1.1 Evaluate how the current legislative framework, evidence-based research and organisational protocols impact on the management of domiciliary services

The main legislative policy in the UK covering domiciliary services and care for children and adults is the Care Act of 2014. It provides specific guidelines to social and domiciliary caregivers regarding the promotion of citizens’ welfare. Perhaps one of the most notable principles is empowerment that encourages support for people in making their own decisions and the encouragement of informed consent. In this respect, domiciliary services must be provided following the patient’s consent or that of their family. In addition, the principle of prevention is based on the fact that actions are better taken prior to the onset of harm. The principle of proportionality also encourages the use of responses that are not intrusive to the patients. This principle ensures that the affected patients are made comfortable during the provision of care services. The principles of protection and accountability ensure support for those in need while encouraging openness in the safeguarding practice. Lastly, the Act encourages partnerships through the involvement of communities in identifying, reporting and preventing cases of neglect and abuse (Mozley, 2014).

The provision of domiciliary services has received increased interest in research over the last decade. Community involvement has been observed to be a key component of the success of domiciliary care. It is not surprising therefore that the regulation advocates for the sue community social organisations in advancing the services. The evidence from research has encouraged the application of relevant principles in advancing the services. Moreover, organisation protocols are largely bent towards a focus on prevention of abuse and harm. In this way, the extension of domiciliary services is largely based on the principle of prevention.

1.2 Explain how person-centred practice influences the management of domiciliary services

Person-centred practice involves the treatment of people as individuals thus ensuring they receive timely and appropriate care for their individual needs. This concept of care provision is independent of the client’s housing, health or social care service restrictions. In this regard, it resonates and influences the management of domiciliary services in the UK through its focus on individual service provision. For one, it is a holistic approach that is based on putting the patients or clients at the centre of care provision. In this manner, the provision of domiciliary services is based on the particular needs of the client and not a predetermined outcome. In addition to this, the management of domiciliary services involves such professionals as social workers, physiotherapists and nurses at the district level. In so doing, the process incorporates professionals that have quicker reach to the clients and who know the client’s needs better.

Still, person-centred practices conform to the management of domiciliary services through the structure of care needs and plans. Indeed, the current regulations provide that each client be facilitated to form a care plan that identifies and targets to solve the different care needs. The fact that both clients and their families are involved in the provision of domiciliary care services makes it person-centred. Indeed, the concept of person-centred services is based on the prior notification of the client regarding the processes that will be undertaken. In the UK, domiciliary services are structured in a way that an eligibility criterion is shared with the client before the actual service is provided. Further, the incorporation of local partnerships in the process provides for person-centred service provision.

1.3 Analyse ethical dilemmas and conflicts experienced by managers and practitioners of domiciliary services

The provision of domiciliary care services is no mean task for the managers and practitioners. Part of the schedule involves working for long hours away from home and office settings. One of the biggest conflicts revolves around social isolation and the onset of loneliness for the professionals owing to long schedules away from home (Gray & Birrell, 2013). Also, the involvement of the family may present challenges to the professional as they may come up with very conflicting directions. Far from the client’s home, the practitioners have the challenge of calls allocation where the time is quite low. For instance, the time allocated may be too few for a thorough provision of the required service thus presenting numerous challenges to the practitioners. Still, the requirement that clients make the decision regarding care given is a source of ethical dilemma to the practitioners. For instance, some of the clients may make decisions that are medically unwise even though they have mental capacity.

The decision to include family members to make decisions for frail clients is potentially unethical as the decisions may be unwise at the time. For instance, some members may make decisions that are not in the best interest of the patients. Also, caregivers have a challenge of maintaining confidentiality when they are required to share information with relevant professionals. In some cases, therefore, information shared to the professionals may be confidential thus giving the practitioners a hard time in the process. Moreover, the issue of funding is also quite challenging owing to the incidence of budget cuts within the country. Some of the budgets allocated to the patients may be too low to make any meaningful impact on the health needs of the patients.

2.5 Explain systems that calculate and justify charges for domiciliary care

The consideration and calculation of domiciliary service fees is dependent on two factors: bottom up and competition. While the first factor has to do with the wage and salary cost as well as the business overhead costs, the second one is based on the acceptable fees in the market. Domiciliary fees are paid by either the public or the private service user through different avenues. For instance, public funding sources include community health care, direct pay as well as social services. The use of public funds is advantageous as it encourages the negotiation of discounted rates from selected suppliers based on the volume of business introduced. Also, public funds have the benefit of increased information thus facilitating faster assessments to the benefit of the patients. The fact that public funds commit to paying regularly helps in the proper management of business cash flow. In this way, the public fund is considered a safer and better alternative compared to the private service users.

The benchmarking conducted by local authorities stemming from government regulations also influences and justifies the domiciliary fees. Part of the role of the local authorities is to benchmark the fee for domiciliary services thus justifying the amount payable for different care needs. The fees paid by private clients are further based on the number of social visits as well as the specific services rendered. It would be unfair to charge a similar fee regardless of the services offered to different clients. Some of the costs included in the calculation of private service fees include travel time, cost of supplies and staffing. In addition, such factors as mileage and training are also included in calculating and justifying domiciliary fees.

References

Gray, A. M., & Birrell, D. (2013). Transforming adult social care: Contemporary policy and practice. Bristol, UK: Policy Press.

Mozley, H. (2014). The Care Act 2014.

 
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