Choice and control: Dignity in care videos

What is the video about?

Owning a budgerigar; deciding between mince with dumplings or a roast chicken dinner; going off shopping and buying the items you've chosen. Just three examples, shown in this film, of how people with care and support needs can be supported to have choice and control. The young men with learning disabilities who draw up their preferred shopping list travel to town unsupported, buy the food, come back and cook it and then eat it. It's important to take time to understand and know the person, their previous lives and past achievements, and to support people to develop things like ‘life story books’. If you treat people as equals, you can make sure they remain in control of what happens to them.

• Video transcript Open

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  Dignity in care – choice and control

  Narrator

  Giving people choice and control is all about empowering people.

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  Empowering people

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  Knowing the person

  Frank

  Can I show you something? I worked my way up to quartermaster. And all the quartermaster did was steer the vessel.

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  Doing things for yourself

  Matthew

  Chile con carne

  Yes?

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  Respecting culture and traditions

  Shabbia Habajee, Supervisor, Khidmut Group, Age UK

  I think you need to be sincere with your respect. And you’ve got to understand the cultures as well.

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  Having things the way you want them

  Lesley Gregg, Manager, Harton Grange Residential Care Home

  Well everybody has their own care plan. It’s all about what each individual resident wants to do. Their choice.

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  Making decisions

  Val

  Can we have fish and chips?

  Sharon

  Fish and chips?

  Angela

  Peas!

  Val

  We usually get them on a Friday.

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  Doing things the way you want to do them

  Gaenor

  One can still decide what you want to do. Such as whether you want new shoes, or clothes. Just ensures you don’t lose all control of your life.

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  We all want to feel in control of our lives

  Supporting how people choose to live

  Narrator

  Supporting people to choose how they want to live.

  Emma Fisher, Care Worker, Care Concern Homecare Ltd

  My role as a carer, it can vary on different clients, obviously their needs, their abilities. You need to get to know the person quite well to obviously understand their needs. The most important thing for me, personally, is to obviously listen to what they want, their needs. It’s not so much what I want, it’s following their lead, so to speak. With Gaenor, it all depends sometimes because she’s quite able bodied, so she can do a lot of chores herself but since she had a knee replacement and she broke her arm a few years ago, she’s not able to lift heavy objects or do certain things like put her tights on. But I always encourage people to live a life as independently as they can do, they want to be in their own home, we should be supporting them in decisions that they make.

  Emma

  Is there anything you need to do in the bathroom or are you…?

  Gaenor

  No I’ve done my teeth.

  Emma

  You’ve done your teeth, ok.

  Gaenor

  Now I’d like to put that sweater on.

  Gaenor

  I would recommend that they do what I’m doing, certainly, which is to stay in one’s own home, as long as possible, with the carers coming in. Well it’s taken over a lot of little odd things that I probably do without thinking about and then you find you can’t do it, simple things like putting dishes in cupboards and loading the fridge and so on. They make the bed, and take the rubbish out again, and check I’ve taken my pills. I think this is very important. As you get older you are more dependent on the carers, but I think you’ve got to carry on doing things for yourself. You just have to adjust really.

  Catherine Gunnewicht, Manager, Care Concern Homecare Ltd

  It’s about understanding what somebody wants and you know, it’s their choice. So if somebody, let’s say in the care plan it says going in in the evening for a bath and that person doesn’t want a bath that evening, that’s fine. It’s about understanding the situation and listening to that person and sort of seeing, ok well what would you like to do instead. It might just be that they’re having a bad day and they want to have a chat or they’re feeling a bit lonely, they just want somebody to watch telly with them for half an hour. You have to spend time with that person, you have to again give them choice, you have to enable them to do things for themselves.

  Lesley Gregg, Care Manager, Harton Grange Residential Care Home

  Well everybody has their own care plan, it’s all about person-centred care, about each individual are different, how they like to have their hair done, what time they like to be up in the morning, what time they have their breakfast, it’s all about choice. The staff find out about people as well and they’ll sit and say ‘do you fancy doing a bit of baking today?’ or ‘do you fancy doing some artwork today?’

  When people come into the care home, sometimes it seems like they lose their skills, washing up, making their beds.

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  Maintaining skills

  Darren Kinghorn, Senior Care Worker, Harton Grange Residential Care Home

  I think it’s important that people keep doing what they’re doing in their lives, because that’s something they’ve done before they came in here, and their life should be no different really to what it was when they were at home. Getting to know that person, what are their needs, what their likes and dislikes are, so that actually helps overall. It’s the little things that matter in life altogether anyway.

  It’s their home at the end of the day. If they want to do something they’re more than welcome to do it.

  Frank

  I think that I had a hard life, of 40-odd years at sea, from the age of fifteen to when I retired. I make my own bed every morning. When I shower, I come through the shower and I wash my underwear, that’s a lifetime habit.

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  Feeling at home

  Narrator

  You feel more in control when you feel at home with the things you want around you, such as having your own phone.

  Frank

  It’s handy having a personal phone, I didn’t realise that at first I thought you wouldn’t be able to have a phone in here, we’d have to have an official one. But I’ve got my own phone now.

  Narrator

  Or having a pet

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  Having a pet

  Eveline

  It knows me alright. The last one I had I had it for ten years. Tweety. This one I got now, it’s gone five years, I’ve had it.

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  Eating what you like

  Lesley Gregg, Manager, Harton Grange Residential Care Home

  For mealtimes we always have two choices. Plus an alternative menu. We have menus and we have menu board and we also plate the food up and give people a choice by looking at the food.

  The majority of people choose to eat together, because it’s a way of chatting, meeting people. But there are people who like their own privacy in their own room. It’s about them, it’s about their choice.

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  Meeting cultural needs

  Shabbia Habajee, Supervisor, Khidmut Group, Age UK

  Dignity to me, me personally, makes me who I am really in the sense that I’m able to understand people. Actually, that’s what comes into it where you actually start understanding people because of their culture.

  You’re quiet today? There must be a reason. She’s asking that you’re doing all this but are we going to get to see. When it’s finished, we’ll get a CD and we’ll show it on a big screen in the room next door. And charge £1 entry! [in Gujarati]

  Saeed Maleck, Equality and Diversity Coordinator, Age UK

  We ensure that we listen to people, and their carers and families. And we need to take on board cultural needs and differences, so this could be related to their diet, their individual religious or cultural practices, so some people might be quite devout and other people may belong to the same faith but have a different level of devoutness. So we will try and find that out and tailor our services accordingly.

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  Having choice and control over what we eat and how it is prepared

  Narrator

  We all like to choose what we eat.

  Shabbia Habajee, Supervisor, Khidmut Group, Age UK

  With food with regards to this particular centre it’s very sensitive, because we’ve got the Punjabi group, we’ve got the Gujarati group, we’ve got the Halal group, and then there’s a cultural style of food as well. To the general public it’s just Asian food but there’s big differences, just in the rotis, there’s a big difference. They want something that they’re used to or they like or they love or whatever. I mean sometimes they’d like a little change as well. So again that’s a choice.

  Saeed Maleck, Equality and Diversity Coordinator, Age UK

  If you’ve been attending a service for a number of years you’re likely to be quite involved, you’d be considered as somebody who’s an established user of the service, and that kind of creates a sense of ownership in people. A lot of the services are kind of owned and managed by the people who use them.

  Shabbia Habajee, Supervisor, Khidmut Group, Age UK

  The people in the group they actually have got the talent and the knowhow of a certain dish and they’ve got loads of experience. They’ve got knowledge with regards to cooking, the method of cooking, the style of cooking, the taste of cooking. They’re the experts and they’re the mother of food, they’ve got a lot of talent in them. And they actually contributing how the food should be cooked in there.

  Cook

  This is chicken biriyani. This is rice, fried chicken, fried potatoes, and all the presentation I’m doing.

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  Doing things with, not for people

  Narrator

  Supporting people to do things for themselves.

  Gill Williams, Personal Assistant, Equal Partnerships Ltd

  There we go. Right, now we choose for the week from Saturday.

  Janis White, Director, Equal Partnerships Ltd

  We’re enabling Matthew to lead the life that he lives, that he wishes to, by for example running his own home, working out what he wishes to eat, the meals he wishes to have. Ensuring that we sit down with him and he’s got the control over that, he knows what his budget is –

  Gill

  Carrots and what else do we need?

  Matthew

  Peas.

  Gill

  Peas, uh huh.

  Matthew

  And turnips.

  Gill

  Uh huh.

  Janis White, Director, Equal Partnerships Ltd

  - he knows what his shopping money is every week.

  Matthew

  We get the money, take it down to the shop, get the items first before you pay.

  Gill

  So what else do we normally buy for packed lunch from the -

  James

  Bananas.

  Gill

  Bananas.

  Matthew

  Bananas.

  The shopping list – I’ll read it to you – sprouts, onions, salad, bananas… There should be an ‘s’ on there.

  Janis White, Director, Equal Partnerships Ltd

  At first he used to get driven with the staff to the supermarket, now they walk to the local supermarket. He was supported initially to do the shopping –

  Mark

  If you have any problems and you can’t find anything, give us a ring.

  Janis White

  - now he does it and the staff are in the background supporting him. But he knows that they’re there just in case, it’s kind of they’re just-incase PA’s when he’s doing that task.

  Matthew

  We do this every Thursday now. Sometimes we do it with staff, we let the staff sit back, we do it independently

  (to James) Don’t we James?

  James

  Yes.

  Matthew

  We find stuff, find items. It’s amazing. It’s all done now. Time to pay.

  Janis White, Director, Equal Partnerships Ltd

  The sense of wellbeing and self-esteem for doing that independently is enormous for him. And for his housemate and the other people we work with.

  Title: Key learning points

  Everyone has the right to make choices about how they live and how their support is provided

  Staff should get to know the people they support so that they know what their needs and preferences are

  People should be supported to do things for themselves rather than having things done for them

  Staff should be flexible about the way they support people

  END

Who will find this useful?

Care staff, commissioners of services, family carers and anyone in the community who can provide dignity by supporting people to have choice and control over their lives.