The Dignity in Care Campaign

1. The Dignity in Care Campaign Above and Beyond the Call of NI 128: Delivering Dignity through Local Area Agreements Ruth Passman Senior Health Policy Adviser

2. Your Care, Your Dignity, Our Promise Background: Dignity • 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)

3. Your Care, Your Dignity, Our Promise 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 providers and care recipients 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.

4. Top Level Outcomes: displays the four key messages that together affect dignity. Local Priority Indicators: Promote ownership by engaging care providers in decision-making. Whole Service Assessment: Measures to assess the delivery of service

5. 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 their users. • Local Priority Indicators: The LPI allows care 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 Service 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.

6. Your Care, Your Dignity, Our Promise Key Principles • Dignity is Elusive – Yet Powerful What drives Dignity? – The conversation is more important than the answer • Open Source Policy can provoke real change Three aims • Set Context – By raising profile of issue • Remove Barriers – By exploring concept • Provide Impetus – By encouraging innovation • Engagement, Involvement, Ownership • Coherent, Consistent, Relevant • Expressed through articulation of what success will look like to care recipients • Applicable to policy makers, service providers, commissioners, frontline care staff and recipients

7. Dignity and Local Area agreements Areas which have chosen the Dignity Indicator • Oldham • Manchester • Windsor and Maidenhead • Greenwich • Bromley • Lewisham • Isle of Wight • York • Barnsley • Hartlepool

8. NI 128: Patient and User reported Respect and Dignity • National Indicator definition to be published 2009/10 • Local proposals for proxy measurement of user reported respect and dignity to be used in LAAs • Methodology and degree of stretch to be determined • GOs (CSIP /DH Regional Presence) to consider quality of local proxy measures and determine risk attached to their inclusion • Regional DH colleagues to make recommendation to DH • Vital sign Tier 3 indicator alignment

9. Next Steps • How can the Dignity Map be linked to the LAA and Dignity agenda? • Open Source • User Generated Content • Co-Production • Collective Ownership • Open Source – Users must be able to engage with the product and tailor it to their own circumstance • User Generated Content – Our work is only the beginning. The depth, focus, vibrancy and life of the work will be generated locally by those who know best how to make change happen. LAA local targetry can be woven through it • Co-Production – All work is collectively useful and proactively shared adding to the knowledge, skills and tools of all working for improvement in the area • Collective Ownership –Dignity Champions and Senior Board leaders will drive the Dignity and LAA agenda; they will develop, drive and design its direction and challenge and hold one another to account

10. Next Steps • New NHS Constitution: Explicit recognition that a world class NHS must give a new priority to dignity and respect for patients-Dignity at forefront of local work in response to NSR Implementation • Dignity Map as part of the Darzi NSR Support package and as part of the NHS Operating Framework supporting ‘patient experience’ (North Wet embedding Dignity via its Darzi pathway groups) • Help the Aged - launched the framework of Dignity measures for use by care organisations on 11 November 2008 • Local Area Agreement Dignity Indicator (NI 128) to be refreshed with local proxy data in Autumn 08

11. Oldham – The Story So Far • Oldham held 2 events to raise the profile of the Dignity Challenge, July inviting agencies across Oldham & in October with our Training partnership • Identified Dignity Champion, who is the chair of the Safeguarding Adults Executive Partnership • There were many exciting ideas about how we promote the challenge in the future, these include: • Recognising encouraging and sharing positive practice • Planning and organising a launch event • Inviting the elected member for social care to take a lead • Dealing effectively with compliments and complaints • Raising the profile at every opportunity • Produce dignity badges to distribute to recognise good practice

12. Some Examples of Dignity • Life Story Book – Streamlined – Yesterday, Today, Tomorrow • Detailed Care Plan • Too much info at once – needs breaking down • Increased choice – Self directed Support • Assisted technology to enable people to remain at home • Aids and Adaptations • Committed to taking good practice forward • Share good practice

13. Next Steps • Oldham is progressing the Dignity Challenge agenda through the implementation of Safeguarding Adults. • The development of the Policy & Training partnership sub-group, membership is made up of OMBC, Police, Health, Housing and other statutory & non-statutory agencies. • Through the Policy & Training sub group a smaller working group is currently being developed to specifically work on the Dignity agenda and the Human Rights in Health care and make the links with other areas of work especially in Safeguarding Adults. • Other areas to explore is the impact of Individualised budgets, ensuring that independence & individual choices are met to meet their needs and that their Dignity and respect is adhered to throughout. • Work is under way in developing NI 128, currently collating data through Satisfaction Surveys that focusing on Home Care for 2008/09. • Oldham is expected to start monitoring and reporting on the NI 128 in Spring 2009.

14. Your Care, Your Dignity, Our Promise Feedback • What are the LAA Dignity proposals in your area? • How can you share your experiences and practice with the ‘NI 128 club?’ www.dignityincare.org.uk