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Dignity in Care Policy

1. Purpose

This policy ensures that all people we support are treated with dignity and respect at all times. It aims to uphold their rights, preferences, and autonomy while promoting person-centred care. It also ensures compliance with Regulation 10: Dignity and Respect under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This policy ensures that care is delivered in a respectful and considerate manner, taking into account each individual’s needs, preferences, and beliefs, while preventing any practices that could compromise their dignity.

2. Scope

This policy applies to all staff, including permanent, agency, and volunteers. It also applies to people we support receiving care at {{org_field_name}}, visitors, family members, advocates, and external professionals interacting with people we support. The principles outlined here are applicable across all areas of care provision and ensure that dignity remains at the core of our services.

3. Related Policies

This policy should be read alongside CH07 – Person-Centred Care Policy, CH09 – Consent to Care Policy, CH13 – Safeguarding Adults from Abuse and Improper Treatment Policy, CH30 – Equality, Diversity, and Inclusion Policy, and CH42 – Communication and Engagement with People We Support and Families Policy.

4. Principles of Dignity in Care

4.1. Providing Person-Centred Care that Recognises Individuality and Respect

Care and support must be tailored to individual needs, preferences, and cultural backgrounds. People we support must be involved in all decisions affecting their care and support. Personal choices, religious beliefs, and lifestyle preferences must be respected and accommodated where possible. Staff must engage in active listening and respect each person’s voice in their own care plan.

4.2. Ensuring Privacy, Confidentiality, and Discretion in Personal Care

Personal care must be delivered discreetly, ensuring the person’s dignity is upheld. People we support must have private spaces for personal conversations and activities. Staff must always knock before entering rooms and seek permission before assisting with personal care. Confidentiality must be maintained at all times, and sensitive information must not be discussed in public areas.

4.3. Promoting Autonomy and Independence in Everyday Living

People we support must be empowered to make their own decisions and maintain independence. Assistive technology, mobility aids, and adaptive strategies should be provided to support independence. Staff must facilitate social inclusion, enabling people to participate in their communities. Decision-making support must be provided where needed, ensuring people retain as much control over their lives as possible.

4.4. Communicating Respectfully and Engaging in Meaningful Interactions

Staff must use polite, respectful, and clear language in all interactions. Communication preferences, including sign language, communication aids, and interpreters, must be honoured. People we support have the right to decline conversations or requests. Staff should engage in positive interactions, showing interest in the experiences and feelings of those receiving care.

4.5. Upholding Equality, Diversity and Inclusion in Care Practices

Care and support must be provided without unlawful discrimination, harassment or victimisation and with due regard to each person’s relevant protected characteristics under the Equality Act 2010. For the purposes of dignity and respect in care, these include age, disability, sex, gender reassignment, pregnancy and maternity, race, religion or belief and sexual orientation.

Staff must recognise, respect and respond appropriately to each person’s identity, individual circumstances, cultural background, religion or belief, communication needs, relationships, lifestyle and personal preferences. Care planning and delivery must take relevant protected characteristics into account and must not disadvantage a person because of a protected characteristic.

Reasonable adjustments must be made for disabled people where required by the Equality Act 2010. This may include adjustments to communication, information, equipment, routines, the environment or the way in which care and support are provided.

Staff must not discriminate against, harass or victimise a person receiving care and must report and appropriately challenge discriminatory behaviour or practices in accordance with the organisation’s safeguarding, equality and disciplinary procedures.

Staff must receive appropriate training, support, supervision and guidance necessary to enable them to understand and meet their responsibilities relating to equality, diversity, inclusion, dignity and respect.

4.6. Delivering Personal Care with Sensitivity and Compassion

Personal and intimate care must be provided in a manner that protects the person’s dignity, privacy, comfort and emotional wellbeing.

Before providing personal or intimate care, staff must explain what they intend to do, communicate in a way the person can understand and obtain the person’s consent in accordance with CH09 – Consent to Care Policy. Consent must be treated as an ongoing process and a person with capacity may refuse or withdraw consent at any time.

Every reasonable effort must be made to identify, record and respect each person’s preferences about who provides their personal or intimate care, including any preference for care to be provided by a member of staff of a specified sex or gender. Where a preference cannot reasonably be met, this must be discussed sensitively with the person and appropriate alternatives considered.

Doors, curtains and screens must be used appropriately to maintain privacy. The person’s body must not be unnecessarily exposed and staff must not enter rooms, bathrooms or other private areas without following the person’s agreed privacy arrangements, except where immediate action is necessary to prevent serious harm.

Staff must not rush personal care or disregard the person’s communication, wishes, preferences, discomfort or distress. Care must be provided at the person’s preferred pace wherever reasonably practicable.

Where a person lacks capacity to make a particular decision about their care, staff must act in accordance with the Mental Capacity Act 2005, including its principles and best-interests requirements, and must use the least restrictive option available.

4.7. Providing Dignified End-of-Life and Palliative Care

CH38 – End of Life and Palliative Care Policy must be followed, ensuring compassion, choice, and privacy for individuals receiving palliative care. Families and advocates should be involved in discussions about care preferences. End-of-life care should be managed with the utmost sensitivity and respect, ensuring individuals receive support that aligns with their wishes.

4.8. Maintaining Nutrition, Hydration and Mealtime Dignity

The nutritional and hydration needs of each person must be assessed, recorded, met and reviewed as part of their care planning. Food and drink provided must be suitable, nutritious and sufficient to sustain life and good health and must reflect the person’s assessed needs.

The person’s preferences and any reasonable requirements arising from their religion, beliefs, culture, ethical choices or other individual circumstances must be identified and respected. Any allergies, intolerances, swallowing difficulties, clinically required diets, prescribed nutritional supplements or other identified risks must be clearly recorded and acted upon.

People must be offered appropriate choice about food and drink and, so far as reasonably practicable, about when and where they eat and drink.

People who require assistance to eat or drink must receive appropriate support. Assistance must be provided sensitively and respectfully, allowing the person sufficient time and encouraging independence wherever possible. Appropriate equipment, adaptations, prompts or physical assistance must be provided where required.

Food and drinks must be placed within the person’s reach where appropriate, and drinking water and other suitable fluids must be available in accordance with the person’s assessed needs.

Staff must monitor and record nutritional or fluid intake where this is required by the person’s assessment or care plan and must take prompt action where there are concerns about dehydration, malnutrition, weight loss, weight gain, swallowing, eating or drinking.

A person with capacity has the right to make decisions about eating and drinking, including refusing food or drink. Staff must respect lawful decisions and follow the organisation’s consent procedures. Where the person lacks capacity to make the relevant decision, staff must act in accordance with the Mental Capacity Act 2005 and the person’s best interests.

Mealtimes must be managed in a manner that protects privacy, dignity, independence and social inclusion and must not be rushed or conducted in a way that causes avoidable embarrassment or distress.

4.9. Supporting Relationships, Visiting and Visits Outside the Care Home

People living at the care home must be supported to maintain relationships that are important to them and to have appropriate contact with family members, friends, advocates and other people they wish to see.

In accordance with Regulation 9A of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, people living at the care home must, unless exceptional circumstances apply, be facilitated to receive visits at the care home and must not be discouraged from taking visits or spending time outside the care home.

Visiting arrangements must be based on the person’s individual needs, wishes and preferences. The person’s care plan and any relevant risk assessments must be taken into account when arrangements are made.

The starting position must be that in-person visiting can take place. Where a risk has been identified, staff and managers must first consider what reasonable precautions or measures can be introduced to enable the visit to proceed safely.

Any restriction on visiting must:

• be based on an individual assessment rather than a blanket restriction;
• be necessary because of exceptional circumstances;
• pursue a legitimate aim relating to health, safety or welfare;
• be proportionate to the identified risk;
• represent the least restrictive reasonably available option;
• take account of the person’s wishes, rights, wellbeing and relevant care plan;
• involve the person and, where appropriate, their family, friends, representative or advocate;
• be clearly recorded, including the reason for the decision and the people involved in making it; and
• be reviewed regularly and removed as soon as the exceptional circumstances no longer apply.

A person with capacity must not be required to receive a visitor against their wishes. Their decision about whether they wish to receive a particular visitor must take priority over the wishes of the person seeking to visit.

Where the person lacks capacity to make the relevant decision, arrangements concerning visiting must be made in accordance with the Mental Capacity Act 2005 and the person’s best interests.

People receiving end-of-life care must be supported to receive in-person visits, and every reasonable effort must be made to facilitate contact with people who are important to them.

Staff must respect the privacy of people receiving visitors and support them to spend time together privately where this is safe and consistent with the person’s wishes.

5. Implementation and Monitoring

5.1. Ensuring Staff Are Appropriately Trained and Competent

All staff must receive appropriate training, supervision, support and professional development necessary to enable them to carry out their roles competently and to uphold the dignity, privacy, autonomy, equality and human rights of people receiving care.

Dignity in Care training must form part of staff induction and the organisation’s ongoing training programme. Refresher training must be provided in accordance with the organisation’s training needs analysis and, where the organisation has established an annual refresher requirement, at least annually.

In accordance with the statutory requirements applying to CQC-registered providers, staff working for the purposes of regulated activities must receive learning disability and autism training that is appropriate to their role.

Learning disability and autism training must comply with the applicable statutory Code of Practice. Staff must undertake appropriate training at least every three years and more frequently where required because of a change in role or responsibilities, an identified learning need or other relevant circumstances.

The provider must maintain records of staff training and completion and must take reasonable steps to assess whether learning has been understood and embedded in practice.

Managers must use supervision, competency assessment, observation of practice, feedback, complaints, incidents and other relevant information to identify further training or development needs.

Where a member of staff does not demonstrate the knowledge, competence or behaviour required to protect people’s dignity and rights, appropriate support, retraining, supervision, competency assessment or management action must be taken.

5.2. Appointing Dignity Champions to Promote Best Practice

Dignity Champions will be appointed to promote and monitor dignity in care practices. They will liaise with people we support, families, and staff to ensure concerns about dignity are addressed. Champions will also facilitate peer learning and share best practices.

5.3. Encouraging Feedback and Handling Complaints Efficiently

People we support, families, and staff are encouraged to provide feedback about dignity-related concerns. CH14 – Receiving and Acting on Complaints Policy applies to dignity-related complaints. Complaints must be handled with transparency, and lessons learned should be integrated into service improvements.

5.4. Conducting Regular Audits and Quality Assurance Reviews

Monthly dignity audits will be conducted to monitor adherence. Findings will be reviewed at quarterly governance meetings with senior management and care staff. Any identified issues will be addressed promptly, with continuous monitoring for improvement.

6. Responsibilities

6.1. The Role of the Registered Manager in Enforcing This Policy

The Registered Manager ensures this policy is implemented and monitored. They investigate dignity-related complaints and concerns and provide leadership in embedding a dignity-first culture. The manager is responsible for ensuring that all staff are aware of and adhere to dignity standards.

6.2. The Duty of All Staff Members to Uphold Dignity in Care

All staff members must adhere to the principles of dignity and respect in all interactions. They must report any breaches of dignity standards immediately and support people in maintaining their independence. Staff should demonstrate empathy and professionalism at all times.

6.3. The Role of Dignity Champions in Promoting a Dignity-First Culture

Dignity Champions promote best practices and train colleagues. They act as the first point of contact for dignity-related concerns and regularly engage with people we support for feedback. Champions advocate for continuous improvements in care standards.

7. Compliance with Legislation and CQC Requirements

This policy must be implemented in accordance with the Health and Social Care Act 2008 and the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, as amended.

The requirements particularly relevant to this policy include:

• Regulation 9 – Person-centred care: care and treatment must be appropriate, meet the person’s needs and reflect their preferences, with the person or their lawful representative appropriately involved in care planning and decisions.
• Regulation 9A – Visiting and accompanying in care homes, hospitals and hospices: people living in the care home must, unless exceptional circumstances apply, be facilitated to receive visits and must not be discouraged from taking visits outside the care home.
• Regulation 10 – Dignity and respect: people must be treated with dignity and respect, including protection of privacy, support for autonomy, independence and involvement in the community, and due regard to relevant protected characteristics.
• Regulation 11 – Need for consent: care and treatment must only be provided with lawful consent, and where a person lacks capacity staff must act in accordance with the Mental Capacity Act 2005.
• Regulation 13 – Safeguarding service users from abuse and improper treatment: people must be protected from abuse, neglect, degrading treatment, unnecessary or disproportionate restraint and other improper treatment.
• Regulation 14 – Meeting nutritional and hydration needs: people’s assessed nutritional and hydration needs must be met, including appropriate food, drink and support to eat and drink where required.
• Regulation 17 – Good governance: effective systems must be operated to assess, monitor and improve the quality and safety of services, maintain accurate records and seek and act upon feedback.
• Regulation 18 – Staffing: sufficient numbers of suitably qualified, competent, skilled and experienced staff must be deployed, and staff must receive appropriate training, support, supervision and professional development.

The service must also comply with the Equality Act 2010, the Human Rights Act 1998, the Mental Capacity Act 2005 and other applicable legislation relevant to dignity, equality, privacy, autonomy and lawful decision-making.

Compliance with this policy and the applicable regulations must be demonstrated through staff practice, care records, care planning, observations, feedback from people receiving care and those acting on their behalf, complaints, incidents, safeguarding information, audits, training and competency records, governance processes and other evidence relevant to CQC’s assessment of the service.

Where a breach or potential breach of dignity, privacy, equality, autonomy or another requirement of this policy is identified, the Registered Manager must ensure that immediate action is taken to protect the person, address the concern, make any required safeguarding referral or statutory notification, investigate the circumstances where appropriate and ensure that learning and remedial action are implemented.

8. Policy Review

This policy will be reviewed annually or sooner if legislation changes or business needs evolve.

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