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What you are telling us about dignity in care: week five
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Last modified date:8 February 2007
Similar to last week, we also had a greater proportion of surveys completed by professionals compared to members of the public. Responses from professionals accounted for three quarters of the results. In previous weeks it has been around half.
Good examples of dignity in care services
Again, the quality of dignity in care experiences was seen as variable depending on the person providing the care and where it was being provided.Ã' Specialist and smaller services (such as palliative care and not for profit organisations) were cited as best examples.
The following are characteristics of services which people felt helped provide dignity in care:
Ã' - Staff acting as a team, behaving the same way when giving care
- Giving people privacy
- Ensuring people do not feel isolated or alone
- Thinking about all of the personâ¬TMs needs, not just their immediate medical ones
Ã' Another person described how they felt that they had been treated with dignity when staying on the ward of a general hospital:
- â¬oeThe aspects of care which impressed me were the fact that I was always told what was going to be done, asked if that was all right and offered pain relief.â¬Ã½
Disrespect for dignity in care services
Similar to the responses we received in survey weeks one and two, several professionals responded with examples of lack of dignity in care which they attributed to: leaders not setting a good example; not enough staff to help all the service users; poor facilities, doing things in the way they have always been done without thinking of how they could be improved.
- â¬oeIn the hospital that I work in now, dignity is lost partly due to outdated accommodation, partly low staffing levels andÃ' partly because there is a poor example set from the top.â¬Ã½
- â¬oeI think that a personâ¬TMs dignity is compromised due to poor facilities, lack of knowledge and the ability to put yourself in someone elseâ¬TMs shoes.â¬Ã½
Several people thought that a lack of privacy was one of the most common breaches of dignity.
- â¬oeIâ¬TMve known of people given strip washes in the lounge of care homes in front of others.â¬Ã½
- â¬oeThere is often a lack of quiet rooms to discuss confidential issues and privacy seems to be non existent.â¬Ã½
People not being confidential about an individualâ¬TMs medical condition was given as another example of people not being treated with dignity.
- â¬oeHand-overs by nurses at the end of the bed means that everyone gets to know what is wrong with the person discussed.â¬Ã½
Others told us of some particularly distressing instances of lack of dignity.Ã' These included:
- People being sworn at or mocked because of their disabilities
- Older people being asked to demonstrate that they can wash themselves while several healthcare professionals observe them in a state of undress
- Relatives being allowed to walk onto a hospital ward to find their family memberâ¬TMs dead body, without being told that they had died.
What action you took
Like other weeks, the majority of people who said they were able to do something said their action was to bring it to the attention of the people either in charge of or running the service.Ã' Most of these people however did not feel the outcome of their complaint was satisfactory. The process took too long and they felt that they were not being listened to.
Worryingly, a few professionals commented that complaining about the care services provided in their workplace had resulted in a negative outcome for them.
- â¬oeI complained to the manager and I was sacked.â¬Ã½
However, other professionals told us that they did not hesitate to challenge poor services.
- â¬oeI frequently challenge incidences of poor dignity, i.e. coming behind closed curtains without being invited and usually at an inappropriate time. I am usually met with answers such as â¬-itâ¬TMs ok, they wonâ¬TMt mindâ¬TM which I think is appalling.â¬Ã½
- â¬oeIn my professional role I challenge poor practice and also alert people to resource needs too.â¬Ã½
Suggestions for how Government and service providers can help
Similar to the surveys completed in earlier weeks, improving complaints procedures and providing better training and education for staff came out as key areas in which you thought providers of services and Government should focus.
They said that complaints systems needed to be simpler to use and that you should be able to believe that by making a complaint that something will be done. Some people do not uphold the formal complaints system as being useful.
- â¬oeI put in a formal complaint â¬' what a joke that system is.â¬Ã½
- â¬oeOfficial complaints had already been made and supposedly addressed but were ineffective.â¬Ã½
Some people commented on how care staff should behave towards service users:
- Communicate with them in a way you would wish to be spoken to yourself
- Spend time with individuals when discussing their treatment and get to know them as people
- Value people
- Be respectful and refer to individuals as â¬-Sirâ¬TM or â¬-Madamâ¬TM rather than terms of endearment (such as â¬-sweetieâ¬TM or â¬-darlingâ¬TM)
Top three priorities for Government
The top three priorities for Government action were:
Ã' - Ensure complaints procedures are simplified and action takes place more quickly
- Improve advocacy services to support people in making their complaint
- Ensure that people have a right to know they should be treated with dignity
Other priorities suggested by a few people included:
- Setting up a central, independent complaints body
- Training care staff
- Include a dignity section in the patient survey
- Give public and patient forums more power to act on poor services
- Encourage more involvement from local people
- Have an older peopleâ¬TMs champion
Your general comments
Some new issues emerged from the general comments.Ã' These were that:
Ã' - local authorities should have the legal right to take control of services when an emergency closure order is made
Ã' - services should address the needs of disadvantaged groups in society
Ã' - leadership is not strong in nursing.
A number of issues raised previously also came up again in the section including:
Ã' - criticism of the creation of Dignity Nurses as all nurses should respect dignity
Ã' - the standard of nursing care suffers when people are under pressure to treat service users quickly and discharge them as soon as possible
Ã' - private sector care homes are run like businesses and do not put the care of the service user first
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