Case Study: Angelique Home Care

Organizational leaders are responsible for establishing standards of behavior and for effectively communicating those standards to all managers and employees in the organization. One of the traditional ways by which organizations and top management have fulfilled this responsibility is through the use of code of ethics or codes of conduct. The code of conduct acts to clarify what behavior is expected to the employees. It provides employees with a chance to confirm whether their behavior is acceptable to the company. It also allows employees to try to convince others and warn them of their inappropriate behavior (Carroll & Bunchholtz, 2011, p. 255).. This paper will create an ethical code of conduct for Angelique Home Care. This paper will also

examine the Organizational structure of the facility, two possible ethical dilemmas, ways to implement ethical code of conduct, and consequences if there is a violation of the code of conduct.
Angelique Home Care
Angelique Care was founded in 2000 in Pearly City, Hawaii, on Oahu to offer the best quality home care in Hawaii for the elderly, so that they may live a healthy and comfortable life.

At Angelique Care Home Care we hire the best caregivers in order to provide the highest quality services to the residents. Using the highest standards when selecting employees by checking applicants’ work and personal references and performing detailed background and DMV investigations are one of the primary objectives of Angelique Care. All Angelique Care caregivers are employees and are thus bonded and insured and abide by the strict Angelique Care code of ethics.

Angelique Care is a 100- bed skilled nursing facility, concentrating on post hospitalization transitional care. The greatest success of Angelique is the capability to help patients get better and discharge back home or to a lower level of care. Angelique Care employs own therapist and operate a large, fully contained therapy unit. The primary goal of Angelique Care Home Care is to help patients achieve their highest level of functional

independence.
Angelique Care Home Care is licensed by Oahu Hawaii State Department of Health and the Federal Government. Licensed nursing staff are on duty 24 hours a day and work with a team of trained certified nursing assistants to provide quality services to the patients. These services include: assistance with activities of daily living (dressing, bathing, grooming, transfers, ambulating, etc.), feeding or assistance with meals, giving of medications, treatments, etc. The level of services provided to an individual patient can vary greatly depending on that patient's needs.

I. Angelique Home Care: Organizational Structure
Healthcare Administrator: Suzette Ochea
Supervise the daily operations of Angelique Care. The responsibilities of healthcare administrator includes but not limited to staffing, financial management, supervising resident care, and marketing. And ensure that the facility complies with the rules and regulations of government accrediting bodies.
Management Team
Director of Nursing: Annalyn Melendez
• Supervises the nurses in the facility
• Supervise the care provided by nurses in the department and maintains relationships with patients, families, physicians and other ancillary staff
• Manages the nursing department budget and staffing
• Reviews department policies and procedures in areas such as infection control, medication control, restraint and safety procedures
MDS Nurse (Minimum Data Set): Kelli Galbraith
• Monitor, evaluate, and manage the care given to residents
Medical Records
• Responsible for maintaining and securing all written and electronic medical records within a facility's medical records department or its equivalent.
• Responsible for ensuring that the information in the record is complete, accurate, and only available to authorized person.
Nurses/ LVNs
• Monitor patients’ conditions and assess their vital signs, noting any physical or mental decline and reporting back to the doctor.
• Administer medications and other treatments and help patients manage common age-related conditions such as incontinence, sleep disturbances or loss of mobility.
• Supervise CNAs
Certified Nursing Assistants
• Assist patients daily activities such as helping patients bathe, dress themselves, get up and down, walk, and use wheelchairs or walkers.
Social Services Director: Amanda Parker
• Responsible in providing physical, psychological, and social needs of the residents

Director of Rehabilitation: Mark Stewart
• Directs the programs and staff of the rehabilitation services department.
• Sets and implements guidelines for rehabilitation programs such a physical therapy, occupational therapy, and speech therapy
Activity Manager: Junica Denina
• Responsible for the daily activities of the residents
Admission Director: Susan Fortuno
• The main responsibility of admission director is to develop relationships with a growing base of referral sources, leading to a consistent flow of quality referrals to the center. Majority of time allocated to external sales development.
• Responsible for making sure that the facility is getting an appropriate number of residents.
Dietitian Director: Maria Marquis
• Assess nutritional needs, diet restrictions and current health plans to develop and implement dietary-care plans and provides nutritional counseling.
• Monitor food service operations to ensure conformance to nutritional, safety, sanitation and quality standards.
• Coordinate recipe development and standardization and develop new menus for independent food service operations.
Dietitian Supervisor: Vanessa Lee
• Supervises dietitians who educate patients about nutrition and administer medical nutrition therapy.
• Oversees and provides advice to food service operations.
Housekeeping Manager
• Supervise the overall operation and management of the Housekeeping Department.
• Develop and maintain standards of cleanliness and maintenance and ensure they are consistently met throughout the department by all team members.
• Inspect and evaluate work performance of team members to ensure standards are met
• Ensure that the facility is clean and the residents’ rooms and bathrooms are clean.
II. Ethical Dilemmas
Personal Autonomy
One of the important issues for residents in long-term care facility is personal autonomy.

Residents deserve to have control of their lives as much as possible even though they live in an institution. Autonomy means different things to different people. For other residents, it means being able to decide what to eat and when to it and what to do. Other residents, autonomy means being able to refuse or accept treatments. For the staffs of the facility, it means being able to comply the residents’ individual wishes without compromising the quality and effectiveness of the care given with the residents. This is a big challenge for the facility because most of the residents have physical and mental disabilities. Many residents are not totally competent to make important decisions by themselves. Facility staffs must find ways to make sure that decisions are made with the best interests of the resident in mind. In doing that, the staffs must give great credence to what they believe to be the wishes of the resident, protecting that person’s autonomy whenever possible (Pratt, 2015, p. 109).

Another autonomy related issues in long term care facility is the issue of individual choice versus group choice. In long term care facilities, residents are not always able to have all their wishes granted if those wishes have a negative impact on others in the group. A resident may want a private room but it is not available. Or if it is available the resident’s reimbursement coverage may not allow

it. Other variations of this issue tend to center on day to day activities