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Nursing Times Awards 2010

Patient Dignity Award

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WINNER: Dignity in care homes, Rita Jones, Janet Robson, Nikki Leach and Jill Pinington, NHS Tameside and Glossop

Background

After a successful funding bid in 2009, NHS Tameside and Glossop aimed to improve patient experience with regard to dignity in care. A nurse-led team was created and was asked to identify patient experiences with residents of local care homes, using the 10 elements of the government’s dignity challenge.

The initiative investigated patient issues that led to low standards of dignity in care. A unique partnership was established between internal and external stakeholders to ensure residents received the highest standards of care, delivered with dignity and respect.

The partnership provided the necessary skills and experience to address these issues. It was the small details that led to the big differences, often with no costs attached. For example, asking patients how they would like to be addressed by staff made a big difference to how they felt. The work addressed the personalisation agenda as identified in Putting People First: a shared vision and commitment to the transformation of adult social care.

The process

Using an interprofessional approach the team met internal and external stakeholders involved in delivering care to local residents. Discussions involved how we could demonstrate that care was being delivered according to the 10 elements of the dignity challenge.

Sharing best practice, a workbook was created and a pilot site chosen which included several providers. Evidence was provided against the 10 challenges and an observation tool was developed to confirm care was being delivered in the manner described. A patient experience survey undertaken in the pilot area asked patients if they felt they received care with dignity and respect.

All staff have received dignity training and the profile of dignity champions has been raised. In some areas there has been 100% sign-up of champions challenging poor standards of care.

A resource file sharing best practice has been developed and links through our website for the public and staff. On completing the process to ensure they provide dignity in care, individual care homes are awarded a plaque demonstrating to residents and families that care is delivered with dignity and respect.

Advice to other organisations

Communications and working in partnership with a number of providers has been crucial. When we initially approached external home care providers we were met with hostility and a “we already do this” response. However, by making them equals in examining poor care they became engaged and provided useful ideas in how to assess care delivery.

The 10 elements of the dignity challenge, the relevant Department of Health web page, champion’s information, and RCN train the trainer resource pack were all used to enhance the project and our patient experience group played a key role in delivering our survey.

One of our challenges was to ensure that there were no inequalities for any specific groups, such as residents with dementia. Working with a local care home we identified examples of excellent practice in seeing the resident not the illness.

Benefits of the initiative

An audit of our patient experience survey and the evidence demonstrated in the workbook showed 85% of residents now feel they receive care with dignity and respect. This is a significant improvement. Partners have benefitted from networking opportunities and interprofessional training, which has improved standards of care.

Residents were encouraged to complete a “This is me” resumé of their likes and dislikes which is posted in their room, ensuring they could receive personalised care.

Best practice is shared with all partners and a resource file is being developed. There is a dignity champions’ database highlighting the services where care is being challenged and dignity resources are at a premium.

Dignity is on everyone’s agenda including the PCT board where all members are champions and advocate that dignity is everyone’s business.

Financial implications

North West SHA provided funding of £200,000, which covered the costs of training, employed a team for 12 months to embed dignity in all partner organisations and paid for marketing resources to promote the campaign which are available for partners to purchase.

Staff have been trained to deliver future training needs. Ongoing monitoring of standards are being embedded in normal monitoring. Dignity will be part of all staff job descriptions and everyday activities and maintaining the focus on dignity should require no ongoing running costs.

Future plans

The resource file will be made available for other service users to purchase and will include a report of the project, pilot findings, details of best practice and useful contacts. A web page has also been developed for sharing of good practice.

Contact

For more information on this initiative please contact David Bourque: david.bourque@nhs.net

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