Living and Ageing Well with Dignity: Telford and Wrekin

Report - 1 April 2015

When we are choosing care or support we want to know that dignity and compassion are valued and that human rights are considered as paramount. We wanted to understand what improvements needed to be made in the care and support of people with Dementia

Summary

Treating people with respect and dignity in health and social care is a constant area of spotlight. People are often at their most vulnerable when they are using these services and so respect for dignity is hugely important.

We wanted to ask people what they felt is currently working well and what improvements needed to be made in the care and support of people living with Dementia, by:

using a survey to ask people what 'dignity' meant for them
conducting a series of Enter and View visits to explore service provision, hearing from those living with Dementia
conducting a survey of local health and social care services to seek information about their provisions for those living with dementia, as well as their family and carers

Recommendations

Services should utilise mystery shoppers; dignity champions; carers views and other local, low-cost resources to evaluate how people’s dignity is being respected
Matrons and managers should ensure staff appraisal includes dignity and respect awareness and implementation. Recognition of the role that staff have in patients’ experience of dignity in their care and treatment is essential and examples of best practice should be acknowledged and shared
Services should provide training and support to ensure that both clinical and support staff are comfortable with the work they are asked to do and feel confident. Dementia, dignity and customer service training can give staff the tools to communicate better with the users of health and social care services
The use of tools in ensuring one’s dignity should be considered. Tools can include aids such as dignity screens but can also mean the use of forms to request sensitive information. Providers should consider some of the examples shared in our Enter and View visits
Commissioners should address local need for more privacy. Many of the services were unable to provide even a basic level of privacy. Whilst this is the responsibility of individual providers it is advised that commissioners across both health and social care should consider it a key provision
Including people in their own care did not appear to be well-recognised as either an aspect of dignity or of dementia care. Promoting an individual’s dignity, informed choice and ensuring good practice been a driving force in health and social care provision and must be addressed not only at the provider level but across health and social care delivery at all levels
Understanding what informed choice looks like and how it can be delivered should be a key priority, particularly as services skipped questions in the provider survey regarding, ‘involving people living with dementia’ and ‘awareness of support’
Additionally, local services could include and liaise with carers and families where appropriate and possible in order to support inclusion of the person living with dementia and promote support and awareness. Family involvement has been important for people living with dementia, as they can advocate for their relative - particularly if the person living with dementia cannot clearly communicate their wishes
Front-facing areas such as GP receptionists or pharmacies need to systematically consider people’s dignity through finding ways of communicating with people that especially maintains privacy and confidentiality
Healthwatch Telford & Wrekin to propose working with GP practices in developing a Dignity “chartermark” for reception staff
Dying/death/end of life is an area that must be treated sensitively and is often not addressed directly in service provision. Further exploration into how local services can promote dignity in death could be somewhat reassuring for those who have life threatening illnesses, and their families and friends