Dignity Matters

Jamie Rentoul, designate Director of Regulation & StrategyCare Quality Commission25 November 2008

Ensuring better care for people

What is CQC ?

What is CQC?

We will bring together and build on the excellent work of three commissions

As a new, combined and powerful regulator across health and social care, our work will touch the lives of everyone in England at some point

People who use services, their families and carers will be at the heart of everything we do

The CQC model of quality care

Safety and safeguarding

Outcomes, including clinical outcomes

Experience of people who use services

‘Functionality’, independence and quality of life

Access to services

Making best use of our resources

Our values

Put the people who use services first

Be independent, expert and authoritative

Champion joined-up care

Work with service providers and professions to agree definitions of quality

Be visible, open and transparent

Building on success – key functions

Registration

Provider assessment

Risk-based inspection

New enforcement powers

Commissioner assessment

Trusted, accessible information

Gatekeeping role

Knowledge to influence policy

How can CQC play its part in promoting dignity in health and

adult social care?

Not being given proper information

Being spoken about as if they were not there

Not seeking their consent and/or not following their

wishes

Being addressed in an inappropriate manner

Being left in soiled clothes

Being exposed in an embarrassing manner

Not being given food or help with eating/drinking

Being placed in a mixed sex accommodation

Being in a noisy environment at night thus causing lack of sleep

Being left in pain

Having to use premises that are unclean and smelly –

toilet and wards

Lack of protection of personal property including personal aids – hearing or visual

Being subjected to abuse and violent behaviour

I don’t believe it.!!!

There is no standard definition of ‘dignity’.There is no standard definition of ‘dignity’.

How do people define dignity?

How good is existing care?

‘State of social care’ – personal dignity & respect:- 74% of councils ‘good’ or ‘excellent’;- 88% of care homes meet relevant standards.Surveys of people in healthcare settings:- 78% always treated with dignity in acute hospitals;- Over 80% treated with respect & dignity in community mental health

services;- 93% of those seeing a GP treated with dignity ‘all of the time’; but…- 20% of those needing help to eat did not get it;- Significant proportion still sharing accommodation when first admitted

or sharing bathrooms later on;- Considerable variation between providers of care.

Dignity in care – the golden thread

Dignity is an integral part of providing care in any care setting.

Dignity is central to the personalisation agenda.

Maintaining dignity does not always require resources, small changes can make a big difference to people.

Dignity is fundamental to CQC’s human rights based approach

Caring for dignity – building blocks

Involving people in their care A culture focussed on delivering personal care in a way that ensures dignity for the person using services

A workforce that is equipped to deliver good quality care

Strong leadership at all levels Supportive environment

Source: “Caring for Dignity”, Healthcare Commission 2007

Who has a role in improving quality?

Commissioning

Performance Management

NHS Constitution

Professional accreditationPersonalisation

Quality Accounts

Quality Framework

National Quality Board

Other Regulators

NHS Litigation Authority

3rd Sector

NPSA

Audit Commission

NICE

Improvement Agencies

PROMs

GSCC

RIEPs

ADASS

NMC

GMC

Human Rights

E&D

DCLG

Political landscape

DH

CAA

JSNA

Quality observatories

CommissionersDarzi review

NHS Choices

Staff

SCIE

ProvidersJIPs

LAA

Topics for registration requirements

Department of Health consultation:Making sure people get the nourishment they needMaking sure people get care & treatment in safe, suitable places which

support their independence, privacy & personal dignityUsing equipment that is safe & suitable for people’s care & treatment and

supports people’s independence, privacy & personal dignityInvolving people in making informed decisions about their care & treatmentResponding to people’s comments & complaintsSupporting people to be independentRespecting people and their families & carers – people’s privacy, autonomy

& dignity are safeguarded and their human rights & equality are respected. Where appropriate, people are assisted to maintain their private and family lives and social support networks

How can regulation help?

Giving people using services & their carers a stronger voiceEnsuring that all providers meet registration requirementsAssessing performance of all providersAssessing performance of Local Authorities and Primary Care

Trusts as commissioners of careGiving people trusted information that helps them & their carers

make decisions on their care

We need your help to ensure our work reflects what is important to people

Your questions ?