Evaluatiom of Key Features of Work Practice Organisation

1)    Key Features of Work Practice Organisation

A)    Evaluate the work practice organisation in terms of status and size in relation to both the Irish economy and world economy

Kiltipper Woods Care Centre

Kiltipper Woods Care Centre (KWCC) is located on Kiltipper Road in Tallaght, Dublin 24. It is a privately owned nursing home which was first established in 2004 and is registered with the Company Office, Nursing Homes Ireland and the Health Information Quality Authority (HIQA).

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Mary Woods and her husband Dermot McDermott are the company directors and Mary is also the Director of Nursing. KWCC has a multidisciplinary team of over 200 highly skilled staff who are passionate about delivering person centred care to residents. KWCC provides 24-hour nursing care and is designed to ensure the comfort and safety of their residents in a home-like environment. They have a café shop that is open to the public and residents. It is a place where resident’s and family members go to for a chat and eat.

They provide residential accommodation of 85 single en-suite bedrooms and 14 double en-suite bedrooms and 1 x 4 high dependency units with en-suite. It includes a garden on the bottoms where residents can go out to. Hydrotherapy is available with 34-degree warm water pool that relaxed the entire body with exercises. The maximum agreed cost to stay in KWCC is €1,255 for a single room per week and the cost for a double room is also €1,255 per week.

Compared with TLC Nursing Home Citywest:

TLC Nursing Home in Citywest just a few kilometres away has 4 nursing homes across the greater Dublin areas which are in TLC Santry, TLC Citywest, TLC Cara Care Santry and TLC Maynooth. TLC Citywest has services of hairdressing, manicures, physiotherapist, occupational therapy, speech therapist, dietician, chiropody, advocacy weekly prayer services, fortnightly mass, psychiatric of later life and wound Care specialist. They also have additional services available on request which include hydrotherapy, aromatherapy and reflexology.

KWCC and TLC are a little bit similar from them both having hydrotherapy, hairdressing, chiropody services, speech and language therapist, wound care management, palliative care, physiotherapist and dietician. They are both 24-hour nursing care.

Local Economy

KWCC is an employer of many staff and pay them wages which they spend in the local shops. KWCC gets their bed linen and towels laundered in Kings Laundry in Oldbawn Tallaght and they are supporting the business by getting them washed there every day and buying fresh bed linen and towels from them. KWCC gets their source of food from Musgraves as it is one of the largest suppliers in Ireland where they can buy food in bulk every week. Quigley Meats supplies them with fresh meat daily. Another local company that supplies KWCC are United Drug in Tallaght where they deliver the medication to the nursing home in the afternoons and drop it off at the nurse’s station so the residents can have the best treatment.

Irish Economy

KWCC supports the Irish economy in Ireland as an employer which is struggling to keep nursing staff and HCA’s in the sector as they want to work in the HSE for higher wages or work abroad. That is because the HSE hourly rate pays more than you get in the private sector. However, Ireland has reached full almost employment in other areas making the healthcare jobs in KWCC hard to fill.

Global Economy

Irish nurses and HCA’s leave Ireland to move abroad to have a better work life and better pay, however, foreign nurses and HCA’s around the world leave their home country to live and work in Ireland hoping to get better working conditions and more pay. If it wasn’t for them, our hospitals and other healthcare facilities would not be running smoothly. Some send part of their salary back home to their family in India or the Philippines for example which help them.

The medication KWCC use is supplied from Irish and Global Companies. Ireland supplies the EU with medications and other health supplies while getting the same in return.

B) Summarise the work practice organisations structure, main aims and overall objectives

Mission Statement

 “Our mission it to provide a special place where people can live, laugh, socialise and to provide an environment that enables all those in our care to experience a quality of life which is characterised by dignity, independence and compassion.” (See Appendix 1)

KWCC is committed to promote the independence of their residents/patients personally, medically, psychologically, socially and spiritually. They respect each residents/patients dignity in a homely environment that fosters a holistic approach in all aspects of care. The residents have the right to be left alone and undisturbed whenever they wish.

Mary Woods and her husband Dermot McDermott are the company directors of KWCC, and Mary is also the Director of Nursing (DON). Below them is Margaret Feeney who is the Clinical Director and below her are the 4 Assistant Directors of Nursing who are Sheeja Kavalkatt, Marie O’Farrell,Esther and Mairead Keenan. Next are the nurses and the HCA’S. (See Appendix 2)

Structure:

Organisational Chart

Mary Woods

Company Director/Director of nursing

Dermot McDermott

Company Director

Margaret Feeney

Clinical Director

Maire O’Farrell

Assistant Director of Nursing

Mairead Keenan

Assistant Director of Nursing

Esther Keating

Assistant Director of Nursing

Sheeja Kavalkatt

Assistant Director of Nursing

Nurses

Nurses

HCA’S

Aims & objectives

The aim & objectives of KWCC is to provide a home environment for residents/patients to experience a good life which is characterised by dignity, independence and compassion. They are cared for, supported and encouraged to what their preferences are. In order to do this residents are served fresh products of food on a daily basis to give the residents/patients a good nutrition and allowing them to be independent by choosing what they like to eat and drink throughout the day. [www.kiltipperwoods.ie]

C)    Determine the organisations culture and values as demonstrated by management practices and staff client engagement

The culture of the Kiltipper Woods Care Centre is welcoming and friendly. A person-centred holistic model of care and Company Directors Mary Woods DON and Dermot McDermott who make sure all aspects of care is excellent. Another way the Aims and objectives are seen in practice is that KWCC celebrates the diversity of their staff and resident’s by accepting each individual and treating everyone with respect and dignity.  Most healthcare organisations cultures and values are often quite reflected through staff-client interactions and management practices. In KWCC employees are trained to know the needs of elderly and provide a person centred approach to care.

In order to create a homely atmosphere for the residents, they have some personal items of furniture and furnishings in their room such as picture frames, armchair, dressing table, duvet covers, and fleece throw blanket and their own small laundry basket.

Residents have access to amenities and a host of recreational activities which provide for an active retirement in a warm and friendly atmosphere. When the residents attend the activities they get to socialise with other residents from different units. The HCA’s attend the activities along with the residents.

Activities Provided by KWCC:

Staff Client Engagement

A resident committee is in place for residents to voice their opinions, offer any suggestions they may have about the nursing home, food, activities or anything in particular they want to share and in the delivery of care and service. The residents are encouraged by Management and staff to attend the residents committee meeting once a month in the Day Room. If some are unable to go the Committee members will visit the residents in their room to hear about any concerns they may have. The management team addresses the feedback they get from the residents and their concerns and formulate an action plan to solve any problems.

[www.kiltipperwoods.ie]

2)  Key Factors which impact the Work Practice Organisation

A)  Evaluate the impact of globalisation, new technology and Science on the Work Practice organisation

Globalisation

“Globalisation is a process by which economies and cultures have been drawn deeper together and have become more inter-connected through global networks of trade, capital flows, and spread of technology and global med” [www.tutor2u.net].

Healthcare is a globalised sector as it is everywhere in the world. Meanwhile the healthcare sector worldwide is at times struggling to meet the needs and expectations of patients and others in their care. This is true in Ireland where the demands on the Health Service are not met by the HSE. Even so there is much advancement which impact positively on my Work Placement Organisation which has strong links with Tallaght University Hospital.

New technology

Technology in the healthcare industry is changing and improving just like other industries. They are changing year by year for the purpose of changing the way medical services are delivered. They are benefiting patients with new treatments, research and medicines.  [www.healthline.com]

Digital diagnostics Nuetrotrack is an example of digital diagnostics, a software-based Alzheimer’s diagnostic test that can identify damages on the hippocampus (the first part of the brain to be affected by the disease) by viewing eye movement. There are a lot of residents in KWCC with Dementia and others who may be developing it. This benefits future residents who are at the early stage of Alzheimer’s or who are at risk of getting Alzheimer’s as it will stop their hippocampus from getting affected.  [www.hisi.ie]

EpicCare is one of the largest health information technologies used in nursing homes as it informs the multidisciplinary team of any updates from the residents. It is used to store resident’s information of daily activities such as bathing, toileting, mobility, recording of fluid intake and eating. The use of EpicCare system makes the HCA’s work easier and updates the multidisciplinary team quicker. The EpicCare System is vital in ensuring continuity of care and is used in Kiltipper Woods Care Centre nursing home.

Here are some other new technologies used in KWCC:

• Posey Alarms
• Hoists
• Beds operated by remote control system
• Motorised wheelchairs
• Recliner Chairs

Science

Cancer research is ongoing to find a new way to treat cancer permanently. There’s a new type of anti-cancer drug discovered by Melbourne scientists where it can stop the cells from being awake and put them in a permanent sleep. Unlike conventional cancer therapies it does not cause harmful side-effects. Associate Professor Voss stated “Rather than causing potentially dangerous DNA damage, as chemotherapy and radiotherapy do, this new class of anti-cancer drugs simply puts cancer cells into a permanent sleep”. She has said there is still a lot of work that needs to be done before they can be tested on human cancer patients [medicalxpress.com].

B)    Review the impact of relevant government policy on the Work Practice Organisation

Fair Deal Scheme

The Fair Deal Scheme was introduced by the Government in October 2009. It helps to support those who are in need of long-term nursing home care such as those in KWCC. Every person makes a contribution to the cost of their care under the Fair Deal Scheme. The state will pay the balance. The HSE makes a payment to people for residential care in a registered nursing home prior to October 2009. To apply for the Scheme, you must be resident in the State, the process takes up to three months. [www.trinitycare.ie]. 

Trust in Care

This policy is about safeguarding the dignity and welfare of resident’s/patients by providing a caring environment. It is also a policy for the Procedure for Managing Allegations of Abuse against Staff Members. All employees of KWCC are trained in this policy. Trust in Care have the responsibility to protect the welfare of the residents/patients, adults and young children and to provide a caring environment where abuse does not occur. They are treated with dignity and respect at all times. 

HIQA

HIQA developed the National Standards for Residential Care Settings for Older People in Ireland. There are 32 standards that nursing homes need to meet to be registered by HIQA. KWCC has met these standards as they are registered by HIQA since they provide a high quality of person-centred care to the residents and patients.

Garda Vetting

Under the National Vetting Bureau (Children and Vulnerable Persons) Acts 2012-2016, it is mandatory for people working in Kiltipper Woods to be Garda vetted before commencing employment.[www.thejournal.ie]

C)   Assess if social or ethical issues have affected the Work Practice organisation or may impact in the future

On the days of my work placement, I have seen a recycling box in the staff canteen with a sign stating what can go in the recycling box and what does not.  Each kitchen on the units has also got the recycling box with the same sign. KWCC goes by the three R’S, Reduce, Reuse and Recycle. They reduce the amount of plastic and paper they use; they save energy by turning off the lights. They are saving water by limiting the use of how much water they use by turning it off. For example, turning it off when showering a resident.

The handover sheet has DNR “Do Not Resuscitate” clearly marked beside some of the resident’s names. Before the resident’s arrive to the nursing home, the family had already made the decision for their loved ones not to be resuscitated. They made this decision just in case if that day comes to it and because of how old they are.

The unit I work on has 4 residents who only want female HCA’s looking after them. One of those female resident’s would only allow a male resident to get her ready if they are very short staffed

The HCA’s cannot restrain the residents from stopping them from leaving their room by putting a table in front of them, keeping them in the bed all day and leaving them to stay in their room. Some residents have a bed lever to prevent them from falling out the bed accidentally when they are sleeping. When the HCA’s are finished getting the residents up, they must record in the Epic Care what time they have got them up for the nurses to see how long they have been restrained in bed.

When the nurse strike was happening back in February it was impacting on the resident’s as their hospital appointments got cancelled or rescheduled. During my work placement a respite care patient had to wait until the strike was over for the nurses to come back for Tallaght University Hospital to reschedule her appointment. Other residents got their hospital appointments cancelled or was not told it was cancelled and the nurse in charge had to ring Tallaght University Hospital to see what was happening.

D)      Comment on any impact to the Work Practice organisation in relation to economic and population shifts

Kiltipper Woods Care Centre is a multicultural nursing home where the people who work there are from all around the world. They come from Ireland, India, Philippines, Croatia, UK and other Asian countries.

Population Shifts

During the past year HCA’s and nurses are leaving KWCC to work in HSE or abroad to America, Canada and the UK for better pay and better and working conditions. This is impacting on KWCC causing them to have short staff and involving the staff nurses to work alongside the HCA’s and HCA’s to assist the nurse in charge with the medication and vital signs. It’s not just impacting on the staff but also the resident’s as they know they are short staffed. The HCA’s and nurses from different units had to go to another unit as they were short staffed. The delivery of care was slow as some of the residents who normally get up first in the mornings were complaining to the HCA’s for not getting ready in time.

Economic reasons

Irish people are not only moving to the HSE and abroad but Healthcare Professionals are moving to Ireland from abroad as they see it has better working conditions. The staff are working hard to support their families back in their home countries by sending money to support them.

Health, Safety & Welfare at Work: Employment & Equality

3)      Health, Safety & Welfare at Work: Employment & Equality

A)      Summarise the main legislation and regulations relevant you your organisation especially relating to health, safety and welfare, employment, equality and any other matters related to your organisation

The Safety, Health and Welfare at Work Act 2005 outline the main provisions for employers to secure and improve the safety, welfare and health of the employees.  KWCC States has a specific Mission Statement on this. (Please see Appendix 3)

Health, Safety & Welfare at Work Act

As an employer KWCC has many responsibilities under this Act as does the Employee.

Responsibility of employer:

• Provide and maintain a safe working environment

• Provide protective clothing and equipment to employees

• Ensure competence

• Report accidents to authority

• Provide information, instruction and training to employees on health and safety

• Prevent improper conduct and behaviour

• Safe practice programmes

• Adequate emergency plans

• Appoint a competent person as the organisation’s Safety Officer

Responsibility of employee:

• Comply with legislation and safety statement

• Take responsibility and reasonable care

• Not to engage improper behaviour

• Not to be influence of intoxicant in the workplace

• Use protective equipment

• Adhere to safe systems of work

• Do not interfere with safety statement

• To undergo any medical or other assessment if requested by the employer

• Report any defects, contraventions or danger in the work place or equipment.

Manual Handling

The importance of manual handling in the healthcare sector is crucial as it reduces the risk of injury to us and the residents from incorrect manual handling. All employees have manual handling training and KWCC has up to date manual handling training in place.

Employment

Organisation of Working Time Act 1997

The average working week for employees is no more than 48 hours a week. This does not include paternal leave, maternity leave, adoptive leave, sick leave or annual leave. This act protects the employees from working 24 hours a day. The working time and rest periods does not apply to all employees in Ireland which are the Gardaí, self-employment, and defence forces, family employees on farms or in private homes.                         [www.citizensinformation.ie]

In Ireland it is authorised to have leave and time off from work under the Organisation of Working Time Act 1997.

• Maternity Leave and Adoptive Leave
• Paternity Leave
• Parental Leave
• Urgent family leave/force majeure leave
• Career’s Leave
• Jury Service
• Bereavement leave
• Time-off
• Special leave – Career break.

They have an employee handbook for the staff and it is given on their first day of starting work. In the handbook, section 3, Page 67, it outlines the Equal Opportunities Policy where it gives a statement of policy stating “We recognise that discrimination is unacceptable and although equality of opportunity has been a long standing feature of our employment practices and procedures, we have made the decision to adopt a formal equal opportunities policy” (See Appendix 3).

General Data Protection Regulation (GDPR)

It has been updated to the Data Protection Act 1988-2018 on the 24^th May 2018. They protect people’s privacy of their personal data from employers or anyone from leaking out their personal data. The employers cannot retain their information no longer than is necessary.

The Equality Status Acts 2000 to 2015

It is forbidden to discriminate a person in your workplace, vocational training, collective agreements, advertising and the provision of goods and services under these acts. Those who provide services to the public cannot discriminate others. The Equal Status Acts 2000-2015 cover the nine grounds of;

• Gender– cannot discriminate someone for being a man, woman or transsexual.
• Marital Status – who is single, married, separated, divorced, widowed, people, civil partners and former civil partners.
• Family Status – a person under the age of 18 or parent of a person with a disability or the resident primary carer.
• Age – does not apply to someone under the age of 16
• Disability – a person with physical, intellectual, learning cognitive or emotional disabilities and a range of medical conditions
• Sexual Orientation – this includes gay, lesbian, bisexual and heterosexual.
• Race – includes their skin colour, their race, nationality or ethnic origin
• Religion – religious beliefs, background, outlook or none
• Membership of the Traveller Community

[www.ihrec.ie]

Disability Act 2005

People in Ireland who has a disability are entitled to have their health needs assessed along with educational needs, access to public buildings and public service employment and are allowed to access independent complaints and appeals procedures. This policy applies to KWCC and we must make sure we improve the quality of life for people with disabilities.

Internal and external policies and procedures

4)    Internal and external policies and procedures

A)      Explain the internal and external policies and procedures appropriate to your own role and that of others within your organisation

My role as healthcare assistant is to make sure that I understand all policies and procedures in my work place are read and I do my part in implementing them in order to provide high quality care to all resident’s. To work in the nursing home as a HCA we need to have QQI Level 5 Major Award in Healthcare Support which is a HIQA and also internal policy.  Internal and external policies and procedures are very important.

There are over 200 staff employed in KWCC while there are about 115 residents. Employees are entitled to have a contact of employment either if full-time, part-time or bank staff. They are given an employee handbook where they must sign the last page stating they have read the handbook and understand it. Once finish they must pull it out and hand it back to the HR.

It is required to give at least one month notice of the staff’s intention to take holidays and two weeks’ notice is required for odd single days.

Public Health (Tobacco) Acts 2002-2015 purpose is to protect employees and the public from exposing themselves to the dangerous effects of tobacco in your workplace. In Ireland it is forbidden to smoke in enclosed places under this ban e.g. health premises, company vehicles and licensed premises. Meanwhile, there are a few exceptions of this ban e.g. nursing homes but KWCC had recently became a non-smoking environment. The staff must leave the premises to smoke as they are not permitted to smoke anywhere on the ground or within 25 metres of any entrance onto the grounds. This includes but is not limited to car parks, courtyards and other external areas.

The fire drill tests takes place regularly in KWCC where they run it in each unit at the same time. They have an assigned fire safety mentor where they tell the staff where to go. Once they find the cause of the fire, they have to check if they got it right and see if they missed anything out. I had attended two fire drill tests on one of my work placement days.

All HCA’s and the nurses should know the policies and procedures on Infection Prevention & Control (IPC) in the healthcare environment. The SARI hand washing technique poster is above each washing station in Kiltipper. I use the SARI hand washing technique all the time on my work placement, but we can use alcohol-based hand rubs as an alternative. They do this to prevent spreading infection and cross contaminating the things we touch.

The 5 moments of hand hygiene are:

1. Before touching a patient
2. Before clean/aseptic procedure
3. After body fluid exposure risk
4. After touching a patient
5. After touching patient surroundings

Wearing PPE is extremely important as it prevents those getting infections when touching blood, body fluids excretions, or sections but they must choose the correct PPE according to the risk.

HIQA standards for Older Person in Residential Care is followed by the HCA’s. The standards above are what the nursing homes should do in Ireland to provide a high quality of care and safe environment for people living there. Each standard describes of what a nursing home should be meeting.

Conclusion

I have seen how much I have grown as a person by how much my self-confidence had built up and how my shyness had went. I have grown a lot personally but also in a professional way as I had learnt to not receive feedback in a personal way.

I had learnt to enjoy myself and have a laugh with the residents and the staff members the past few weeks of work placement. The first couple of weeks of work placement I would never had done this as I did not felt comfortable at all. I am not the only one who has seen how much I have grown as the Staff members and residents had told me how much they can see a difference in me. The staff members are proud of me on how I look after the residents and take the time to chat with the residents.

I am happy I did not give up doing my work experience in Kiltipper Woods Care Centre because I would never had met such lovely people and the residents are very friendly, caring and loving. The Senior HCA had told me she can see how caring I am towards the residents and how competent I am. If it wasn’t for the people there I wouldn’t be the person I am now.

The last few weeks of work placement and the 2 block week, I released how much passion I have to care for the elderly by the way I talk with them, look at them and how I assist with their ADL’s.

I would stay being a HCA because I enjoyed seeing the resident’s daily and they also enjoy seeing me.

Webography

• http://www.kiltipperwoods.ie/
• https://www.tutor2u.net/economics/reference/what-is-globalisation
• https://www.healthline.com/health-news/tech-innovations-healthcare-2018#1
• https://medicalxpress.com/news/2018-08-anti-cancer-drugs-cancers-sleeppermanently.html
• https://www.trinitycare.ie/paying-for-care
• https://www.citizensinformation.ie/en/employment/employment_rights_and_conditions/data_protection_at_work/garda_clearance_for_employees.html
• https://www.thejournal.ie/patients-nursing-home-beds-hse-1869732-Jan2015/