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The Dignity in Care Campaign

. Dignity - one word, seven letters, but with a multitude of different definitions and explanations for what it means. Dignity is one of those words like tolerance, respect and love. We all instinctively know it is a good thing, but when asked what action it translates into, we struggle to find an

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The Dignity in Care Campaign

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    1. The Dignity in Care Campaign Improving Dignity in Care through Commissioning Anna Gaughan Dignity Care Lead in the North West (CSIP) Very pleased to be here today to talk about the DHs Dignity in Care Campaign and specifically about the Dignity Map that I have been involved in developing nationally and testing within our region. DIC Campaign launched in late 2006. Campaign has the aim of stimulating a national debate around the need for people receiving social and healthcare services to be treated with respect. It is simply about creating a care system where there is zero tolerance of disrespect, zero tolerance of the abuse of older people-indeed of all people. There has been quite a high profile press campaign around dignity agenda - particular focus upon highlighting the often hidden problem of elder abuse in a range of care settings. Dignity in elder care received a welcome boost this summer when Michael Parkinson was named as National Dignity Ambassador. Dignity tour pledge “ensuring the issue of dignity moves to the heart of all NHS and care services.“ Recap-key aspects of D.I.C campaign. 2008 important year for dignity ASC Green Paper/ Review of care funding system – universal system with defined contributions of state and of individuals with clarity on quality expectations. Care andsupport reform regional stakeholder events (Green Paper) CSCI reporting to the Minister for Social Care this Autumn with a review of the care eligibility criteria –ensure equity and transparency on judgements re eligibility and care provision Publication in the Autumn of the first ever national strategy on dementia- in recognition this is a challenging condition for families and the care system. 6m New Deal for Carers rolled out - regional implementation events for Carer’s Strategy-24th September in Liverpool Consultation/ Full review of AP system –Beeshard Enquiry- POVA/POCA –safeguarding vulnerable groups act- review of ‘No Sectrets’ 8 years on- to see how it is working/ wntbd Sit alongside Comic relief/ support for action on elder abuse studies- information on risk of abuse to people in own homes and with domiciliary care workers Push for an extension of DIC Champions network into new settings eg care homes 3 year transformational programme in L.As overhausling the quality of info and advice given to all those individuals funding their own care/ care of a family member A focus upon commissioning with ‘incentivisation’ to providers offering quality, choice and dignity, not just minimum standards Very pleased to be here today to talk about the DHs Dignity in Care Campaign and specifically about the Dignity Map that I have been involved in developing nationally and testing within our region. DIC Campaign launched in late 2006. Campaign has the aim of stimulating a national debate around the need for people receiving social and healthcare services to be treated with respect. It is simply about creating a care system where there is zero tolerance of disrespect, zero tolerance of the abuse of older people-indeed of all people. There has been quite a high profile press campaign around dignity agenda - particular focus upon highlighting the often hidden problem of elder abuse in a range of care settings. Dignity in elder care received a welcome boost this summer when Michael Parkinson was named as National Dignity Ambassador. Dignity tour pledge “ensuring the issue of dignity moves to the heart of all NHS and care services.“ Recap-key aspects of D.I.C campaign. 2008 important year for dignity ASC Green Paper/ Review of care funding system – universal system with defined contributions of state and of individuals with clarity on quality expectations. Care andsupport reform regional stakeholder events (Green Paper) CSCI reporting to the Minister for Social Care this Autumn with a review of the care eligibility criteria –ensure equity and transparency on judgements re eligibility and care provision Publication in the Autumn of the first ever national strategy on dementia- in recognition this is a challenging condition for families and the care system. 6m New Deal for Carers rolled out - regional implementation events for Carer’s Strategy-24th September in Liverpool Consultation/ Full review of AP system –Beeshard Enquiry- POVA/POCA –safeguarding vulnerable groups act- review of ‘No Sectrets’ 8 years on- to see how it is working/ wntbd Sit alongside Comic relief/ support for action on elder abuse studies- information on risk of abuse to people in own homes and with domiciliary care workers Push for an extension of DIC Champions network into new settings eg care homes 3 year transformational programme in L.As overhausling the quality of info and advice given to all those individuals funding their own care/ care of a family member A focus upon commissioning with ‘incentivisation’ to providers offering quality, choice and dignity, not just minimum standards

    2. Dignity - one word, seven letters, but with a multitude of different definitions and explanations for what it means. Dignity is one of those words like tolerance, respect and love. We all instinctively know it is a good thing, but when asked what action it translates into, we struggle to find an answer.

    3. How do people define dignity?

    4. Dignity Challenge Have a zero tolerance to all forms of abuse Support people with the same respect you would want for yourself or a member of your family Treat each person as an individual by offering a personalised service Enable people to maintain the maximum possible level of independence, choice and control Listen and support people to express their needs and wants Respect people’s right to privacy Ensure people feel able to complain without fear of retribution Engage with family members and carers as care partners Assist people to maintain confidence and a positive self-esteem Act to alleviate people’s loneliness and isolation Dignity Campion launched by Ivan Lewis in 2006 Phil Hope (new Minister) equally committedDignity Campion launched by Ivan Lewis in 2006 Phil Hope (new Minister) equally committed

    5.

    6. Hot off the press – Key messages! “Human Rights rests on Human Dignity” “Need to galvanise people into action and create a social movement for dignity and improvement” “Amazing wake up call – need to now move forward from focusing on speed of access to achieving high quality care for all – Dignity is central to achieving this” “Announced a new ‘People’s award’ for Dignity in Care Phil Hope – Minister for Health

    7. Integral to key national policies (1) Putting People First – Transforming Social Care New NHS Constitution Lord Darzi – Next Stage Review – High Quality Care for All – Operating Framework Quality Outcomes Framework World Class Commissioning Practice Based Commissioning Competencies for World Class Social Care Commissioning Equality leglisation

    8. Integral to key national policies (2) Dementia Care Strategy Carers Strategy End of Life Care Strategy No Secrets - Safe Guarding Vulnerable Adults Valuing People 2 Mental Health Act Mental Health in Later Life (Let’s Respect Campaign) Human Rights Bases Approach (HRBA) to Health and Social Care

    9. Dignity Achievements in the North Manchester City Council – First National Award for Dignity in Care ‘Daisy Campaign’ Leeds City Council – Health and Social Care Award Warrington MBC – First Beacon Award for Dignity in Care But... We can do more!

    10. CQC – Key message Dignity in care – the golden thread Dignity is a integral part of how we commission based on individual needs 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 and respect are fundamental to human rights based approach to health and social care

    11. DH Consultation CQC Requirements for Registration (1) Requirements related to Dignity: 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 people’s care & treatment and supports people’s independence, privacy & personal dignity

    12. DH Consultation CQC Requirements for Registration (2) Involving people in making informed decisions about their care & treatment Responding to people’s comments & complaints Supporting people to be independent Respecting 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

    13. Care Quality Commission – key aims 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 (in particular how they develop commissioning in an integrated way to meet individual needs) Giving people trusted information that helps them & their carers make decisions on their care “Need to ensure that the work of the CQC reflects what is important to people – Dignity is important”

    14. Caring for dignity – building blocks Engagement - Involving people in their care and decision about their lives Attitudes & Culture – Attitudes and behaviours which are focussed on delivering personal care in a way that ensures dignity for the person using services Education & training - A workforce that is equipped to deliver good quality care Dispersed leadership - Strong leadership at all levels (Corporately owned and accountable for) Supportive environment –enabling and supporting change Source: “Caring for Dignity”, Healthcare Commission 2007

    15. What role do you have as commissioners in improving Dignity in Care?

    16. Making it easy to commission for Dignity – Dignity Map! Building a Conceptual Framework for people’s experiences of dignity in care. Research and literature review to collate measures of ‘dignity’ Measuring dignity and ‘indignity’ – One ‘tool’ with which to ascertain whether the dignity programme is delivering its aims. Early consultation on the Dignity Framework: Contributions of organisational and individual knowledge and experience of dignity in care (e.g.: CSCI, Help The Aged, BGS, GONW, Older Peoples Fora and Parliaments). Dignity is a key strategic objective of the Department of Health (DSO) and as part of the Local Government Framework displays that dignity is an important agenda for Central Government. (LPF NI)

    17. The Dignity Map The Dignity Map: Your Care, Your Dignity, Our Promise (YC,YD,OP) unites the elements of dignity into a single strategic structure. It aims to bring clarity to the concept and to display what high quality care for the elderly looks like (a similar structure to ‘Every Child Matters’). YC,YD,OP is a template that allows local care commissioners and providers and care to map out their Local Priority Indicators to reach the gold standard of ‘ people being treated with dignity and respect all of the time during care’. The Map will illustrate what is expected and will be a formal promise as to how care will be delivered. The outcomes will feed into the consultation on Next Stage Review – Quality Framework and CQC Quality Indicators

    19. The Dignity Map Top Level Outcomes: There are four important messages set together with drivers of experience that together affect dignity. We look for care providers to digest this and build these messages into a formal promise to individuals Local Priority Indicators: The LPI allows care commissioners and providers to customise the map to meet local need. Change happens when driven locally by those who know best how to make it happen. Whole System Assessment: This displays the measures collected from the extensive literature review and covers the four messages: Focus on the Person, Dignified and Respected, A Better Service and Getting the Basics Right.

    20. Outcomes Focus on the Person: Services will engage and empower older people by making them active partners in their care, linking to the wider community and ensuring that the there is a joined up approach through which people are assured high quality care. Dignified and Respected: No care should be provided in a way which demeans or is seen as disrespectful. Throughout care people are made to feel central to it and that at any stage their individuality and humanity is of paramount importance.

    21. Outcomes A Better Service: Services will strive to be better, consistently looking for ways in which care can be improved with a workforce that is engaged in this by a leadership that drives the improvement and cares about the outcomes. Getting the Basics Right: We must protect human rights, personal information must be safe, accountability must be clear, medication must be effectively administered, nutrition must be monitored and discrimination will be expunged.

    22. Evolving approach... Getting ahead of the game ..... Set Context – By raising profile of issue Remove Barriers – By exploring concept Provide Impetus – By encouraging innovation Adapted the approach of the Dignity Map into a Baseline Assessment Tool (in your packs) But ....Engagement, Involvement, Ownership is critical

    23. Baseline Assessment Tool Early testing out of the tool Discussion with DH Policy Colleagues – lots of interest Commitment by DH Policy team to work on it to ensure convergence with the emergent CQC agenda on quality assurance and regulation Age Concern – particularly interested in piloting it as part of work requested by the Home Office about dignity in prisons Convergent with existing audit tools (Essence of Care / Leeds/ Age Concern Cheshire etc) but want it system wide and corporately owned A couple of LAAs in the NW have already adopted the dignity metrics

    24. Next Steps

    25. Feedback Is the Baseline Assessment Framework helpful in assessing where we are with embedding dignity in care at an economy level What can you do to ensure that the dignity metrics are embedded in the LAA and LSP and then in your commissioning processes Really welcome feedback: Anna.gaughan@csip.org.uk Sally.rodgers@csip.org.uk

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