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What you are telling us about dignity in care: weeks seven and eight
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Last modified date:9 February 2007
Good examples of dignity in care services
Again, the extent to which people were shown dignity in care was seen as variable depending on the person providing the care and where it was being provided. Hospices, district nursing services, voluntary sector services and palliative care services were given as the best examples. People thought that geriatric services were the least likely to consider the dignity of service users. Other people said that they had a better experience in council-run care homes than private sector ones.
- "the best care I think was received in council-run old people's homes, due mainly to constant inspections and better staff."
The following are characteristics of services which people felt helped provide dignity in care:
- Controlling people's symptoms
- Helping people feel they can rest and relax in a safe environment
- Respecting people as individuals
- Staff being consistent in the care they provide
Disrespect for dignity in care services
Similar to the responses we have received already from the survey, several professionals responded with examples of lack of dignity in care which they attributed to:
- staff being unaware of what dignity is;
- staff accepting the culture that exists of not respecting dignity;
- rushing people through care in order to discharge them more quickly; and
- a lack of resources in general.
Other people told us of some particularly distressing instances of lack of dignity. These included:
- a carer emptying people's catheter bags into a bucket in full view of visitors to the care home.
- people's meals being placed on bedside tables next to their urinal bowls.
What action you took
Again, the majority of people in the survey who said they were able to do something said they tried to bring it to the attention of the people in charge of running the service. However, many people did not think that the outcome of their complaint was satisfactory or said that nothing was done about it.
- "If I have been in a situation where I felt a patient's dignity was not being respected I would intervene."
- "I tackle the offending carer directly. I ask them about their training and if appropriate inform their manager. I also find myself apologising to patients for other people."
Other professionals said they thought there was little they could do to challenge poor services:
- "I attempted to speak with senior managers but was seen as a troublemaker. In the end I felt that I had to take the matter further."
- "I spoke to the sister in charge, each time and the individual staff, but the situation was not always improved."
Some professionals told us about what they had done to try to improve services. Some of the things that people did were to train staff about dignity, bring in person centred care plans and implement the National Service Framework for Older People.
Suggestions for how Government and service providers can help
Similar to the surveys completed in earlier weeks, the key areas that people thought providers of services and Government should focus on were improving complaints procedures and providing better training and education for staff.
People made some new suggestions, which were as follows:
- Break down the institutional practices that allow for a lack of respect and dignity
- Give financial incentives that encourage providers to demonstrate evidence of where they have listened to service users and acted on their complaints
- Change the Government targets so that they are focussed on people's experiences and not on money
- Make dignity a core value for people to respect when caring for service users
- Raise the profile of older people in society and challenge views that portray older people in a negative light
- Have more unannounced inspections of care homes
- Introduce a charter or best practice document on dignity.
- "Draw up a nationally accepted charter which is agreed by every Trust. The charter must be the same for each Trust so that over time all staff will recognise it as a gold standard for care."
- "Help foster positive images of older people in society. Combat negative stereotyping of older people."
Top three priorities for Government
The top three priorities for Government action were:
- Simplify the complaints procedure
- Support vulnerable groups to complain and seek their feedback
- Have more support from PALS (Patient Advisory Liaison Services)
- "Try to eradicate the feeling that if people complain or make their feelings felt, that there will be implications for the person being cared for."
- "Give patients the opportunity to speak up without prejudice or fear of backlash."
Other priorities suggested by a few people included:
- Have more unannounced inspections of care homes
- Provide more funding to voluntary sector advocacy groups
- Name and shame poor service providers
- Introduce fines for providers where the service is not good
- Have a more independent complaints system which is independent from Government control.
- "Set up an independent and accountable arbitration scheme for those who wish to complain about the poor health service."
- "Set up committees of local people, where any issues are taken on board and presented to the hospital committee/board to investigate and put procedures in place to protect people's dignity."
- "Shame them. The wider public should know about poor practice. Fine services that are poor â¬' owners are interested in profits so fines would make a real impact."
Your general comments
Some new issues emerged from the general comments. These were that:
- the NHS should follow the practice of the service industry (e.g. supermarket giants) and attempt to offer value for money alongside a good standard of service
- improve hygiene standards
A number of issues raised previously also came up again in the section including:
- only recruit people as carers who have a caring attitude and are suitable to the role
- dignity should be taught in school and ought to be reflected in society as a whole
- more resources are needed.
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