided within the workplace (GSCC, 2010).

1.3 Different approaches that may be used to ensure the selection and recruitment of the best individuals to work in health and social care.

The selection process usually follows the submission of an application form and / or CV by the candidate (Miller and Bird, 2014). The prospective manager of the candidate will then review the applications and select those who display the correct skills, knowledge or level of training required for the job (MacFarlane et al, 2011). These individuals will then be invited for interview which can be carried out by an individual, a panel or a selection board (West et al, 2011). During this process, the candidate will be asked a number of questions and, in many cases; the quality of their answers is usually graded, thereby providing a score at the end of the interview (Harris et al, 2007). As such, the highest scoring candidate will be offered the job. However, this process may result in the more articulate individual being offered the job regardless of their actual ability to fulfil the role (Hendry, 2012).

Another approach for recruitment is the assessment centre, where a number of exercises are utilised to mimic the available job role (Edgar and Geare, 2005). These can be in the form of group exercises, one to one role-plays, structured psychometric tests, behavioural tests or capability questions (Patterson et al, 2005). From these tests the assessor, or assessors, will observe the performance of the individual and thereby predict the aptitude of the individual for the available role (Gale et al, 2010).

Question 2

2.1 How do individuals interact in groups by making reference to relevant theories.

The most famous theory of group working is Tuckman’s (1965) model. Tuckman (1965) divided the team’s interaction into four different phases; forming, storming, norming and performing.

The first step, forming, is where all members are learning about the opportunities and challenges facing the team. There will be a high level of dependence on their manager for guidance and the team will be bonding together, sharing personal information and forming friendships and alliances (Armstrong, 2006).

The second step, storming, is where different ideas to tackle problems or issues are developed. This step can cause conflict as each idea competes for consideration. Effective management of this step is vital to enable all members of the team to have their say and resolve any lasting conflicts (Armstrong, 2006).

The third step, norming, is where the team members fall into agreement over the solutions for their team. In this step, the team members are able to talk openly about their opinions and have the ability to adjust their behaviour to avoid conflict. The team members agree on the team’s values, rules, professional behaviour and methods of work (Armstrong, 2006).

The final step, performing, is where the team fully understands, co-operates and supports one another, thereby working as a single unit rather than individuals. Teams that have reached this step display high levels of motivation, knowledge, competence and autonomy (Armstrong, 2006).

2.2 Different types of team in health and social care setting

There are formal and informal teams within health and social care. The former of these is a structured team that has been formed with a specific purpose in mind (Taggar and Ellis, 2007). This team will have a definite leader and every individual within the team will have a distinct role (Taggar and Ellis, 2007). An example of this is a theatre team that is led by the surgeon, with the anaesthetist and other theatre staff supporting the surgeon during the operating procedure.

Informal teams have no structure and every individual has an equal status (Farrell et al, 2001). Within the healthcare setting the formation of multi-disciplinary teams often follow this informal team description (Sheehan et al, 2007). A good example of an informal team can be given using a case study of a child in social care. This child may have special educational needs, may have behavioural or mental health problems or may require counselling. In such a situation, an informal team is developed between the foster carers, the education providers, a child psychiatrist and counselling services, who will all work together to ensure the best outcome for the child.

2.3 Factors that influence the effectiveness of teams working in health and social care

The first and most significant factor is poor communication (Hambley et al, 2007). This may be in the form of poor discussion of ideas or solutions between the team members or may be as a result of conflict within the group preventing the effective flow of information between team members (Xyrichis and Lowton, 2008). However, both of these are a result of poor management, as the leader’s role is to encourage the development of relationships and to iron out conflicts within the group (Hambley et al, 2007).

The second factor is that of poor understanding of the roles and responsibilities of each team member (Hall, 2005). This is more likely to be a problem within an informal, multidisciplinary team, who are not used to working together. As such, professional boundaries may be blurred, leading to confusion over who is responsible for certain aspects of the patient’s care (Xyrichis and Lowton, 2008).

Another problem is that of information sharing (Mesmer-Magnus and DeChurch, 2009). Again this is more likely to affect the multidisciplinary team, however, it can also occur in the formal team, where one individual is reluctant to share information or knowledge as that knowledge is considered to be an aspect of power (Moye and Langfred, 2004).

2.4 Approaches that may be used to develop effective team working

Many approaches exist to help develop effective team working. These include brainstorming and team building exercises (Borrils et al, 2000). However, it is the role of the leader to ensure that team harmony is maintained. This can be achieved by ensuring that all team members have ‘a turn’ at suggesting ideas or solutions, encourage an environment of listening through regular team meetings whilst ensuring that any problems, or solutions, are followed up and not ignored (Borrils et al, 2000). It is also vital to ensure that all feedback is constructive without being overly critical; negative feedback can restrict the flow of information and damage the morale of the team (Borrils et al, 2000). Finally, it is vital that the manager is able to keep all communication routes open to encourage the exchange of information (Leonard et al, 2004). This can be done through email, face-to-face, phone conversations or letter but it is necessary for each individual to be aware of their role in disseminating information to other team members (Leonard et al, 2004).

Question 3

3.1 Different ways in which the performance of individuals may be monitored in health and social care.

Monitoring of an individual’s performance can be done in several ways. The first step is to identify the current level of performance, identify where improvements can be made and form an agreement between manager and employee on how those improvements are going to be made (Bevan and Hood, 2006). In order for these improvements to be made, it is necessary for the manager to link them to the team’s aims and objectives. This enables the employee to understand their role within the team and have ownership over their own job (Bevan and Hood, 2006).

Performance appraisal is the most frequently used tool to measure an individual’s performance. The appraisal has five key elements: measurement, feedback, positive reinforcement, exchange of views and agreement (Curtright et al, 2000). Another option is through the use of key performance indicators or the setting of team or individual targets (Bevan and Hood, 2006).

3.2 Identifying individual's training and development needs

As previously mentioned, the performance appraisal is the most frequently used tool to measure an individual’s performance. However, this tool can also be used to identify areas of weakness which will highlight the training and development needs of the individual (Bevan and Hood, 2006). Non-achievement of team or individual targets also highlights a training need, however, the manager is required to keep a close eye on the performance of all the team members when team targets are used as some team members may be more efficient than others (Grigoroudis et al, 2012). Continued professional development (CPD) is another way in which a team member can ensure they have sufficient, ongoing training throughout their career. CPD includes formal courses, practice workshops, self-directed reading and attendance at conferences to ensure the level of skills is maintained or improved throughout the individual’s career (Legare et al, 2011).

3.3 Different strategies for promoting the continuing development of individuals in the health and social care workplace.

The promotion of continuing development is achieved through a number of means. Torrington et al (2008) suggest that performance feedback (through the use of appraisals or targets) followed by an incentives package are the most effective way of ensuring continuous development. However, it is vital that the feedback is relevant, specific and credible and that it is done frequently to ensure that the employee remains focused on the team’s aims and targets (Torrington et al, 2008). Incentives are normally provided through an increase in salary, the provision of training or bonus rewards (Torrington et al, 2008). In addition, in some healthcare professions, CPD is an obligation to ensure that individuals maintain an adequate level of knowledge and expertise within their professional area (Legare et al, 2011).

3.4 Implementing an effective staff development program

According to Gould et al (2007), there are a number of measures that need to be taken in order to implement an effective staff development program. Firstly, it is vital that all employees have a clearly written job description that is fit for purpose. This job description may include a set of skills or level of expertise to be worked towards, with development of the individual, through training and experience, being structured in accordance with their needs and level of knowledge upon commencement of the role (Gould et al, 2007). Another effective method of development is through the use of mentors (members of staff who are particularly good at their job) for new team members or for individuals who may be struggling with certain aspects of their work (Shah et al, 2011). Finally, it is vital that the manager implements regular performance appraisals to ensure that individual and team targets remain focused and relevant (Torrington et al, 2008).

3.5 The effectiveness of a specific staff development program

Studies suggest that the most effective staff development programs are those which follow a structured approach (Poulton and West, 1999; Leatt and Porter, 2002; Forsetlund et al, 2009). As such, many promote the use of the performance appraisal as it focuses on the performance and the training and development needs of the individual (Gould et al, 2007; Torrington et al, 2008). This staff development program is also simple to implement and encourages conversation and the exchange of information between manager and employee. By tailoring the employee feedback and linking employee targets to the aims of the team, the manager can ensure that staff remain focused (Gould et al, 2007). In addition, the appraisal can highlight areas in which the employee has weaknesses or training needs, therefore effectively highlighting a logical development process for each employee (Gould et al, 2007). In these circumstances, specific training can be set as targets and can be achieved through self-study or through the attendance on specific courses.

Question 4

4.1 Theories of leadership and applying them to management in a nursing home setting.

There are four key theories of leadership that have recently replaced the traditional hierarchical-based leadership seen within the NHS. These four key domains of leadership are relational, personal, contextual and technical all of which can be applied to the nursing home setting. Relational leadership promotes organisational and individual change, encourages engagement and communication between staff and patients and focuses on the dynamics of working relationships and patient experiences (Bolden and Gosling, 2006). The personal leadership theory includes the promotion of reflective learning, personal resilience and self-awareness as a leader (Boaden, 2006). Contextual leadership utilises policy and strategy within the healthcare field to promote development by understanding the positions and strengths of various stakeholders and/or employees (Brazier, 2005). Technical leadership involves the improvement of methodologies, approaches and philosophies within the working environment. This theory adopts the position of the leader changing things for the better while a manager maintains existing systems in good working order (Checkland, 2014).

4.2 The way of influencing individuals and teams by task allocation

According to Dowding and Barr (1999), task allocation influences both individual and team performance. This is obvious when considering the role and skill set of each individual within the workplace. When considering a nursing home environment, a simplified task list may be used for the doctor to examine and diagnose the patient, the nurse to provide the correct medication and for the carer to feed or bathe the patient. As such, these tasks are allocated in accordance with the skill and expertise of the individual. Where tasks are not allocated effectively within the team and do not match the skill set of the individual, performance of both the individual and the team will obviously be impaired (Stewart and Barrick, 2000). However, if tasks are allocated effectively, team and individual performance will be enhanced.

4.3 Managing working relationships

The most effective way of managing working relationships is by trusting your employees to carry out their role to a high standard (Williams, 2007). In addition, an effective leader should always respect their workforce, be honest, considerate and value their employees’ opinions and values (Williams, 2007). They should promote a culture of openness within their team and strive to understand the different backgrounds and perspectives of the team members. There should also be a great focus on communication both within the team and between the manager and team members (Barrick et al, 2007). This focus should be on utilising the most effective form of communication in each specific scenario. For example, when discussing weaknesses, a private meeting would be appropriate whilst for team targets, team meetings or group emails would be more effective. In addition, body language, listening skills, ability to maintain eye contact and attentiveness are all effective ways to develop and maintain a working relationship.

4.4 Evaluating own development that has been influenced by management approaches

My own development has been influenced through a number of leadership and management approaches. Firstly, through the use of personal performance appraisals, I have been encouraged to focus on areas of weakness as well as my strengths. By highlighting these weaknesses, I have then been able to concentrate on training or the gathering of information through self-directed reading, to improve my knowledge in these weak areas. Team-working has been improved through the promotion of working relationships between team members, through the use of team-building sessions and activity workshops. In addition, whilst it is acknowledged that everyone has a poor manager at some point in their career, these poor managers accentuate the skills of the effective leader and have helped me to develop good leadership skills. I have also been allowed to mentor new employees as I was very effective in my role. However, I consider the most effective management approach for me, to have been through the use of task allocation and team target setting. Whilst I originally assumed that the task allocation was for an individual’s benefit, I can now see how this benefits the whole team.

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