Dignity Matters

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Dignity Matters

• Jamie Rentoul, designate Director of Regulation
  Strategy
• Care Quality Commission
• 25 November 2008

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Ensuring better care for people
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What is CQC ?
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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

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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

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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

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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

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How can CQC play its part in promoting dignity in
health and adult social care?
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How do people define dignity?
Not being given food or help with eating/drinking
I dont believe it.!!!
Being spoken about as if they were not there
Being placed in a mixed sex accommodation
Not seeking their consent and/or not following
their wishes
Not being given proper information
Lack of protection of personal property including
personal aids hearing or visual
Being addressed in an inappropriate manner
Being subjected to abuse and violent behaviour
Being left in soiled clothes
Being in a noisy environment at night thus
causing lack of sleep
Being left in pain
Being exposed in an embarrassing manner
Having to use premises that are unclean and
smelly toilet and wards
There is no standard definition of dignity.
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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.

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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 CQCs human rights
  based
• approach

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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

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Who has a role in improving quality?
PROMs
National Quality Board
NHS Litigation Authority
Commissioning
ADASS
Other Regulators
Performance Management
Commissioners
GMC
Staff
Darzi review
NPSA
RIEPs
3rd Sector
NHS Constitution
NMC
GSCC
ED
Audit Commission
DH
Improvement Agencies
LAA
Quality observatories
DCLG
CAA
Quality Framework
SCIE
NICE
Quality Accounts
Human Rights
JSNA
Providers
JIPs
NHS Choices
Personalisation
Professional accreditation
Political landscape
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Topics for registration requirements

• Department of Health consultation
• Making sure people get the nourishment they need
• Making sure people get care treatment in safe,
  suitable places which support their independence,
  privacy personal dignity
• Using equipment that is safe suitable for
  peoples care treatment and supports peoples
  independence, privacy personal dignity
• Involving people in making informed decisions
  about their care treatment
• Responding to peoples comments complaints
• Supporting people to be independent
• Respecting people and their families carers
  peoples 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

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How can regulation help?

• Giving people using services their carers a
  stronger voice
• Ensuring that all providers meet registration
  requirements
• Assessing performance of all providers
• Assessing performance of Local Authorities and
  Primary Care Trusts as commissioners of care
• Giving 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

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?

• Your questions