SCIE Practice guide 09: Dignity in care
Published November 2006
New content added August 2007 and February 2008
About this practice guide
What's new
Introduction
About this practice guide
Who is the guide for?
The aim of the guide
What the guide does not cover
Background
How you can help
What’s New?
We have added a brief guide to Dignity in Care legislation to this site. The guide will explain to practitioners how dignity is supported by several key pieces of legislation and how this affects peoples’ rights to high quality care.
Introduction
SCIE aims to improve the experience of people who use social care by developing and promoting knowledge about good practice. Using knowledge gathered from diverse sources and a broad range of people and organisations, we develop resources that we share freely, supporting those working in social care and empowering service users.
At the request of the Department of Health, we have produced this practice guide to support their wider Dignity in Care initiative.
Dignity consists of many overlapping aspects, involving respect, privacy, autonomy and self-worth. The provisional meaning of dignity used for this guide is based on a standard dictionary definition:
a state, quality or manner worthy of esteem or respect; and (by extension) self-respect. Dignity in care, therefore, means the kind of care, in any setting, which supports and promotes, and does not undermine, a person’s self-respect regardless of any difference.
While 'dignity’ may be difficult to define, what is clear is that people know when they have not been treated with dignity and respect. Helping to put that right is the purpose of this guide.
About this practice guide
This guide has been designed for people who want to make a difference and improve standards of dignity in care. It provides information for service users on what they can expect from health and social care services, and a wealth of resources and practical guidance to help service providers and practitioners in developing their practice, with the aim of ensuring that all people who receive health and social care services are treated with dignity and respect.
Whether you only have five minutes to get some quick ideas, or five hours to gain an in-depth understanding, this guide should meet your needs.
You may like to go straight to our Quick Links section. Here you can find ideas about small changes you can implement that make a big difference. You can also download ready-made training packages and dignity audit tools or see the dignity challenge.
If you have more time to spare, you will find this guide very informative and easy to use. It begins with an overview of what is known from UK and international research and policy about dignity in health and social care for older people. Further sections, based on subject areas identified by older people and their carers, translate these findings into recommendations for practice (practice points) and give examples (ideas from practice) from people and organisations that have already tackled these issues. There are also links to other useful websites and sources of information.
Who is the guide for?
This guide is aimed at a wide audience. People who use services and their carers will find much useful information on what they can expect from services. The guide will also help frontline workers, practitioners, managers and commissioners to ensure that dignity and respect are integral to the services they provide.
What does 'in care’ cover?
This covers all care provided by paid workers in any setting (hospital, residential, nursing, day centres and in people’s own homes), including care that is paid for either partially or wholly by the recipient.
The guide applies to England only.
The aim of the guide
Quick and easy access to:
- the meanings and aspects of Dignity in Care and the many related issues
- information and guidance on how to tackle poor standards of service, for practitioners, people who use services and their carers
- key pointers to improving the dignity of older people (practice points)
- examples from all around the country of tangible ways in which dignity can be incorporated into care (ideas from practice)
- the policy context and key research and policy findings, with references
- relevant guidance and standards
- links to further information and useful websites.
What the guide does not cover
Abuse: this guide does not attempt to cover the many complex issues relating to abuse, but a small section gives basic information on how to decide whether abuse is taking place, what to do about it and where to seek further advice.
Background
This guide is part of a wider Department of Health campaign to promote dignity for older people in the health and social care sectors. The issue of dignity features prominently in the new framework for health and social care services. The Department of Health’s Green Paper, 'Independence, well-being and choice' (2005a) and subsequent White Paper, 'Our health, our care, our say' (2006f), are set around seven key outcomes identified by people who use services, one of which is personal dignity and respect. The Commission for Social Care Inspection (CSCI) has incorporated these into their new assessment framework, 'A new outcomes framework for performance assessment of adult social care' (2006). The Department of Health’s National Service Framework for Older People (2001) also supports a 'culture change so that all older people and their carers are always treated with respect, dignity and fairness’, and its 'Essence of Care: Patient-focused benchmarking for health care practitioners' (2003c) offers a series of benchmarks for practice on privacy and dignity.
Factors that have been held responsible for the absence of dignity in care include bureaucracy, staff shortages, poor management and lack of leadership, absence of appropriate training and induction and difficulties with recruitment and retention leading to overuse of temporary staff. There are also wider societal issues, including ageism, other forms of discrimination and abuse. A great deal of work is needed to tackle negative attitudes towards older people, to bring about a culture change and to ensure that such attitudes have no place in the health and social care sectors. This guide seeks to highlight the small changes that can make a big difference in day-to-day practice.
How you can help
This guide will be helpful but it cannot reflect everything people have learned about ensuring people's dignity. We plan to develop this guide so we would welcome email or written comments on any aspect of this guide, in particular if you have a success story about how you improved people’s dignity. The feedback will inform future practice guide updates. We are also keen to collect examples that translate key research findings and practice points into practice.
See our contact us page for details.
Next: Dignity challenge
