Dignity in care

Dignity factors - Choice and control: Ideas you could use

• Find out how you are doing on dignity and develop tools to promote improvementOpen

  Measure how well your service is doing on privacy and dignity by asking people who use the service about their experience of it. With the information you gather you can identify areas for improvement. You can remind people about ways to improve by developing fact sheets or posters for staff and a charter to ensure the people using the service know what they can expect.

  This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.

  For example, this idea has been put into practice by Southampton University NHS Trust. The trust’s Essence of Care Group carried out an audit to uncover areas of dignity in care that needed further work, identified five factors of privacy and dignity (206kb PDF file). Guidance was provided for all wards on the 'five factors’ and they also developed a charter for patients (23kb PDF file) .

  For further information contact Julie Dawes, Associate Director of Nursing. Tel 02380 798435. Email julie.dawes@suht.swest.nhs.uk

• Use a reassuring checklist as part of your admission procedureOpen

  Create a simple checklist to act as a prompt to the person undertaking the admission, reminding them to discuss certain aspects with the person using services (or a relative if appropriate) –  for example, knowing how to call for assistance, knowing where the toilet is, etc. Any relevant issues can then be transferred to the care plan so this is communicated to other staff.

  If people have concerns or anxieties, they will be able to raise them right from the start, opening up communication between staff, people who use services, and their relatives and carers from day one – and helping make people feel they are able to approach staff at any time.

  This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.

  For example, this idea has been put into practice by Burntwood, Lichfield and Tamworth Primary Care Trust. See the checklist (17kb PDF file) they are using.

  For further information contact Dawn Llewellyn, Modern Matron. Tel 01827 263819. Email Dawn.Llewelyn@southstaffspct.nhs.uk

• Involve people who use services in staff trainingOpen

  Involve the people who use your services in training staff on how they would like to be treated. Support people to do this, for example by providing training in presentation skills.

  This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.

  For example, this idea has been put into practice by Westminster Adults and Community Services Department, London. A significant number of their development and training courses routinely involve older people, who share their experiences and say how they would like staff to treat them.

  Many older people are already experienced presenters but, if any feel anxious, personal presentation skills training can be arranged. The department has also arranged presentation and assertion skills training for groups of older people who volunteer or work in the voluntary sector.

  The department has also held a number of successful consultation events with older people. A checklist has been developed in conjunction with key Partners  Older People’s Consultation Checklist (100kb PDF file). This and all development and training activities have been formally evaluated and changed in response to learners’ or managers’ feedback.

  For further information contact Jane Simms,  Workforce Development Commissioner, Westminster Adults and Community Services.  Tel 020 7641 2079. Email jsimms@westminster.gov.uk

• Develop a team of volunteer escortsOpen

  Develop a team of volunteers to act as escorts to people who need to go out, for instance to hospital appointments.

  This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.

  For example, this idea has been put into practice by Bucknall Hospital, Staffordshire, where they use a team to support older people who need to undergo medical investigations away from the ward. The escorts ensure that people’s safety, nutrition and dignity are a priority during time away from the ward. Patients say they feel safe and secure having a team member escorting them.

  For further information contact Lyn Charlton, Modern Matron, Stoke-on-Trent Community Health Services. Tel 01782 273510. Email Lyn.Charlton@stoke.nhs.uk

• Involve people in their own care planOpen

  Sit down with people who use services and work out goals for their care plan together. Provide people with a folder containing their goals, so they can monitor progress themselves.

  This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.

  For example, this idea has been put into practice by Oldham Intermediate Care Team, who are piloting a system of goal and treatment planning which was developed and introduced by one of their occupational therapists (OT).

  On admission, the patient and OT together set the goals and the patient receives a folder which contains these goals, to help monitor progress and reinforce a sense of purpose. It is expected that this method of involving people in their own care will ensure that they feel informed, listened to and treated as an individual.

  For further information contact Tracy Acton, Clinical Specialist OT. Email t.acton@nhs.net

• Provide an advocate to people undergoing medical treatmentOpen

  When people may need medical treatment, including for life-threatening or terminal conditions, an advocate can support them to express their wishes and make decisions.

  In some cases it is a legal requirement for a person to have the support of a special kind of advocate – an Independent Mental Capacity Advocate (IMCA). This is when serious medical treatment decisions are being made in the best interests of people lacking capacity to make these decisions themselves and who don’t have family or friends who can represent them. It is the responsibility of the NHS trust considering the treatment to involve the IMCA.

  The case example below provided by East Cheshire Advocacy shows the difference an advocate can make when someone is terminally ill. It also demonstrates how services were tailored for an individual with obsessive compulsive disorder.

  Case Example - Advocacy (36kb PDF file)

  For further information contact Maggie Harwood, Manager, East Cheshire Advocacy, The Moss, 4-6 Congleton Road. Macclesfield SK11 7UE. Tel:01625 4299 22 Website www.ecadvocacy.co.uk.

• Use an advocate to help people express their wishesOpen

  When people who use services have difficulty expressing their wishes, using the specialist support of an advocacy service may enable them to speak up.

  This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.

  For example, this idea has been put into practice by Advocacy Partners to help someone with learning disabilities achieve the celebration he wanted.

  Peter had recently had his 60th birthday. When asked by members of the self-advocacy group what he had done for his birthday, Peter said that staff where he lived had been busy on the day of his birthday and so he had gone out for a pub lunch with three people he lived with at the weekend. Unfortunately, the pub was not serving food that day so they just got fish and chips to eat at home.

  When the advocate asked about a party, Peter said he would like one, but that the staff hadn't asked him if he had wanted one. The advocacy group didn't think the staff had supported Peter well for such an important birthday. This was communicated to the service, who acknowledged quickly that they had not treated Peter with dignity and helped him organise the party he wanted, inviting his family and friends, including members of the self-advocacy group.

  Peter’s story highlights the importance of effective and timely communication and shows how, through joint working between the staff and the advocacy supporter, Peter was able to express his wishes and make them happen.

  For further information contact David Thompson, SCIE. Email David.Thompson@scie.org.uk

• Help people to make choices using artOpen

  When working with people with dementia or learning disabilities, use art to aid communication and enable them to make choices.

  This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.

  For example, this idea has been put into practice by Age Concern Calderdale and Kirklees. People were encouraged to use arts and crafts to create a range of pictures and objects to facilitate communication and choice. The work was also shared through public displays. A local community artist gave workshops in crafts and collage work giving help with constructing ‘life story books’ as well as boxes containing items that the individual can use to communicate their preferences.

  For further information email Eileen Redden.

• Improve communication with people with long-term conditionsOpen

  Establish a multi-lingual helpline for people with long term conditions to enable them to better manage their condition.

  This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.

  For example, this idea has been put into practice by Birmingham Own Health. People are empowered to take greater control of their health and engage more effectively with healthcare services; the aim is to improve their overall health and quality of life. The project also reduced hospital admissions and pressure on healthcare services and resources, arguably helping the participating PCTs evolve from a reactive sickness service to a patient centred one which encourages people to play a greater role in staying healthy. The service is run by highly experienced nurses and care managers specifically trained in giving telephone advice.

  People are referred to the service and invited to enrol as a member by their GP.

  The aims are to enable people to:

  • Better understand their own medical condition
  • Acquire skills and knowledge to make positive lifestyle changes which can benefit their condition and overall health
  • Correctly follow treatment programmes as prescribed by their GP and/or other healthcare professionals
  • Understand how to engage and use local NHS services more appropriately and effectively

  For further information contact Mark Danesi

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