The recently published report from the Commission on Dignity in Care for Older People looks at the undignified care of older people in our hospitals and care homes and how this can be improved. The report which is out for consultation, draws on the body of evidence gathered over the past eight months.
The report recommends:
- The new NICE quality standard for patient experience in adult services, which includes dignity, should be used by providers, commissioners and regulators across health and social care to provide consistent standard by which to define and measure performance.
- Commissioners should set out in their contracts the dignity standards they expect, and ensure the service providers regularly report on progress in meeting them.
- Individual staff should be required to challenge at the time practices they believe are not in the best interests of the people in their care, and help colleagues understand how their interaction with a patient or resident could be improved.
- The Government needs to take a lead by setting a positive tone for debate about our ageing society, celebrating the contribution that older people already make and seeking to build on this, rather than casting them as a problem to be solved.
Specific recommendations for hospitals include:
- In addition to recording physical and mental health needs, staff undertaking assessments should take time to understand and record the personal preferences of older people and their families and carers, so they can care for the person as well as the patient.
- Freeing the ward sister from command and control management is crucial to ensuring that older patients are treated with dignity and respect. They should feel they have the authority and responsibility to show leadership over everything that happens on their ward, and take the action they deem necessary in the interests of patients.
- Feedback from patients and their families should be discussed and responded to on the ward every day and by hospital Boards at every meeting. Hospitals should give staff the time to reflect on the care they provide and how they could improve; this is an essential part of giving good care.
Specific recommendations for care homes include:
- The status and role of those working in the care sector needs to be elevated so they feel valued and supported in their day to day work. The Government should establish a Care Quality Forum to look at all aspects of care home staffing, including pay, qualifications, recruitment and regulation.
- Care home managers should be recognised as experts in their field. They have demanding jobs, leading and motivating teams of relatively low paid staff doing difficult work. Care home providers should invest in support and regular training for their managers. Local authorities have an important role to play in facilitating this as commissioners of care.
The Commission on Dignity in Care for Older People is an independent body set up by the NHS Confederation, Age UK and the Local Government Association (LGA) to help improve dignity in care for older people in hospitals and care homes.
The Commissioners include representatives of patients and residents, experts from the world of nursing and medicine, and management of health and social care services.