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What you are telling us about dignity in care: week six
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Last modified date:9 February 2007
Good examples of dignity in care services
Again, people told us that where individuals were shown dignity in care varied, depending on the person providing the care and where it was being provided. Specialist and smaller services (such as palliative care and not for profit organisations) were cited as best examples.
- "I have seen many examples of where dignity is shown to patients/clients, bit equally within the same organisation I have seen poor examples - this is very much down to individuals who vary considerably in their attitudes and approach."
- "Most care services, in my experience, try to respect a person's dignity. Though it is very dependent upon the individual care worker."
The following are characteristics of services which people felt helped provide dignity in care:
- Respecting people as individuals
- Staff being consistent in the care they provide
- Involving service users in the planning and delivery of care
- Helping service users to feel safe in someone's care
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 busy;
- poor leadership;
- staff not perceiving the service user as an individual; and
- service users being cared for in a way that suits the needs of the organisation rather than the individual's own needs.
Others told us of some particularly distressing instances of lack of dignity. These included:
- in a hospital, older people were placed on commodes and instructed to eat their meal whilst sat on the commode
- an older person being undressed and washed in full view of other patients
What action you took
Similar to 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. 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.
Several professionals said they took action to improve dignity in care by arranging training courses on dignity or by raising it with management and then encouraging staff to follow their example.
- "I would usually try to rectify the problem and lead by good example."
However, as we have heard in other weeks, professional said that it can be difficult to complain about the quality of care in the organisation where they work.
- "I have always spoken up for myself and others as appropriate. It does not make one popular."
- "I feel that they dismiss my concerns and there is little I can do about this."
Suggestions for how Government and service providers can help
Similar to the surveys completed in earlier weeks, you thought providers of services and the Government should focus on improving complaints procedures and providing better training and education for staff.
One person suggested that providers of services should monitor the behaviour of their staff towards service users, because one-to-one care can vary within organisations. Another person thought that the Government should reward organisations where good practice on dignity in care is taking place. Someone else thought that patient confidentiality should be tackled above everything else.
Recruiting appropriate care staff, training and supervising them seemed to be the most common suggestions for how care providers could improve services and ensure people are treated with dignity.
- "Properly trained, qualified and knowledgeable staff with the right skills set and far more of them will make a great deal of difference."
- "Ensure that they prioritise quality staff over budgets."
- "Staff working with older people should be vetted more closely as they are in charge of the most vulnerable client group. The necessary training and supervision of staff is paramount in ensuring the patient's dignity."
Top three priorities for Government
The top three priorities for Government action were:
- Set standards and guidelines for what dignity in care should look like
- Provide training for care staff in dignity and respect
- Have more frequent inspections of organisations
Other priorities suggested by a few people included:
- Ensure good practice is identified and reward services who respect dignity
- Introduce a charter so that people know what to expect
- Increase staffing levels
- Ensure people with the right skills and attitude are recruited into caring professions
- Have more unannounced inspections of care homes
- Examine whether care for older people is sufficiently covered in student nurse training
"Look at student nurse training and establish whether their training has sufficient focus on the needs of older people - it should be the main focus as they are the majority of service users."
"State specific and measurable standards that you expect staff to adhere to."
"Have a charter showing people what they can expect from the staff that provide care."
"Ensure that the prevailing attitude in care services is one of valuing clients."
Your general comments
Some new issues emerged from the general comments. These were that:
- there should be more of a focus on the needs of people with dementia
- policy, planning and delivery of services needs to be more joined up
- as well as suggesting Dignity nurses, we might also consider having Dignity doctors.
A number of issues raised before also came up again in this section including:
- criticism that private sector care homes are run like businesses and do not put the care of the service user first
- the standard of nursing care suffers when there are not enough staff available
"The private sector appears to be out of control, treating people as income generators and operating with neither ethics nor care."
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