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Operations Management of a Care Facility for the Elderly


Any institution dealing with provision of care to dependent elderly persons should ensure that its strategies are broad enough to cover the wide range of needs of the elderly. In order to ensure quality service provisions in elderly care institutions for the aged, it is important for the management to focus on these diverse needs of the elderly in the institutions be they medical, psychological, psychiatric, emotional, economic or social.

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This can only be facilitated by development of care systems which incorporate provision of both formal and informal support mechanisms which target the specific needs of the residents and where possible the institutions should operate within specified standards and written protocols to guarantee comprehensive and quality provision of services to its residents.

Russell and Bromley retirement home is an institution which provides care to elderly people aged between 55 and 85. The residents needs vary depending on age and health conditions with some of them appearing to be quite fit while others have complex mobility difficulties. The institution seeks to promote privacy to the retired people who want to live independently through provision of self contained housing and other care services. In addition, the institution has extensive grounds which are a pleasant outlook from which residents can enjoy the fine weather. However, the dining hall from where residents access lunch time and evening meals is communal and often overcrowded and has been a source of numerous complaints among residents in Russell & Bromley.

Due to numerous complaints that are raised by the residents in Russell & Bromley retirement home, it is necessary for the institution’s management to improve its operations and service provision in order to enhance consumer satisfaction through quality enhancement.

As Rubina found out, the residents have poor perception on the quality of service provided by workers in the institution while the cook blames the house keeper Mavis for deteriorating services in meals provision. From the case, it is evident that the management has failed to deliver the expectations of the residents which call for the need to improve the quality of services in the institution in order to improve consumer perception of the institution.

Quality and its key aspects at the Russell and Bromley retirement home

Quality is widely perceived as the consistent conformance of an organization to consumers’ expectations (Elearn 2008). Indeed, five varying definitions of quality have been formulated based on the theory of Gurus (Elearn 2008); the transcendent approach defines quality in terms of personal absolute judgment on a product or service, the manufacturing based approach defines quality in terms of the product’s ability to conform with the requirements while the user based approach interprets quality in terms of product’s fitness for purpose.

In addition, quality has been defined through the value based approach where quality is perceived in terms of cost price and through the product based approach which views quality in terms of the measurable set of characteristics (Elearn 2008). The relationship that is known to exist between the employee performance and customer satisfaction is essential in evaluating the effectiveness of the organization in fulfilling its objectives. As shown in the graph below, quality in service provision is achieved by gearing organization activities towards customer satisfaction.

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Quality and its key aspects at the Russell and Bromley retirement home

Defining quality in terms of services provided in Russell & Bromley retirement home is difficult primarily due to the intangible nature of services provided to the residents in the institution. Quality in this context would have to incorporate factors such as consumer expectations, experiences and emotions (Koontz & Weihrich 2006). Quality has transformed in the modern information age to include advanced service provision mechanisms which aim at promoting an organization’s competitive advantage. Service quality is best assessed through the customer oriented approach. At Russell & Bromley, the nature of services provision is defined through the interaction between the providers and the residents, so the key issue in determining quality is the subjective opinion of the customer.

Retirement home care is not only a major service challenge but also an area of increased societal interest emanating from humanitarian concerns. Poor quality of care provided in the nursing homes and other long-term care providers has been long standing in most parts of the world and continues to date. The diverse nature of resident’s needs at Russell & Bromley further complicates the process of achieving quality in the organization which in turns calls for the need for extensive operation management aimed at promoting residents satisfaction.

Consequently, the institution has to strategize on the means of promoting resident satisfaction through the improvement of its key quality aspects. This includes improvement in sanitation and meal service, provision of adequate space, reduction of queuing time, active response to residents’ demands, and attention to residents’ specific needs.

Provision of clean and sanitary measures not only promotes health among the elderly living in the institution but also significantly improves resident’s perception on the quality of service. Meal service is an important aspect of care at Russell& Bromley which calls for the need to abolish the standard menu in preference of a menu that incorporates a wide range of choices for the elderly residents. In addition, the management should urgently address the issue of queuing in the dining hall which has been a major source of complaints among most of the residents. The institution should further address the issue of parking space and should deal with issues brought forward by the residents depending on needs of the specific resident.

Quality assessment

The increased significance of elderly care services in the society has heightened the concerns by service providers and the residents regarding the nature and quality of services being provided. This, coupled with the increasingly hostile nature of elderly persons has prompted most retirement and elderly homes to invest heavily in the delivery of high quality service which in turns earn them a competitive edge.

Continuous quality service provision within these institutions can only be achieved through the support of a systematic approach to quality assessment and measurement. Consequently, interest in the measurement of service quality within these institutions has become an integral part of operation management. However, the greatest challenge often faced by institutions’ management regarding service quality assessment is choosing the most appropriate tool for quality assessment which has the ability to provide accurate results necessary for adjustments.

While research has proven that increased consumer perceived quality is positively related to willingness to pay for services (Brown 1991), consumer perceived quality is often viewed as subjective quality which results from combination of both objective facts and subjective feelings by a consumer towards the service. Consequently, consumer perceived quality is not an effective measure of assessing quality in Russell & Bromley since it may be erroneous or heavily influenced by sheer ignorance.

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An equally unfortunate notion is the service provider’s perception of possessing the inherent ability to provide quality to the customers and viewing them as passive amateurs (Brown 1991). This is evident in Russell & Bromley retirement home where the senior house keeper Mavis takes over all the service decisions in the institution including those that she is not qualified in (purchasing) causing massive dissatisfaction among residents.

Assessment of service quality at Russell & Bromley should focus upon the resident’s responsiveness to their services, availability and overall quality of service. The institution may utilize the SERVQUAL questionnaire which is designed to measure service quality by comparing consumer expectations to their perception of the actual service delivered (Dale 2003). SERVQUAL is a twenty two item scale which has been proven to reliable and valid in understanding service expectations and perceptions of consumers (Dale 2003). The tool has faced numerous criticisms regarding its objectivity but its supporters continue to defend it for its applicability in most service sectors and its five generic service quality dimensions of reliability, responsiveness, assurance, empathy and tangibles (Dale 2003).

In Russell & Bromley retirement home, the residents expect to be provided with a comfortable environment where they can live independently. Using the SERVQUAL questionnaire, the management can find out whether these expectations have been met according to the resident’s views. Through the questionnaire, the management can derive first hand additional information which may be essential in service improvement in the institution. The questionnaire may also serve as a tool through which other grievances unrelated to quality can be captured. However, questions remain as to whether service quality measurement should be based on assessment of performance in absence of expectations and whether attitude is a better description of attitude (Dale 2003).

Evaluation criteria Poor Satisfactory Excellent
Meal service 95% 3% 2%
Provision of Privacy 50% 46% 4%
Availability of space 60% 40% 0%
Efficiency of health facilities 75% 25% 0%

To ensure accurate and comprehensive service quality assessment, the institution needs to measure a wide variety of quality aspects within the organization (Brown 1991). The nature of relationship existing between the care providers and the elderly in the institution is a clear indication of the kind of service provided by the institutions whereby good relations indicate service quality while strenuous relationship imply consumer dissatisfaction. Russell & Bromley should therefore seek to improve relations between workers and the resident and the management should further strive to address their grievances in order to promote cooperation in future quality measurement and assessment.

Quality improvement models and the specific actions involved in the techniques

With the increasing social concerns, government regulations and competition in the service industry, the need for continuous improvement in the organizations is essential in ensuring that service providers deliver quality service at most competitive prices (Anonymous 1993). Russell & Bromley retirement home not only needs to improve its services, but should also continuously monitor and improve the quality of its services in order to promote consumer satisfaction.

The residents in the retirement home are constantly complaining of long queues, poor meal service, inadequate space, lack of parking space, costly meals, lack of adequate choices in the menu, among other grievances. It is therefore important for the institution to address these issues in order to improve its quality service and further seek to improve service in line with technological and environmental advances in order to gain competitive advantage.

The process of quality improvement involves identification of the areas that need to be improved, analysis of the problems needing to be addressed, developing the changes that need to be improved and the eventual implementation of changes in order to promote service quality (Case 2007). Russell & Bromley may adopt the continual service improvement model whose primary purpose is to continually align services with the changes taking place in the modern society (Anonymous 1993).

The model seeks to improve quality through service strategies, service transition as well as service operations. Consequently, continual service improvement model promotes operations effectiveness, efficiency and cost effectiveness (Case 2007). However, the model is considerably expensive to implement in a relatively small institutions like Russell & Bromley since it requires huge technological investment.

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Russell & Bromley may also adopt the total quality management process model which seeks to improve quality and performance which in turn ensures consumer satisfaction (Case 2007). The total quality management process integrates all the quality measures employed in the institution including the management of quality design, quality control, quality improvement as well as quality assurance. Under total quality management, the top management of the institution should act as the main driving force of the strategy and should ensure that it achieves its objectives within the organization.

Employees should also be extensively trained on the quality expectations and should emphasize more on customer satisfaction. In addition, the organization should make decision based on objective facts derived through the use of various techniques and tools. Further the organization should seek continuous improvement through continuous improvement of its quality procedures and emphasizing on a culture of quality within the organization (Case 2007).

With most people claiming that the costs of implementing total quality management are greater than the benefits that the model produces, research across varying industries have proven that the cost of not promoting quality is much larger than the cost of total quality management implementation (Case 2007). The costs associated with TQM are inclusive of operation cost incurred in product requirements, quality planning, quality assurance and training (Case 2007). Other costs are related to product specification such as verification, quality audits, and vendor evolutions (Case 2007). The total quality management system may also be associated with costs emanating from system failures.

Russell & Bromley retirement home supply chain and measures to ensure its effectiveness

Managing the supply chain is one of the core competencies that every institution should possess in order to promote profitability and consumer satisfaction. This is because the supply chain strategies have a great impact on sales revenue and overall operating costs. Consequently, supply chain managers engage in extensive analysis of relevant costs, quality, technology, timeliness, dependability, responsiveness and services in choosing the appropriate supply chain to adapt (Wisner 2009).

At Russell & Bromley, the supply chain is narrow with the institution’s employees directly dealing with the suppliers in the market. Meat and poultry is purchased in the market on a daily basis while vegetables and fruits are purchased from the local street market on specific days of the week. This role was previously conducted by the cook who has ten years of experience in the food industry and had established connections with suppliers in certain stalls in the local market.

This put him in a better place to negotiate for better prices as well as quality. The fact that Mavis the housekeeper took over the responsibility of purchasing food supplies negatively impacts on the efficiency of the institution’s supply chain. This is primarily due to her limited experience in food technology and lack of connection with the suppliers. As a result, the quality of products bought in the market deteriorated despite the claims by the house keeper that the strategy was aimed at cutting costs on the purchasing budget.

Decreasing quality of supplies coupled with lack of experience by the house keeper in her involvement in the supply chain management calls for extensive restructuring of the institution’s supply chain. All the elements of the supply chain management, quality assessment, distribution, and customer service hold a significant role in the long term success of the service organization (Wisner 2009). The role of the supply chain management in Russell & Bromley should therefore be delegated to the cook who is more experienced and has the ability to manipulate the supply chain to the institution’s advantage.

The cook can work carefully with selected suppliers to ensure continuous quality improvement which would in turn serve to lower other costs such as inspection costs. By working with suppliers who meet the supply standards of the retirement home, the cook can save substantial risk costs. This can be achieved by working more effectively with fewer suppliers who meet the organization’s requirements (Hines 2009).

Quality service can further be enhanced through effective coordination of service response in the supply chain (Wisner 2009).This involves management of service capacity, waiting times, distribution channel and service quality. This would enable Russell & Bromley to meet the diverse demands of residents. In addition, the institution may engage more qualified supply chain managers to coordinate the purchase and delivery of supplies in the organization hence relieving the cook off some tasks which would in turn help him to serve the residents more effectively.

Reference List

Anonymous, 1993. A total quality management process improvement model. New York, Diane Publishing.

Brown, W. S., 1991. Service quality: multidisciplinary and multinational perspectives. New York, Lexington Books.

Case, G, 2007. Continual Service Improvement. London, The stationery Office.

Dale, B. G., 2003. Managing Quality. Oxford, Wiley-Blackwell.

Elearn, 2008. Quality and Operations Management. Oxford, Elsevier.

Hines, T. 2004. Supply Chain Strategies: Customer-Driven and Customer-Focused. Oxford, Butterworth-Heinemann.

Koontz, H & Weihrich, 2006. Essentials of Management. New Delhi, Tata McGraw Hill.

Wisner D J, 2008. Principles of Supply Chain Management. New York, Cengage Learning.

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