As a manager, it is vital that all decision that I have to make is based on accurate and recorded information. Making decisions are everyday activities and very often it is being performed without really thinking about them. Information based decision making enables me to understand the problem solving cycle, use creativity in decision making, anticipate potential problems, gain the commitment of others to my decisions in order that they may be effectively implemented and I am able to evaluate the effectiveness of the techniques I used.
Running a care home for the elderly faces me with an everyday activities of decision making. Please look at the case of Mrs W below. Mrs W has been admitted to our care for six months now. Her care plan states that she has dementia and has a poor short term memory but can make her needs known. Ms W is very mobile. She will always look for her husband and her son thinking that they are still living together and this is the trigger for her to be unsettled and anxious. Mrs W used to be a manageress and supervises a number of workers.
She thinks that staff and residents are her workers. She needs constant reminder that she’s not working anymore and where she is now is not her workplace. Mr W, as the next of kin was involved in creating Mrs W’s care plan and he has signed it. A risk assessment was in place to ensure safety of Mrs W. The Kepner-Tregoc method of decision making distinguishes between plans which is seen as the means of dealing with potential problems; problems, seen as deviation from the norms and decisions which are choices between alternatives.
... solution and evaluate results. The first step in decision making- identify and define problem is vital step that impacts on how managers ... on choosing to implement the reorganization plan and introducing computerization. This is a decision made under the behavioral model, through ... had an equivocal thought with the executives. Surprisingly the plan was still given the green light by the executives. ...
Mrs W has a care plan made by the care staff which state of what could be the potential problem that might arise when looking after Mrs W and how the care staff can support her. As mentioned, Mrs W’s dementia presents itself in a poor short term memory and mainly remember only about her husband and son. Also, her workplace and how she manages the people working under her supervision which leads to her being anxious and agitated. Mrs W’s behaviour was getting worst every day.
She was becoming physically and verbally aggressive towards staff, visitors and residents. I have advised the staff to start filling in a behavioural chart to find out if there is any pattern to her behaviour. And so there will be a basis in changing the plan of care for Mrs W. The family has been made aware of her behaviour and we have decided to refer her to the GP to rule out any medical condition and for her to be referred to a psychiatrist. GP visit confirmed that Mrs W needs a psychiatric referral. The potential problem has now become an existing problem.
Problems needs to be analyzed and it requires sharp observation, analysis, specific comparison all aimed at identifying the cause and taking actions. Psychiatrist came and visited Mrs W and looked at her care plan. Family attended as well. An agreed management/plan of care was created for Mrs W and will be monitored and reviewed in an agreed span of time. Family was agreeable to it. Staff has been informed through handover what were the changes in Mrs W’s care and the care plan was updated. Despite the changes in Mrs W’s care, she now wants to get out of the building almost every day to see her husband and son.
... others own understanding of the support required for care plan activities Talking to other staff members about the client, and reconfirming that we ... Record signs of discomfort, changes to an individual’s needs or preferences, or other indications that care plan activities may need to ...
Mrs W’s care plan has been reviewed and referred back to psychiatrist and a medication review has been done. Because of Mrs W’s wanting to get out of the building by forcefully banging and opening the door, I have to adhere to the organisation’s policy and procedure and the essential standards of CQC in ensuring that we are not depriving Mrs W’s liberty . And how we manage her when she is physically aggressive is for her best interest. I have made a referral to the safeguarding team to the local council to carry out an assessment for Mrs W.
Safeguarding team has done their assessment with the involvement of Mrs W’s family and the care staff. The measures we use to keep Mrs W safe do not deprive her of her liberty. This particular incident, proves that all decision made by our care team were based on information that are available on Mrs W’s care plan. All the data gathered and shared to the health team were used for specified purpose only of ensuring Mrs W receives the best care in the care home. Decision making is about choosing from a range of options.
In the case of Mrs W, GP were involved first to rule out any possible medical condition before the referral to the psychiatrist was made. And the involvement of the safeguarding team of the local council. This was made possible because of the quality information through factual recording by the care staff of Mrs W’s behavioural problems. The outcome of the decision in Mrs W’s care has been communicated to the staff through verbal and written handover. All the changes were indicated in her care plan. Staff were advised that it should be carried out with the supervision of the senior carers.
Senior carers has the responsibility to monitor the effectiveness of the new care plan and making sure that it is being evaluated every month and make necessary changes based on the information gathers through observation, assessment and input from the care staff. On supervisions of the senior carers, I always ask them to bring in any of the care plan that they should be updating and check if all the necessary updates are being done. It is my way of evaluating /auditing the effectiveness of the communication method we used in the home.