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Health and Social Care Level 5

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    Unit 5: Working in Partnership in Health and Social Care or Children and Young People’s Settings Unit code: M2c 1 Understand partnership working 1. 1 Identify the features of effective partnership working The policy of person-centred care has become a mainstay of efforts to reform health care in the UK. Government policy is now built around this core concept, a major aspect of which is enabling individuals to participate in decision-making about their care at every level.

    By concentrating on the individual’s wishes and aspirations and placing them at the centre of a ‘planning circle’ the care team can assist with goal setting to ensure their best interests are maintained and the individual’s preferences are considered. Working in partnership is a key element of practice within health and social care. The concepts of power sharing, consultation and joint ways of working are essential for effective service provision. Health and social care professionals need to understand the importance of promoting autonomy with individuals.

    They also need to be aware of their own roles and responsibilities and how they relate to others within the sector. Organisations therefore now need to think creatively about how to recruit and involve individuals in planning and delivering of care services and need to invest time and effort in effective ‘partnership working’ This ensures the individual accessing care or services is placed at the centre. The team should share a common purpose and vision to improve the individual’s life. Effective partnership working involves many features including: * trust empathy * respect for the skills and contribution of colleagues * communication * effective listening skills * realistic expectations * clear objectives * honesty * working to agreed practices * maintenance of balance between task and relationship orientation There are various theories relating to effective partnership working. These include areas such as team working, avoidance of social loafing, avoidance of groupthink and supportive approach Partnership working Theories The Team Roles that Meredith Belbin identified are widely used in organisations.

    They are used to identify people’s behavioural strengths and weaknesses in the workplace. This information can be used to: * Build productive working relationships * Select and develop high-performing teams * Raise self-awareness and personal effectiveness * Build mutual trust and understanding * Aid recruitment processes * Social loa? ng The tendency of some group members to put in less effort if they believe that their underperformance will not be noted – the phenomenon of one group member getting a ‘free ride’ while others do the work Factors that increase loa? ng • Lack of identi? ability No individual evaluation • No individual or group standards of evaluation • Task is easy, boring or the same as others • Individual contributions not necessary • No individual or group incentives • Large group • Unfamiliar group Factors that reduce loa? ng • Individual identi? ability • Individual or group evaluation • Individual or group standards of evaluation • Task is dif? cult, interesting or different from others • Individual contributions essential • Individual or group incentives • Small group • Familiar group Irvin Janis – groupthink Groupthink is a psychological phenomenon that occurs within groups of people.

    It is the mode of thinking that happens when the desire for harmony in a decision-making group overrides a realistic appraisal of alternatives. Group members try to minimize conflict and reach a consensus decision without critical evaluation of alternative ideas or viewpoints. Antecedent factors such as group cohesiveness, structural faults, and situational context play into the likelihood of whether or not groupthink will impact the decision-making process. 1. 2 Explain the importance of partnership working with Partnership working is important in improving the outcomes for individual’s accessing services.

    By working closely with colleagues and others involved in the individual’s care you are able to share, utilise and maximise everyone’s expertise in order to achieve the planned objectives. Each person in the work environment will have their own areas of expertise, knowledge and responsibilities. By communicating with everyone involved and sharing responsibilities, it avoids duplication of tasks and services, ensuring the best possible service and outcomes are achieved. • Colleagues Within my organisation it is important to promote the communication cycle and ideas sharing with colleagues who may include the support workers and managers.

    In order to work well in partnership, there has to be good communication and I will need to have good communication skills. • Other professionals I will always need to make sure that I am doing the right things, in the right way, at the right time, for the right people, openly, honestly, safely and in a professional way. Learning from others and working in partnership is important. It will help me to understand the aims and objectives of different people and partner organisations as they may have differing views, attitudes and approaches.

    It is essential that everyone’s focus is on providing the best care and support to individuals. Other professionals may include workers from other agencies or organisations, advocates, independent visitors • Others It is important to consult the individual’s, their families, friends and any advocates as they will all have expert knowledge regarding the needs, preferences and wishes of the individual at the centre of the plan. They will have details about the individuals past history and life which will all be taken into account when establishing the individual’s plan of care and support.

    An example might be if there are communication difficulties. A carer or family member can share information with me about how I can best communicate with an individual. This enables the individual to be listened to and supported in ways that they desire and choose. 1. 3 Analyse how partnership working delivers better outcomes Health and social care organisations increasingly need to work together in partnership to get better value from the available resources and improve services and outcomes for service users, by improving quality of support for service users.

    Good relationships between partners, a common vision and understanding of expected achievements and what outcomes need to be delivered are critical to the success of partnerships. This will enable a more responsive service, which is well co-ordinated approach to the service delivery, and better value for money by ensuring reduced duplication of services. Multi-disciplinary and multi-organisational working allows for a holistic approach to problems.

    With good communication channels and relationships with people from different organisations and disciplines, the team is made larger and therefore more resources are available to call upon and use, which benefits the teams objectives, to provide the best possible care for the service user. This will also enable the delivery of a flexible service centred on the individual’s needs. To provide person centred care it is essential that communication between inter-agencies, individuals, key people, service user’s family and friends, G.

    P’s, opticians, dentists, psychologists etc. is really effective. Any barriers to communication should be minimised to ensure good communications. Dissemination is the opening of a subject to widespread discussion and debate. It is the process of communicating your ideas to all those working together in the partnership, so that they can be used and lead to change. This should be an on-going activity which is used to inform changes to policies and procedures within the workplace and involves the sharing of good practice leading to reduced professional isolation. . 4 Explain how to overcome barriers to partnership working Working in partnership is crucial and is particularly significant in regard to health and social care. Partnership working across agencies can be a challenging task. The lack of understanding of the respective roles, duties, responsibilities and organisation, of the different agencies and professionals and of their different language, may lead to poor communication, misunderstandings and frustration.

    Key challenges include the need to overcome separate legislative frameworks, organisational imperatives, funding streams and professional rivalries in order to improve people’s experience of services, and so lead to a more co-ordinated care resulting in improved outcomes for service users. Partnership working can become difficult where there are perceived status differences between individual participants or occupational groups. It takes skills and knowledge to work successfully with people from different professional backgrounds and with partners from the wider health and social care economy.

    There are many ways in which barriers to partnership working can be overcome. * Face to face working * Joint training * Informal meetings * Commitment to the partnership * Team building activities * Shared use of terminology/language * Sharing information * Sharing goals, aims outcomes and objectives * An understanding of each partners respective roles * Joint protocols agreeing the roles and responsibilities of the different agencies The first defence against barriers to partnership working is knowledge and open acknowledgment within the partnership of their existence.

    Thereafter, partnerships will need to identify those factors which they can and cannot control and take action on aspects within their power. 1 Be able to establish and maintain working relationships with colleagues 2. 1 Explain own role and responsibilities in working with colleagues It is important in my role to maintain a professional approach whilst upholding my workplace principles and values. it would be up to me to set tasks and clear objectives for my colleagues which should be SMART, specific, measurable, achievable, realistic and there should be timescales.

    Wherever possible I should involve colleagues in the decision making process when setting objectives. By listening and accepting colleague’s ideas, suggestions and opinions I will make sure that they feel important and acknowledged in the work that they are doing. This will make it more likely they take ownership of the objectives and feel more valued and work more actively to achieve the desired outcomes. It is important that I support colleagues and give them feedback and suggestions on how performance can be improved. It is also important to acknowledge the different needs of each individual team member.

    It is important, as manager, to know and recognise my own limitations and to share any concerns I have with colleagues. By holding regular team meetings this will provide an opportunity to share relevant information, make decisions as a team and provide support and help for team members. They are also useful communication tools which ensure that colleagues are kept informed about progress and objectives. As Manager I will be responsible for updating policies and procedures within the workplace therefore it is essential that you keep up to date with your knowledge in order to pass on relevant information to your colleagues.

    Theories The Forming – Storming – Norming – Performing model of” group development” was first proposed by Bruce Tuckman in 1965, who maintained that these phases are all necessary and inevitable in order for the team to grow, to face up to challenges, to tackle problems, to find solutions, to plan work, and to deliver results. This model has become the basis for subsequent models. Forming In the first stages of team building, the” forming” of the team takes place. The individual’s behaviour is driven by a desire to be accepted by the others, and avoid controversy or conflict.

    Serious issues and feelings are avoided, and people focus on being busy with routines, such as team organization, who does what, when to meet, etc. But individuals are also gathering information and impressions – about each other, and about the scope of the task and how to approach it. This is a comfortable stage to be in, but the avoidance of conflict and threat means that not much actually gets done. The forming stage of any team is important because, in this stage, the members of the team get to know one another, exchange some personal information, and make new friends.

    This is also a good opportunity to see how each member of the team works as an individual and how they respond to pressure. Storming Every group will next enter the “storming” stage in which different ideas compete for consideration. The team addresses issues such as what problems they are really supposed to solve, how they will function independently and together and what leadership model they will accept. Team members open up to each other and confront each other’s ideas and perspectives. In some cases “storming” can be resolved quickly. In others, the team never leaves this stage.

    The maturity of some team members usually determines whether the team will ever move out of this stage. Some team members will focus on minutiae to evade real issues. Norming The team manages to have one goal and come to a mutual plan for the team at this stage. Some may have to give up their own ideas and agree with others in order to make the team function. In this stage, all team members take the responsibility and have the ambition to work for the success of the team’s goals. Performing It is possible for some teams to reach the “performing stage”.

    These high-performing teams are able to function as a unit as they find ways to get the job done smoothly and effectively without inappropriate conflict or the need for external supervision. By this time, they are motivated and knowledgeable. The team members are now competent, autonomous and able to handle the decision-making process without supervision. 2. 2 Develop and agree common objectives when working with colleagues It is vitally important to be clear about what’s trying to be achieved and what colleagues are responsible for.

    Everyone needs to know what is expected of them and it needs to be possible to assess how well I am doing in working towards achieving my aims and objectives. In order to develop and agree common objectives when working with colleagues I may need to negotiate and make compromises in some areas. All planning, goal setting and targets must make sure they encompass the needs of the service user and they are at the centre of my planning. By promoting relationships that respect colleague’s ideas and opinions, I am showing colleagues that I value their opinions.

    This can be achieved by having team meetings and giving the team members the chance to share ideas and give feedback on team working and to develop and agree objectives. This also ensures good relationships between team members and that colleagues are aware of the goals of the team and where they fit into those aims. Colleagues will work better in partnership when they are aware of their goals and share common objectives which they are all working towards together. 2. 3 Evaluate own working relationships with colleagues

    Team skills management is a recognised method (created by Belbin) to establish managerial style. Using a self-grading system an individual can establish a personal inventory of their skills, strengths and weaknesses. It is also possible to evaluate my strengths and weaknesses as an open and participatory leader by encouraging and putting procedures in place to receive feedback on my own performance as a leader from the team members and by providing opportunities for all those involved in the working relationship to express their views. As manager I can also complete self-appraisal.

    Self-appraisal is an important part of the Performance appraisal process where the employee themself gives the feedback or views and points regarding their performance. Usually this is done with the help of a self-appraisal form where the employee rates themself on various parameters, tells about their training needs, if any, talks about their accomplishments, strengths, weaknesses, problems faced etc. My effectiveness as manager can be assessed by measuring success against set targets and by reviewing objectives and checking progress 2. Deal constructively with any conflict that may arise with colleagues All managers will at some time, have to deal with conflict. The way I handle discord is a determining factor to success. Initially, I must communicate to gain a clear understanding of what is actually causing the conflict. Conflicts may have many different causes, for example, colleagues may have different work methods, with the same goals but different approaches to achieving them. A clash of personalities, stress and differing views can often all be sources of conflict.

    Conflict is not necessarily a bad thing providing that it is dealt with constructively. When dealing with a group of people conflict and dilemmas are inevitable. If a conflict or dilemma is dealt with successfully, not only will the problem be resolved but an increased understanding of each other and a situation may follow. Communication is a vital tool in dealing with conflict. In order to deal with the conflict the following steps can help: * Identify the issue * Propose several possible solutions * Evaluate the alternatives * Determine the best solution * Implement Continual evaluation of the solution Strategies to minimise conflicts should be embraced, such as respect for others, communicating your expectations, encouraging team work and empowering people. This is all vital when leading teams because it is inevitable that conflicts and dilemmas within the team or concerning the team will arise. It is important that these are solved effectively by using the most appropriate style for the situation to ensure that the team continues to work effectively and hopefully some lessons and development can come from the situation.

    A good way of preventing conflicts from erupting is by creating an atmosphere in which collaboration is valued and interpersonal differences are accepted. 3. 1 Explain own role and responsibilities in working with other professionals In order to provide a person centred service for individuals. I will need to work in partnership with professionals from other agencies and organisations. For this to work successfully I need to be clear about my own role, responsibilities and limitations and also aware of the roles of other professionals; I need to be confident about my own standards and targets and respectful of those that pply to other services, actively seeking and respecting the knowledge and input others can make to delivering best outcomes for the service user. It is an important part of my role and responsibilities within partnership working to share my own skills and knowledge and also to take advantage of any opportunities to observe the practice of other professionals. By making effective use of opportunities to draw upon their skills and expertise it will enable me to extend my own knowledge and understanding.

    In order to work effectively with other professionals, I will need to interact with them in a manner likely to promote trust and confidence in the relationship. This will include the sharing of information, which must be complete and accurate, in order to assist them in their role. I should make sure that I work within the boundaries of my knowledge and responsibility and keep accurate records which are stored correctly in line with the data protection act and my organisations policies and procedures. I will be able to contribute to planning and implementation of joint actions consistent with my role and responsibilities.

    I need to have the confidence to challenge issues where appropriate and be able to state my own judgements in an assertive manner. It is also my role and responsibility to upholding my work sectors principles and values whilst maintaining a professional approach. To summarise I will need * Effective communication skills – by listening and making sure I am listened to * Use plain language during communication not professional jargon * Provide timely, appropriate, succinct information to enable other professionals to deliver their support to the individual * Record, summarise, share and feedback information. Respect the contribution of others working with individuals * Share experience through formal and informal exchanges 3. 2 Develop procedures for effective working relationships with other professionals It is important to develop procedures for an effective working relationship with other professionals because as well as making my workplace more enjoyable to work in, the service users will benefit from a better service with better outcomes, when everyone works as a team. It will also help my organisation to maintain a professional image.

    In an effective relationship parties listen to and understand others’ positions and feelings. The simplest way to understand what is important to another person or to a group is to ask, then and listen to the answer. It is important to clearly define my own role and responsibilities and those of other professionals and agree common objectives, goals, targets and ways of working. I will need to exchange complete, accurate and up-to-date information with other professionals whilst respecting requirements for confidentiality.

    In order to ensure an effective working relationship this must be done in line with good practice, values and ethical requirements. Any commitments I have made should be fulfilled or advise people immediately if I am unable to do so. Any disagreements and complaints should be dealt with promptly, positively and in line with organisational procedures and professional guidelines and also in the best interests of the service users. To summarise: Multi-disciplinary working requires the establishment of shared protocols and formalised procedures to help ensure consistent standards of care * Developing an effective multi-disciplinary team requires the setting of clear objectives through the identification of need and the planning, purchasing and financing of services * Effective planning * Consideration of how services are to be financed * Management of a multi-disciplinary team requires procedures to address the professional, training and developmental needs of individual team members. 3. Agree common objectives when working with other professionals within the boundaries of own role and responsibilities I will need to build relationships with other professionals and be able to work effectively with them, both inside and outside of healthcare in order to deliver a high standard of care and to make sure of the service users safety. It is important to ensure that the service user remains the centre of the process. It is important to respect the skills and contributions of other professionals, and developing effective communication with other members of the team and with the service user.

    Common SMART objectives should be established in the beginning and be agreed by all involved in the partnership. • Specific. This means that they tell you exactly what to do. • Measurable. This means that there should be a way of telling when you have reached the goal. • Achievable. There is no point setting a goal that you cannot possibly achieve, as this will demotivate you. Be honest about your priorities in the coming weeks and do not try to do too much. • Relevant. The goal should help you to move towards your final goal, e. g. to achieve your key skills. • Timed.

    A deadline should be set for achieving your goal I must remain aware of the boundaries of my own role and responsibilities as detailed in my job description. My job description is a communication tool which will advise me where my job role ends and another person’s job role begins. Any agreements, objectives and plans should be recorded in line with my company’s policies and procedures and should detail my role and responsibilities and the role and responsibilities of others, so that everyone is clear on how they are involved, and the objectives, with agreed agendas on how they will be reached.

    So what are objectives? Objectives are the outcomes I expect to achieve from my aims or goals. Objectives act as a reference to guide me through the planning process – they influence all the decisions I make. I will hold meetings with all those involved in planning and implementing the service user’s plan of care in order to discuss objectives and to agree an agenda of how these objectives will be achieved. A meeting is not simply a time to get together and discuss what is going on.

    The main purpose of most meetings is to reach agreement on how to progress in the future. It is important that decisions made in meetings are clearly recorded, so that everyone knows what will be done, who will do it and when it will be done. Written records of meetings are usually known as meeting minutes. They usually record who attended the meeting, what was discussed and what was decided. I must establish the principle of transparency concerning the sharing of information. What types of information would be covered by this?

    How and by whom should information be made available by each of the party(ies)? What are the consequences of failing to make agreed information available to the other party(ies)? What are the agreed expectations concerning the sharing of information? What information can each organisation withhold from the other? What information may be used externally by each party? Me and my partners should agree an agenda at the start so that everyone is clear about the objectives, their personal responsibilities and the responsibilities of others in the partnership. 3. Evaluate procedures for working with other professionals In order to evaluate procedures used for partnership working there has to be a system in place to monitor and review progress. This is where the importance of agreeing the outcomes and timescale at the beginning of the partnership are important. The evaluation should be carried out by monitoring, reviewing and measuring the progress made against set outcomes. Regular progress reports should be produced. If procedures are working well with all the professionals involved this will result in positive outcomes e. . coordinated service provision, professional approach, clear roles and responsibilities, organised communication, avoidance of duplication, preventing mistakes, efficient use of resources. If the procedures are not working it could result in negative outcomes such as professional rivalry, miscommunication, time wasting and mismanagement of funding. The impact of my organisations working with other professionals, on the service users, should be taken into account and their views and opinions should be listened to as part of the evaluation process.

    This part of the evaluation could be conducted by completion of a questionnaire by service users, if possible. Positive outcomes for the individual could include improved services, empowerment, autonomy, informed decision making whilst negative outcomes could consists of miscommunication, information overload, confusion, frustration, duplication of service provision and disempowerment 3. 5 Deal constructively with any conflict that may arise with other professionals It is important for all members of a partnership to be aware that conflict is inevitable.

    Different philosophies, principles, priorities and codes of practice can have a positive effect on team working by providing a more thorough and well-rounded look at how the team should be working to achieve the best possible outcomes for service users. However if the different philosophies, principle, priorities and codes of practice are in conflict with one another it is possible that this will have a negative effect because there will be inconsistencies and this can result in confusion within the workplace. The team’s ability to meet all the needs of all agencies and partners can be difficult if they conflict.

    Conflict is not necessarily a bad thing providing that it is dealt with constructively. In social care work the team members have to deal with each other, multi organisational disciplines such as GP’s, family and friends of service users and the service users themselves. When dealing with this many people and their views conflict and dilemmas are not only inevitable but often daily occurrences. If a conflict or dilemma is dealt with successfully, not only will the problem be resolved but an increased understanding of each other and a situation may follow.

    There are several styles that can be adopted when dealing with conflicts or dilemmas; * Competitive – A competitive style is usually adopted by the person involved in the conflict that has more power. They know what they want and they are not willing to budge from their position. They want to win at the other person’s expense. This can be useful in situations of emergencies when the problem needs a quick resolution. * Collaborative – A person adopting this style is concerned with meeting the needs of all the people involved. In care this can be useful when balancing the needs of service users and the organisational requirements.

    The aim of this style is to achieve a win: win scenario following the conflict or dilemma because everyone has helped to establish the solution together. A person adopting this style is also concerned with everyone getting something that they want but possibly giving up something else, reaching a compromise and reaching a win: win situation. * Accommodating – A person adopting this style is concerned with meeting the needs of others at the expense of their own. This person is not assertive and highly cooperative. This style is appropriate when a peaceful outcome is more important than winning. Avoiding – A person adopting this style is concerned with evading conflict and the dilemma entirely. This style is not very effective at resolving conflicts or dilemmas but is appropriate if there is no chance of winning for either side. A good way to resolve conflicts and dilemmas is to follow some rules. It is based on both parties working together to find a mutually acceptable solution. This is however based on the assumption that there is sufficient common ground to make it worthwhile. I should * Make sure that good relationships are my first priority * Identify the issues * Be open and honest Keep people and problems separate * Pay attention to the interests that are being presented by listening * Listen effectively first and talk second * Non-judgemental approach * Set out the facts * Explore the options together Another option is mediation, which involves including a third party into the situation. The mediator works with both parties passing on information and attempting to get the negotiations moving rather than coming to a halt. The mediator should be neutral and should not pass on their own opinions. They should build trust with both sides in order to be effective.

    This is all vital when leading teams because it is inevitable that conflicts and dilemmas within the team or concerning the team will arise. It is important that these are solved effectively by using the most appropriate style for the situation to ensure that the team continues to work effectively and hopefully some lessons and development can come from the situation. A good way of preventing conflicts from erupting is by creating an atmosphere in which collaboration is valued and interpersonal differences are accepted but are not allowed to jeopardise cooperation. 4. Analyse the importance of working in partnership with others It is essential that I work in partnership with all of the people surrounding the individuals I am supporting in order to ensure a person centred approach to their care and the best possible support and care is provided. Before discussing inter-agency co-operation and participation, it is important to consider how I can promote the participation and empowerment of the service user. No matter how effective the inter-agency collaboration and information sharing is, if the service user does not feel part of the process the chances of successful outcomes will be significantly reduced.

    I will need to work in partnership with carers, families, advocates and other people who are sometimes called “significant others”. In order to work well in partnership, there has to be good communication and I will need to have good communication skills. Others people may be able to provide useful information to support me in my work. They will have knowledge of the needs, wishes and preferences of the individual. Also I may be able to provide useful information to support them in being part of the individual’s lives.

    This is good partnership working. An example might be if there are communication difficulties. A carer or family member can share information with you about how you can best communicate with an individual. The importance of this is it enables the individual to be listened to and supported in ways that they desire and choose. Information should be collated from all the available sources to build a picture of the individual life. In doing so this will promote the individuals well-being and provide a holistic approach to their care needs. . 2 Develop procedures for effective working relationships with others The service users’ needs, preferences wishes and health care requirements need to remain at the centre of any procedures developed for an effective working relationship with them, their family or carers. They should be fully informed and involved in any decisions regarding their care and the delivery of any support they may need. At the start of an individual’s care all those involved should discuss the care package, and establish a shared understanding.

    It will be necessary to set boundaries in various areas for example confidentiality, the recording and storage of information and the sharing of information with other agencies. Everyone involved should be aware of the complaints procedure in case of any future problems. Communication is an important area to discuss and regular contact and updates should be agreed in the beginning. By developing and building good relationships with all concerned and by ensuring my colleagues are aware of procedures an effective working relationship will be established.

    I should provide staff with feedback and suggestions of areas requiring improvement. 4. 3 Agree common objectives when working with others within the boundaries of own role and responsibilities Refer to Outcome 3. 3 4. 4 Evaluate procedures for working with others Refer to outcome 3. 4 Outcomes for users of services: * positive outcomes – will result in improved services, empowerment, autonomy, informed decision making; * negative outcomes – will result in neglect, abuse, harm, anger, miscommunication, information overload, confusion, frustration, duplication of service provision, disempowerment 4. Deal constructively with any conflict that may arise with others Conflicts are inevitable and it is possible to develop the skills required to deal with them in a constructive way in order to minimise the effects they can have. Good communication and even more importantly listening skills are the key to managing ethical dilemmas and conflicts for individuals. I should try to establish what has caused the conflict, be non-judgemental in my approach and establish a common ground to work from. Show empathy and try to understand their point of view and attempt to mediate a resolution by formulating points of agreement.

    Conflicts can be made worse or more frequent by someone’s illness or condition. Some conflicts may prove more difficult to deal with than others especially when it involves one person’s rights as opposed to another person’s rights. I should ensure that all service users are aware of the complaints procedure wherever possible and have support from staff to file a complaint. In ensuring this it is promoting the service users rights choices and well-being and builds a trusting relationship between them, their family and the establishment I work for. .

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