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Major cultural shift needed to improve dignity in care 

18/06/2012 
The Commission on improving dignity in care says health and social care leaders must drive a "major cultural shift" to tackle the underlying causes of poor and undignified care of older people throughout care homes and hospitals in England.
Nurse with elderly patient 

That is the main message in Delivering Dignity, the final report from the Commission on Improving Dignity in Care for Older People, an independent group set up by the NHS Confederation, Age UK and the Local Government Association (LGA).

Widespread and Government support

The report received widespread support following a month long consultation with feedback from more than 230 health and social care organisations, patient groups and individuals across the country.   

In the House of Lords on 18 June, peers from every main political party, led by Professor the Baroness Finlay of Llandaff, asked the Government how it will respond to Delivering Dignity. The Government welcomed the report and said it "will consider carefully all of the recommendations addressed to Government."

Addressing our view that the Nursing and Care Quality Forum’s remit and membership should be expanded to cover social care, the Government said the Nursing and Care Quality Forum is now planning to consider care homes as part of the forum’s next phase of work, and it has already approached a number of individuals to add further expertise in that area.

The Government also promised to review whether the Human Rights Act should be extended to cover residents in privately funded care homes.

Report highlights

'Always' events

Delivering Dignity  includes the recommendation that a number of 'always events' are introduced, things which the Commission says should never be forgotten and should be considered as basic rules for the delivery of dignified care in every hospital and care home.

These include introducing formal and informal feedback from older people and their carers to improve practice.  

Human rights

The Commission also urges the Government to ensure that every person receiving care is protected under human rights legislation. Currently only those people whose care home place is arranged by their local authority are granted this protection. 

Recommendations and action plan

The Commission will now promote its recommendations, which have resonated with NHS and care home leaders, to encourage change in the way the system designs and delivers care for older people.  

A copy of the final report will be sent to every NHS and care home chief executive in England. 

A joint action plan from the three organisations will follow the report later in the year. It will provide practical solutions to the recommendations to help support NHS and care home leaders and to encourage change in the way the system designs and delivers care for older people. 

Older people deserve better - joint foreword

In a joint foreword to the report, the Commission co-chairs, from Age UK, NHS Confederation and the Local Government Association say: "We set up the Commission because older people and their loved ones deserve so much better. 

"Delivering dignity will mean changing the way we design, pay for, deliver and monitor care services as the numbers of older people in care continues to grow. Alongside the consistent application of good practice and the rooting out of poor care, we need a major cultural shift in the way the system thinks about dignity, to ensure care is person-centred and not task-focused. 

Empowered leadership

"This will require empowered leadership on the ward and in the care home, as well as a lead from boards and senior managers. It will also mean changing the way we recruit and develop staff working with older people. 

Learning from feedback

"We have to work with older people to shape services around their needs, and listen to patients and residents and their families, carers and advocates so we learn from their feedback and continually improve dignity in care." 

Other recommendations

Other recommendations include an evaluation of the way staff assess patients' needs to allow adequate time to understand and record preferences of older people. 

The report also recommends commissioners, providers and regulators use new NICE quality standards for patient experience in NHS adults services to help provide a consistent approach when defining and measuring the care provided to patients.

More information

Read Delivering Dignity, available in our online publications library, and read a summary of all the feedback the Commission received.

Find out more about the Commission on improving dignity in care.

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Contacts

Francesca Reville
020 7799 8633
Francesca.Reville@nhsconfed.org

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