Dignity in care isn’t a new issue

In the 10 years since the Social Care Institute for Excellence was created, chair Allan Bowman explains what has changed in providing dignity in care

Last month, around the time that we celebrated 10 years’ work in social care, we wrote a letter to the Guardian, saying that providing dignity in care to adults at risk is a complex issue. We could have probably written the same letter 10 years ago. Although it’s great that issues involving older people are now more likely to make it on to the front pages of national newspapers, those same issues have been around for a long time.

Our letter was a response to a Patients Association report, which detailed some recent accounts of poor hospital care heard by its helpline in the last year. For many, it was a shock to hear that people’s toileting needs were being neglected. Dignity needs to be provided in hospitals, care homes, in people’s homes and in other care settings. But people don’t differentiate. They simply want quality care and choice about how to receive it.

What’s good is that in the last few years, social care has become a really important issue. There’s likely to be a rise in the numbers of people needing social care, and the Dilnot Commission has looked at how it is going to be funded.

The media have picked up on this; it was even discussed in one of the leadership debates at the election. So, a greater awareness has grown over the decade; now, issues like dementia and dignity are often top billing. However, the media reports don’t always include strategies for dealing with the issues involved. And there are plenty.

Some will say: “Why can’t staff just be nice, like they used to be?” Here’s one solution; at Social Care Institute for Excellence we host the Dignity in Care website, where staff are encouraged to become “dignity champions”. Champions believe that care services should be compassionate, person-centred, as well as efficient. On the site you can get 10 top tips on how to be a champion in health and social care settings.

Dignity champion Jasmine Charlson says: “When the other staff see the dignity champion badge, they make sure that dignity and privacy count, for example they make sure that the patient’s curtains or door is shut, and it is amazing that a nurse wearing a badge can make that difference.”

For new champion-recruits, Dignity Action Day is 01 February 2012 and there’s plenty of activities that staff can get involved with.

We know, however, that it’s not just about badges and being nice, important though those approaches are. Here’s a small list of issues that need to be addressed and it’s just a start; training, resources, leadership, attitude, workplace assessment, career development, supervision and pay and conditions.

Staff need the time and resources to do the job and to be encouraged to stay in the job and flourish in it. Have a look at our eight “dignity factors” on the SCIE site – these range from having choice and control, to issues of personal hygiene and pain management.

There are lots of examples of good practice when providing dignity. One of the most obvious ways of helping to contribute to a person’s sense of self-respect is to address nutrition and hydration. We have a Social Care TV film on this; in it, one resident asks if he can have tripe (Look at time code 04.40). Although most of the other residents recoil, the important issue is that his views are taken on board. Food and mealtimes are very important to older people.

The film shows how listening to what older people want to eat and preparing fresh food can enhance the meal time experience.

Closely related to issues of dignity are those of safeguarding. Relatives worry that their loved ones are being treated with respect, but they also worry that they may be abused. At SCIE’s 10th anniversary celebration last month, care services minister Paul Bursow said that adult safeguarding is a top issue on the agenda. Our safeguarding pages look at how to provide care services that are safe, but that also are high-quality.

So, last month we at SCIE celebrated a decade building up a broad, reliable and rigorous evidence base about what works, to improve the lives of people who use services. Wouldn’t it be great if, on our 20th birthday, people who need care and their relatives saw many less negative reports and celebrated the success of dignity in care?

Allan Bowman has been chair of SCIE since March 2006 and is a qualified social worker.