Lead and manage group living for adults

Table of content

1. Be able to develop the physical group living environment to promote positive

outcomes for individuals

1.1 Review current theoretical approaches to group living provision for adults
1.2 Evaluate the impact of legal and regulatory requirements on the physical
group living environment
1.3 Review the balance between maintaining an environment that is safe and
secure and promoting freedom and choice
1.4 Explain how the physical environment can promote wellbeing
1.5 Justify proposals for providing and maintaining high-quality decorations and
furnishings for group living
1.6 Develop an inclusive approach to decision making about the physical
environment

2. Be able to lead the planning, implementation and review of daily living

activities

2.1 Evaluate the impact of legislation and regulation on daily living activities

2.2 Support others to plan and implement daily living activities that meet individual
needs and preferences

2.3 Develop systems to ensure individuals are central to decisions about their daily
living activities

2.4 Oversee the review of daily living activities

3. Be able to promote positive outcomes in a group living environment

3.1 Evaluate how group living can promote positive outcomes for individuals

3.2 Review the ways in which group activities may be used to promote the
achievement of individual positive outcomes

3.3 Ensure that individuals are supported to maintain and develop relationships

3.4 Demonstrate effective approaches to resolving any conflicts and tensions in

group living

4. Be able to manage a positive group living environment

4.1 Evaluate the effects of the working schedules and patterns on a group living
environment

4.2 Recommend changes to working schedules and patterns as a result of

evaluation

4.3 Develop a workforce development plan for the group living environment

4.4 Support staff to recognise professional boundaries whilst developing and

maintaining positive relationships with individuals

4.5 Use appropriate methods to raise staff awareness of the group dynamics in a
group living environment

4.6 Review the effectiveness of approaches to resource management in maintaining

a positive group living environment
 1. Be able to develop the physical group living environment to promote
positive outcomes for individuals

1.1 Review current theoretical approaches to group living provision for

adults

For adults a group living environment is designed to meet the specific needs of
people in situations that are as normal as possible instead of institutional care.
Group liiving can include adult facilities in residences, nursing homes or sheltered /
extra care housing. Wolfesberger (1975) identified some negative characteristics of
large-scale institutions, individuals were segregated from society often kept in
degrading conditions and treated inhumanely. In the course of the different
theoretical approaches of the year on the arrangements of group life for adults have
changed the way in which we offer our services of attention and provisions for living.
Person-centred planning has had significant impacts and has affected group life in
many ways. Eric Erikson developed a theory that divides the life of an individual in
eight stages ranging from birth to death (unlike many developmental theories that
only cover childhood, Erikson (1902-94).

Maslow's hierarchy of needs is another important theory when considering group

living arrangements for adults as it describes the steps that are necessary to carry
out personalization through person-centred planning either through goals, risk
assessments, support planning or key working sessions. His theory suggests that
"individual needs must be satisfied first at a basic level, and then they must be
satisfied at each level before moving onto the next" Maslow (1908-1970).

1.2 Evaluate the impact of legal and regulatory requirements on the

physical group living environment

Safe practice is very important for the promotion of dignity in care. There are a
number of legislative measures and regulations to support health and safety at work.
These are meant to protect people at work those who use services and the general
public. The Health and Safety Executive (HSE), local authority Trading standards
and the Care Quality Commission (CQC) can prosecute care providers who violate
health and safety standards. The CQC expects all regulated suppliers to comply with
their new Core Standards (which replaced the previous Essential Standards on April
1, 2015). For example, essential standards of quality and safety (CQC) 2010,
regulation 15- refers to accommodation that is equipped to ensure comfort and
privacy and meets the assessed needs of the service user. In addition, all allegations
of abuse will be taken seriously and will be investigated accordingly, in accordance
with the health and social care act 2008 and policy and adult protection.

1.3 Review the balance between maintaining an environment that is safe

and secure and promoting freedom and choice

As an assistant manager of ‘Discovery home care’ I have a duty of care for the
service users that I support and have to ensure the health and safety of my
employees and any other people on the premises. Risk assessment and risk
management are a crucial part of adult social care and I have to balance the needs
of the staff and the wishes of the service users. For example, one of my service
users has to be hoisted for every transfer and cannot access the toilet
independently. The main problem is that he is only being funded for five hours of two
to one time a day and health and safety dictates that two staffs must assist with
hoisting. Because of funding we mostly lone work and I have had to enlist a domestic
care agency to come in at 8am., 12 am., 4 pm. and 9 pm. to assist with the hosting.
This was the best compromise which enable him to use the toilet four hourly and at
the same time protect my staff team from harm.

The bedrooms are in line with the National minimum standards by having usable
floor space sufficient to meet individual needs and lifestyles and staffs are always
mindful of the service users’ right to privacy. The home itself has none slip flooring in
the bathroom and kitchen. Moreover, the front door lock is of a design whereby
anyone can exit the property without the need to have it locked because once it
shuts you cannot gain entry from outside. The backdoor has a turn knob instead of a
key so that the mobile service user could leave if he wanted to.
 1.4 Explain how the physical environment can promote wellbeing

The physical environment of a care home should be warm, clean, comfortable and
safe to ensure the service users wellbeing and to promote their independence and
uphold their rights to human necessities and niceties.

When a service uses will maintain a high standard of environment, he/she will have a
sense of self-worth and have a feeling of pride in their home, this will all have a
positive effect on their health, happiness and emotional wellbeing. It can also
promote their sense of identity, self-image and self-esteem and above all make them
happy.

1.5 Justify proposals for providing and maintaining high-quality

decorations and furnishings for group living

As an assistant manager of ‘Discovery home care’ I have to ensure that all

equipment is safe and meet British Safety Standards to ensure that any hazard are
kept to a minimum. Apart from that, I have to keep on my mind the following things;

 Provide a safe environment for residents,

 Ensure their privacy and provide their own personal space under their own
control,
 Protect their dignity,
 Provide a stimulating environment for daily activities,
 Allow them easy access at home; minimize residents' difficulties in
understanding their surroundings,
 Provide a work setting that allows staff to provide high quality care,
 Meet the standards relating to the design and fabric of residential and nursing
homes as required by law, regulations and directives.

1.6 Develop an inclusive approach to decision making about the physical

environment
When making decision about the physical environment of the home we always
involve the service users as far as possible. The service users are provided with as
much information as possible about any proposed changes and they are given
choice. For example, we needed new flooring for the hallway down stairs. The
service users were involved in choosing to have laminate flooring and they chose the
actual boards that were put down.

When making decisions that the service users find difficulty o be involved when I
consider their past choices and desires, staff input is also sought to endeavour to
make the choices that will be what the service users want.

2. Be able to lead the planning, implementation and review of daily living

activities

2.1 Evaluate the impact of legislation and regulation on daily living

activities

The independent care sector is currently going through a period of great change.
These changes have been stimulated by a significant amount of legislation produces
by the government; this is expected to change the way that care is commissioned,
provided and inspected, in the future. Stephen O’Kell, from the University of
Portsmouth, has conducted this survey in order to highlight the currents issues being
faced by the independent care home sector and the issues are;

 The large number of overlapping government initiatives currently being

implemented is causing concern and confusing within the care sector.
 The care sector is no longer attractive as a career option to many people.
There are better jobs, offering more money, available in other occupational
areas, especially within the commercial sector.
 Extended care roles are being taken on by care support workers in some
homes.
 All the homes in this study were reluctant to transfer a resident to another
care facility if his/her care needs change.
  Most homes were very satisfied with the level and quality of community
nursing services available to residents.
 The independent care sector does not have the same access to training
opportunities that are available to the public sector.
 Few homes have reached the target of 50% of care workers having achieved
at least a level 2 NVQ in Care. Many care home owners felt that they have
neither the time nor the resources to properly meet these standards.
 The National Minimum Standards concentrate on structure and process within
care homes. Consideration may need to be given to incorporating the
outcomes of care into the inspection process.
 Because the quality of undertaken by care managers can be very variable, it
is suggested that care home managers do their own formal or informal
assessment on prospective residents before accepting them into the home.

2.2 Support others to plan and implement daily living activities that meet
individual needs and preferences

Tasks as well as following the person's written or electronic support plan, I must
actively involve the person in supporting activities of daily living tasks; that way there
will be less likelihood of any misunderstandings. The method to request assistance
will be agreed upon and established; then, the support worker can help the person to
return to their chair. If I support a person who has mobility difficulties to make their
purchases, the care plan may indicate that they will use sticks to walk and that I can
open doors and carry the purchases. Always confirm the details with the person in
advance.

2.3 Develop systems to ensure individuals are central to decisions about

their daily living activities

I must seek guidance from my manager. Changes need to be reported to my

manager who will then reassess the person’s needs and adjust the support plan to
meet their current needs. If I get that I cannot support the person in accordance with
their support plan because I believe that the demands of my time are so great and I
simply do not have time, then I must inform my manager. This must be clearly
documented and notified to the manager

2.4 Oversee the review of daily living activities

Daily living activities is really essential to review for the adult group. The activities are
review based on the support system, planning and implementation, and assessment
review process etc.

3. Be able to promote positive outcomes in a group living environment

3.1 Evaluate how group living can promote positive outcomes for
individuals

Group living can promote positive healthy lifestyles that include food and nutrition.
When I help people plan meals, they should consider their energy requirements and
the components of a healthy diet. It is also important that people consume adequate
amounts of fluids every day; the recommended intake of fluids is 2 litres. Non-
alcoholic beverages such as water, fruit juices and pumpkin should be encouraged.
Homemade drinks, tea and other beverages rich in caffeine should be consumed in
moderation.

3.2 Review the ways in which group activities may be used to promote the
achievement of individual positive outcomes

The achievements of individual positive outcomes could be;

 Store the food in the right place

 Store it at the correct temperature
 Use within the current timescale
  Using fridge will stop bacteria from growing on the food
 Cooked food, raw food, ready-to-eat food e.g. ready meals and desert should
be between 0 degree Celsius and 5 degree Celsius

3.3 Ensure that individuals are supported to maintain and develop

relationships

There may be an issue with the individuals communication needs, it can be difficult
to establish a relationship and maintain it if your communication needs cannot be
met. I have worked in a setting where a blind Service User has cohabited with a
mute Service User with Down’s syndrome. Probably they couldn’t maintain a
relationship without the support of staff to act as an intermediary. There can also be
further issues with a disability, a Service User with an autism spectrum disorder may
not see the necessity to establish a relationship and see no requirements to maintain
one. However, with care in the community and the requirement of a lot of disabled
people to cohabit with others, social bonds need to be forged and maintained to
keep the peace.

3.4 Demonstrate effective approaches to resolving any conflicts and

tensions in group living

When a team exceeds the mark of healthy difference of opinion, resolving the
conflict requires respect and patience. The human experience of conflict involves our
emotions, perceptions and actions; we experience it on all three levels, and we have
to address all three levels to solve it. We must replace negative experiences with
positive ones. The approaches that can resolve any conflicts and tensions in group
living are;

 Acknowledge the conflict

 Discuss the impact
 Agree to a cooperative process
 Agree to communicate
 Clarify own positions
  List facts, assumptions and beliefs underlying each position
 Analyse in a smaller groups
 Convene back as a team

4. Be able to manage a positive group living environment

4.1 Evaluate the effects of the working schedules and patterns on a group living
environment

As an Assistant Manager of Discovery Care home, we are responsible for ensuring

that the service user receives the experience in the setting and that means care
home delivering care or services by the qualified staff and have enough resources to
carry the service. The work plan of the team is important aspect of this part of the
role and responsibilities. The staffs need to be more concern of the service users at
any given time in order to schedule staff with correct experience and skills to carry
their shift. For example, a change in the condition of a service user may require to
assign a more experienced member of staff to their care and this may have an
impact on the rest of the team work.

4.2 Recommend changes to working schedules and patterns as a result of

evaluation

I have some recommendation which have been gathered based on my experience in

last 5 years. The main way of changes is to occasionally it may need to make little
change on the way the team is working in order to improve the effectiveness of the
service. For example, it is need to check in with staff during supervision session
about their work loads and how they are performing and also collecting feedback
from staff to setting.

4.3 Develop a workforce development plan for the group living environment
The plan of workforce development is;

Step 1- Context and environment

 Why is it important
 What are the goals
 What is the performance measure for our workforce plan?
 Strategic objectives
 External environment; what is happening in the external environment
(internationally, nationally, industrially, regionally or locally)? What policies
and initiatives (national, state, local) are being implemented? What challenges
do you face? (for example, shortage of skills / labour, attraction and retention,
financing)
 Internal environment What is happening in the internal environment? What is
our business planning process? What are the links between business
planning and the problems of the workforce? What initiatives, projects and
current services are offered? What sources of funding are accessed? What is
the organizational structure? What is the capacity and current capacity of the
organization to deliver its products and services?

Step 2 - Current profile of the workforce;

 What is your current profile of the workforce?

 What are the current skills and competencies of your workforce?
 What are your strengths and your development needs?
 What is the consultation with your current staff that informs you about the
problems of the workforce and what is working well or what can be improved?
 What are the current priorities of the workforce, based on the profile and
analysis of their workforce?

Step 3 - Profile of the future workforce;

  What future products and services will the provided by the organization?
 What will the future environment require?
 What are the implications and problems of the workforce?
 What is the supply and demand of labour for priority work functions?
 What future skills and competencies are required?
 What is the consultation with your staff that informs you about future problems
of the workforce?
 What are the future priorities of the workforce, based on the profile and
analysis of its workforce?

Step 4: Gap analysis and closure strategies

 What are the key areas of need / action to move from where the organization
is now to where it wants to be especially priority work roles?
 NOW ... Prioritize the ‘issues’ and develop an action plan with strategies to
address the deficiencies.

Step 5: Conclusion, review, evaluation strategy and next steps

 What are the key results of your workforce action plan?

 How will you evaluate the strategies in your workforce plan?
 What are the next steps for the implementation of your workforce action plan?

4.4 Support staff to recognise professional boundaries whilst developing and

maintaining positive relationships with individuals

The professional boundaries are

 Client focus
 Self-disclosure
  Dual relationships
 Working within our competence
 Looking after self
 Crossing or breaking boundaries
 Professional versus professional

4.5 Use appropriate methods to raise staff awareness of the group dynamics in
a group living environment

The appropriate methods to raise staff awareness are;

 To know own team properly

 Have to tackle problems quickly
 Have to define roles and responsibilities
 Have to break down the barriers
 Have to focus on communication
 Have to pay proper attention

4.6 Review the effectiveness of approaches to resource management in

maintaining a positive group living environment

Effective business needs business plans and as a manager the staff will have been
asked to make ready documents. The department of health requires all care
establishments to have business and financial plans in place for external inspection.

The management might be asked to present financial statement to the care

standards commission to show that clients fees are being used in an effective way in
order to improve their care and delivering best service. A budget refers to the
allocation of finance for the specific way and field. In the context of discovery home
care it is allocated a small part of the overall financial income and will be expected to
audit the expenditure within the period of time.
However, regular monitor and review of the budget is essential as the amount you
spend throughout the year is likely to very. In the winter time, the expense of heating
and lighting is likely to be much more than during the summer months, so seasonal
fluctuations need to be taken into account.

Maintaining a positive group living environment requires shrewd budgetary and

resource planning. How effective it has been will depend on whether it has a positive
impact upon the service users and the setting.
Bibliography

1. Baker, T. (2002) An Evaluation of an Extra care Scheme-Runnymede Court.

Estover, Plymouth: Hanover Housing Association
2. Berger, J. (2000) ‘Sexuality and intimacy in the nursing home: a romantic
couple of mixed cognitive capacities’, Journal of Clinical Ethics, 11(4), 309-13
3. Croucher, K., Hicks, L. and Jackson, K. (2006) Housing with care for later life.
University of York: Joseph Rowntree Foundation
4. Daniels, V. (2003) Kurt Lewin Notes. Sonoma State University
5. DOH (2000) No Secrets: Guidance on protecting vulnerable adults in care.
London: HMSO
6. DOH (2001) Care home for older people. National minimum standards; Care
homes regulations. London: TSO (The stationary office)
7. Greenwood, C. and Smith, J. (1999) sharing in Extra Care. Staines: Hanover