the swampy ground research project
a resource about partnership working for managers & educators in health & social care
Case Study - 'Actually getting together'
'Actually getting together' ....Getting ahead of legislative change for inspection and regulation units
This story is about merging inspection teams from both health and social care who are concerned with the standards of care in residential and nursing homes. The rationale for this was to ‘get ahead’ of the national timetable for this shift and to provide a single service to service users, who often don’t understand that if you’re in a nursing home, you go to one regulatory body, if you’re in a residential care home you go to another one – especially if they need to switch between the two.
This partnership developed following the White Paper, Modernising Social Services in 1998, which emphasised that Health and Social Care should be working more closely together. Stemming from this, the Care Standards Act 2000 required existing arrangements for regulating residential care homes be disbanded, and that from April 2002, a new national standards commission would embrace all regulatory functions in relation to residential care, that is, nursing homes, children’s homes, adult homes.
Researchers’ note: Many of themes in this case are likely to be raised in the shift from 2009 to the Care Quality Commission which will replace the Health Care Commssion and Commission for Social Care Inspection and merge their functions.
In this area people were aware the change to a single inspection format for homes was on the horizon, so an independent report was commissioned to look at the viability of having a voluntary partnership, to prepare for these changes.
People in this case:
Morag's viewpoint, Manager of a Social Services Inspection Unit
Diane's viewpoint, Manager of a Health Authority Inspection Unit
Stella's viewpoint, Inspector in a Social Services Unit, with a nursing background
Sheila's viewpoint, Acting Manager of the new joint unit
Mrs Smith's viewpoint, Head of Nursing in a group of private care homes
Read or download a PDF of all the stories in this case study.
researchers' Commentary
While since this story was researched there have been yet more changes in the inspection regimes for health and social care homes, this story nonetheless highlights some critical issues for partnership working across health and social care boundaries:
- The potential diversion factor of a key resister - but what power do they really have if they are isolated ?
- The movement was achieved when all the actors were brought together [widening the circle - Axelrod]:
- The impact of not having early enough leadership - the need to focus effort and for someone to help the group deal with issues early on:
- The importance of purpose and its relation to the service users, especially where staff are not front-line deliverers:
- Here the actors each worked within their own assumptions about their work and its purpose and philosophy:
- That the positives flowed from involving all the staff not just managers:
- The limits of a ‘zero sum’ view of power:
- How issues of fear and anxiety come to the fore, especially when core matters of how people perceive their own professionalism are at stake:
- How despite a common understanding that a cultural gulf existed to be bridged, the important thing is to have the tools of dialogue to deal with it:
Read or download a PDF of all the stories in this case study.