Dignity in Care is no longer just a mantra – progress on the campaign is kicking in, writes Anabel Unity Sale, and a project in Leeds shows how best practice can be achieved
Everyone wants to be treated with respect when using health and social care services but this simple expectation is not always met. To tackle this, in November 2006 the Department of Health launched a Dignity in Care campaign with the aim of building a care system where the abuse of, and disrespect towards, older people would be met with zero tolerance.
Care services minister Phil Hope says the campaign is about “placing a greater emphasis on the quality of care services in, for example, hospitals, care homes and home help services”.
Help the Aged policy director Paul Cann believes the dignity campaign was needed. “Evidence and our contact with older people shows there are frequent breaches of dignity and respect in health and social care services, despite the National Service Framework for older people,” he says. Such breaches include older people not being listened to and having their privacy ignored.
It is crucial to give meaningful substance and depth to the campaign’s aims so the term dignity is not just a slogan bandied about without professionals having to act upon it. “We now have a better understanding of what dignity is and it’s not just a mantra,” Cann says. “Dignity is not being in pain or discomfort, it is not having intimate care carried out while near a patient of the opposite sex.”
Vague about aims
When the campaign began, Stephen Lowe, social care policy adviser for Age Concern England, supported its push to recognise and respect older people as people first and service users second. But he says its initial vagueness about what dignity meant made it difficult for some to understand its aims. Now he believes there has been progress in developing professionals’ understanding of how to promote dignity because it is more closely linked to human rights.
The dignity campaign was boosted when veteran broadcaster Sir Michael Parkinson was appointed national dignity ambassador last May. He has the task of raising the profile of the campaign and stimulating national debate about treating older people respectfully.
Parkinson has taken part in a national dignity tour of different care settings with Hope. Last November, he attended the national dignity conference and awards ceremony where he met those involved in promoting the campaign’s good practice. The DH is pleased with Parkinson’s performance, saying he has “helped raise the profile of the campaign substantially”. Unfortunately, Parkinson was unavailable for comment because he is in Australia where he has spent three months writing a book. Hope, although, is clear about the success of his involvement: “His ability to motivate others has made a real difference to the campaign.”Frontline support
Those at the coalface of services also support Parkinson. “He has done a lot of important symbolic work he’s talked to lots of people in his role,” Cann says, adding that it is vital for the campaign to have substance and depth so “people don’t just walk away from it” when the media spotlight shifts. (See review of Dignity in Care Website from Community Care 12 March right.)
Key to the campaign is the recruitment of nearly 4,000 “dignity champions”, most of whom work in health and social care, to push forward the campaign in their areas. However, Hope says anybody can sign up as a dignity champion because the role is unofficial and informal. So does this devalue the role of dignity champion?
Not according to Hope. He says the DH is creating “a social movement of people who go that extra mile”. He adds: “We will never improve dignity in care if we restrict that role to a chosen few.” Such a cultural change, he says, cannot be dictated by passing laws but is achieved by highlighting and sharing good practice.
In the future the campaign will need to build on what it has already established. Lowe urges the Care Quality Commission to place dignity and human rights at the centre of its inspection methodology. “The political agenda needs to start fleshing out what is meant by dignity and respect,” he says. “We want to see specific proposals in the adult green paper for a system that respects people’s dignity and what is needed to support their care needs.”
Leeds: ‘The approach gives older people the confidence to have high expectations’
In Leeds, older people were consulted on what they wanted health and social care staff to know about respecting and maintaining their dignity. Six posters were produced, each depicting a local older person in a different health and social care setting, with a quote about what matters to them personally about dignity.
The posters (see left) are displayed in libraries, community centres and hospitals and carry contact numbers for concerns or complaints about services.
Then came a series of postcards featuring the 10 national dignity standards, four advertisements on a local radio station and a complaints leaflet for older people.
“This approach gives older people the confidence to have high expectations of the services we are delivering,” says Mick Ward, head of strategic partnerships and development for older people and disabled people, in a role that spans Leeds Council and NHS Leeds. “You need a mature organisation to do this because it highlights bad practice and the number of complaints increase. It’s enabled us to listen to that and given us the opportunity to learn and improve our future practice.”
Leeds Council and NHS Leeds also had a scrutiny board inquiry into dignity across its health and social care services and has conducted dignity audits in some of its acute care services. The 10 dignity standards have been incorporated into its commissioning contracts with providers. It is little wonder that Leeds won the national Dignity in Care Award 2008. “The award was a great celebration and has given us more impetus to drive forward the agenda locally and nationally,” says Ward.
Margaret Pease signed up as a dignity champion in May 2007 because, as resource manager for Leeds Council’s adult social care community support service, she felt it dovetailed with her job. “I have a massive workforce working with the most vulnerable people and I’m in a good position to get the message about dignity in care out,” she says.
As a dignity champion, Pease attends bi-monthly multidisciplinary team meetings with 13 other dignity champions in Leeds to discuss relevant issues and share good practice. She receives a regular dignity champions’ newsletter and tells clients and professionals about her voluntary role. She supports the fact that anyone can be a dignity champion. She says because there are no restrictions it helps reiterate the importance of treating older people well.
“It makes people think ‘no, being treated like that is unacceptable’ and people can complain about services,” she adds.
• This article first appeared in Community Care 12 March issue under the title
“We now understand what dignity means”