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What you are telling us about dignity in care: weeks nine and ten

  • Last modified date:
    9 February 2007
In weeks nine and ten we received 58 responses in total, 30 responses were received in week nine and 28 in week ten. 28 of the responses were completed by professionals and 30 by members of the public.

Good examples of dignity in care services

Again, the extent to which people were shown dignity in care depended on the person providing the care and where it was being provided. Hospices, specialist services, voluntary sector services and palliative care services were cited as best examples. Services supporting people with mental health problems and services for people with a learning disability were also praised.

  • "As a chronically ill patient I am appalled at the way that I or others are sometimes treated/ I find the problem much worse among care assistants."
  • "Unfortunately pressures placed upon staff e.g. to move patients from various places does not always consider patients dignity."

The following are characteristics of services which people felt helped provide dignity in care:

  • Making sure people are not left in pain
  • Addressing people how they wish to be addressed i.e. as Mr or Mrs
  • Speaking to the service user and not their family/carer when discussing their medical condition

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 said were caused by:

  • staff not having a caring attitude
  • staff not considering how it must feel to receive care that does not respect dignity
  • pressure to rush people through services quickly so they can be discharged sooner.

One professional said:

  • "In general there seem to be some people within the NHS who never seem to reflect that the person they are seeing is a human, not just a cipher or thing to be processed."

Others told us of some particularly distressing instances of lack of dignity. These included:

  • a gentleman being kept on a trolley in a hospital corridor for a long period of time and also having his request to use the toilet repeatedly ignored.
  • a blind lady not being offered help to drink and then being reprimanded for spilling her drink.
  • "There are some very committed young nurses but they are in the minority. The majority are disrespectful and couldn't care less. A service orientated approach is required."
  • "The way in which a person's care needs is assessed is increasingly budget defined rather than need defined. This obviously does not respect that person's dignity."

What action you took

Again, the majority of people in the survey 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. Many people, however, did not feel the outcome of their complaint was satisfactory and that nothing was done about it.

  • "It is quite difficult to do anything about dignity in care, especially if you are the patient / client as you tend to feel less able, vulnerable and possibly less inclined."

One professional said that they had recently tackled the issue of Dignity in Care by raising it through an Older People's Champion Programme at their local NHS Trust. Other professionals said they did not hesitate to tackle colleagues when they thought that someone's dignity had not been respected.

  • "We take a dim view of any member of staff who does not respect a resident's dignity. We encourage residents, carers, family, next of kin etc. to complain to the management whenever they feel that the residents are not treated properly."

Some people said they were afraid to complain in case there were any repercussions or did not think their complaint would be acted upon.

  • "After my mother died I simply chose to allow my complaints to drop. What was the point, I would simply have received a placatory letter for my complaints."
  • "I complained to the ward sister and the matron responded in a negative way especially when I kept drawing their attention to people who were asking for help and not being responded to."
  • "If you do say anything you are considered an interfering troublemaker. One dare not make too much noise in case it reflects back on the poor elderly person."

Suggestions for how Government and service providers can help

Similar to the surveys completed in earlier weeks, the key areas in which you thought both providers of services and the Government should focus on were:

  • improving complaints procedures; and
  • providing better training and education for staff.

Some people thought that making small changes to how carers relate to service users would have a significant improvement.

  • "A person's dignity is respected by minor things, such as effective communication, a friendly atmosphere and a smile. Things which cost the NHS nothing but produce a much valued service."
  • "Treat the person as an individual. Dress them in clothing appropriate to their dress style. Provide stimulation and appropriate activities."
  • "Listen to service users and encourage staff to think of service users as people rather than a diagnosis."

Other people thought the answer was to recruit professionals who genuinely have a caring attitude and also to train staff in the importance of treating people with dignity and respect.

  • "Recruit those who are genuinely caring. Without that, it is not really possible to teach respect."
  • "Employ the right person to begin with."
  • "Give staff regular training and supervision, and proper induction training."

Some new suggestions people made were to:

  • include dignity and respect within a hospital's patient survey
  • be more accountable for poor services
  • include Dignity as a quality indicator
  • allow patients and their families to provide anonymous reviews of what they think of nurses / care staff
  • perform psychometric tests on care staff at the recruitment stage to ensure that appropriate candidates are recruited into the care profession
  • raise the status given to caring as a profession
  • "Listen to carers and service users, get proper feedback and act on it."
  • "Patients should be able to send in anonymous appraisals of named community nurses. In hospitals many nurses interact with the patient, but in their own homes patients are much more vulnerable."
  • "Make sure that the people who are responsible for employing care personnel are themselves caring enough about their responsibilities and really know their job."

Top three priorities for Government

The top three priorities for Government action were:

  • providing more training for care staff
  • taking complaints more seriously
  • establishing an independent body to look at complaints
  • "People who work in social and health care need to be trained and educated so that they respect people's dignity. The job is very demanding and without training/education it is sometimes difficult to cope and understand why people behave in a certain way and what their needs are."
  • "An Ombudsman, to which independent complaints could be made would be a good idea. They could have powers to close an institution."
  • "Publicise complaints procedures."

Other priorities suggested by a few people included:

  • introduce fines for providers where the service is not good
  • encourage the use of individual budgets
  • have more complaints advocates to help guide people through the complaints procedure
  • "There should be staff at local level who would help service users to communicate with the providers in order to put things right and also help with the complaints procedure when needed."
  • "Ensure that poor services are investigated fully and that the people reporting the poor service or the receivers of those services are not discriminated against in any way."

Your general comments

Some new issues emerged from the general comments. These were that:

  • the privacy of male service users is sometimes overlooked because some care staff assume males are less concerned with undressing/bathing in front of care staff than female service users are.
  • better education is needed for care staff working with service users with a learning disability
  • dignity and respect could be taught as part of equality and diversity awareness in social care organisations.

A number of issues raised previously also came up again in the section including:

  • more resources are needed
  • pressure to discharge patients from hospital can compromise care
  • some NHS staff can often feel as if they themselves are not being respected by their employer and this attitude can affect how they treat patients
  • "The delayed discharges targets put people under pressure to discharge too quickly."
  • "When service providers work under a lot of pressure it is inevitable that the dignity of care will suffer. More money is required to make the quality of care better."

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