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{{org_field_name}}

Registration Number: {{org_field_registration_no}}

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Dignity in Care Policy

1. Purpose

The purpose of this policy is to ensure that {{org_field_name}} protects, promotes and maintains the dignity, privacy, autonomy, independence, rights and well-being of every individual living in the care home. This policy supports compliance with the Regulation and Inspection of Social Care (Wales) Act 2016, the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended, Welsh Government statutory guidance for care home services, Care Inspectorate Wales (CIW) requirements, the Social Services and Well-being (Wales) Act 2014, the Human Rights Act 1998, the Equality Act 2010, the Mental Capacity Act 2005, the Deprivation of Liberty Safeguards, data protection legislation, and relevant Social Care Wales Codes of Professional Practice.

Dignity in care means that individuals are treated as people with their own identity, history, wishes, feelings, language, culture, beliefs, relationships, strengths, risks and personal outcomes. Care and support must be delivered in a way that is person-centred, rights-based, compassionate, inclusive, safe and respectful.

{{org_field_name}} will ensure that dignity is embedded in daily practice, personal plans, staff training, supervision, quality assurance, complaints, safeguarding, communication, Welsh language arrangements, end-of-life care, and the way concerns are identified, investigated and acted upon.

2. Scope

This policy applies to all employees, agency staff, volunteers, and external professionals working within {{org_field_name}}. This policy applies to all care, support, communication, personal care, clinical support, social activities, mealtimes, moving and handling, continence care, end-of-life care, room entry, visitors, record keeping, complaints, safeguarding, use of technology, and interactions with individuals, their representatives and professionals.

For the purpose of this policy, the term individual means the adult receiving care and support from the service. Where existing documents use the term “service user”, this should be understood to mean “individual” in line with Welsh regulated-services terminology.

It covers:

• Providing person-centred care that recognises the individuality of each service user and responds to their personal preferences, background, and values.
• Ensuring service users have control over their choices, privacy, and independence in daily living and decision-making.
• Preventing neglect, abuse, and discrimination by maintaining high standards of safeguarding and accountability.
• Promoting effective communication and active listening to maintain respectful, meaningful interactions with service users.
• Embedding staff training and professional development to ensure that dignity and respect are consistently upheld in care practices.

3. Principles of Dignity in Care

 All staff must follow these key principles:

• Respect and empathy: Treat every service user as an individual, acknowledging their personal preferences, history, and culture.
• Choice and control: Empower service users to make informed decisions regarding their care and daily lives.
• Privacy and confidentiality: Protect service users’ personal information, space, and dignity in all aspects of care.
• Independence and support: Provide the necessary assistance to enable service users to maintain independence while ensuring safety.
• Inclusivity and fairness: Care must be delivered equitably and without discrimination, in line with the Equality Act 2010 and other relevant safeguarding legislation.

• Rights-based care: Individuals’ human rights, legal rights, privacy, family life, dignity, equality, liberty and autonomy must be upheld at all times.
• Personal outcomes: Staff must understand what matters to each individual and support them to achieve their agreed personal outcomes.
• Welsh language and communication: Individuals must be supported to communicate in their preferred language and method, including Welsh, British Sign Language, Makaton, communication aids, pictures, objects of reference, interpreters, or assistive technology where required.
• Positive risk-taking: Individuals must be supported to make choices and take appropriate positive risks where this supports independence, well-being and personal outcomes.
• Open and honest culture: Staff must be open, honest and transparent when things go wrong and must follow the organisation’s duty of candour, safeguarding, complaints and whistleblowing procedures.
• Co-production: Individuals and, where appropriate, their representatives must be involved in planning, reviewing and improving their care and support.

4. Person-Centred Care, Personal Outcomes and Personal Plans

Person-centred care means providing care and support in a way that reflects the individual’s personal outcomes, wishes, feelings, strengths, needs, risks, routines, relationships, cultural identity, language, faith, sexuality, gender identity, life history and preferences.

Staff must ensure that each individual’s dignity is reflected in their personal plan and day-to-day care. This includes clear information about:

• how the individual wishes to be addressed;
• preferred routines for waking, sleeping, bathing, dressing, eating, drinking and socialising;
• cultural, religious, spiritual and Welsh language needs;
• privacy preferences, including room entry and intimate care;
• what matters to the individual and what supports their well-being;
• communication needs and any aids or equipment required;
• support required to maintain independence and positive risk-taking;
• relationships, visitors and contact with family, friends and community;
• any known triggers for distress, anxiety or loss of dignity;
• how staff should support the individual when they are upset, unwell, confused, in pain or approaching the end of life.

Personal plans must be prepared before care and support starts, except in urgent circumstances where they must be prepared within 24 hours. They must be reviewed at least every three months, or sooner where the individual’s needs, risks, wishes or personal outcomes change. The individual and, where appropriate, their representative and placing authority must be involved in the preparation and review of the personal plan.

5. Provider Assessment and Review of Dignity Needs

Within seven days of the commencement of care and support, {{org_field_name}} will complete or update the provider assessment to identify how the individual’s care and support needs, personal outcomes, wishes, feelings, communication needs, dignity needs and risks can best be met.

The assessment must be completed by a person with the skills, knowledge, competence and training to undertake assessments. Where the individual has complex needs, specialist communication needs, nursing needs, cognitive impairment, mental health needs, sensory impairment or end-of-life care needs, appropriate professional advice must be sought where required.

The outcome of the provider assessment must be used to update the personal plan. Staff must follow the personal plan and report any change that may affect the individual’s dignity, privacy, safety, well-being or personal outcomes.

6. Respecting Choices, Privacy, and Independence

To uphold dignity, staff must:

• knock, wait for a response and seek permission before entering an individual’s bedroom, bathroom or private space, unless there is an immediate safety concern;
• explain what they are going to do before providing care and check the individual’s consent, comfort and understanding;
• close doors, curtains and screens during personal care, continence care, moving and handling, clinical care or dressing;
• keep the individual covered as much as possible during intimate care;
• support the individual’s choice of clothing, hairstyle, appearance, toiletries, continence products and personal possessions;
• support individuals to make choices about meals, drinks, activities, visitors, bedtime, waking time, routines and how care is delivered;
• encourage individuals to do as much as they can safely do for themselves, including washing, dressing, eating, drinking, mobility, communication, hobbies and self-care;
• support safe access to personal possessions, money, letters, mobile phones, tablets, photographs and items of emotional or cultural importance;
• respect the individual’s right to private conversations, private visits and confidential correspondence;
• avoid discussing personal care, health, finances or family matters where others can overhear;
• record and follow individual preferences in the personal plan;
• report any practice that compromises dignity, privacy, independence or choice.

7. Welsh Language and the Active Offer

{{org_field_name}} recognises that language is an important part of dignity, identity, safety, emotional well-being and effective care. Individuals must not have to ask to receive care or communication in Welsh where this is their language of need or choice.

Staff must:

• identify and record each individual’s preferred language and communication needs during assessment and care planning;
• provide information, day-to-day communication and support in Welsh where this is required and reasonably practicable;
• use Welsh-speaking staff, bilingual materials, interpreters, translation support or communication aids where needed;
• record Welsh language needs in the personal plan;
• understand that Welsh language need may become more important when an individual is distressed, confused, unwell, living with dementia, receiving personal care or approaching the end of life;
• inform the Registered Manager where the service is unable to meet an identified Welsh language need so that action can be taken.

The service will evidence its commitment to providing, or working towards providing, an Active Offer of Welsh language care and support.

8. Communication, Information and Advocacy

{{org_field_name}} will ensure that individuals receive information in a language, style, format and presentation they can understand. This may include large print, easy read, pictures, objects of reference, audio, digital information, interpreters, British Sign Language, Makaton, communication passports, Talking Mats, assistive technology or support from a person who knows the individual well.

Staff must give individuals time to understand information, ask questions, express choices and take part in decisions about their care. Staff must not rush, ignore, speak over, patronise, infantilise or exclude individuals from conversations about their own lives.

Where an individual has difficulty expressing their wishes, feelings or concerns, staff must consider whether advocacy support is required. Individuals must be supported to access independent advocacy services where this would help them understand information, make decisions, raise concerns, take part in reviews or protect their rights.

9. Consent, Mental Capacity and Deprivation of Liberty

Staff must assume that an individual has capacity to make a decision unless it is established otherwise in accordance with the Mental Capacity Act 2005. Individuals must be supported to make their own decisions wherever possible, including decisions that others may consider unwise.

Where there is concern that an individual may lack capacity for a specific decision, staff must follow the Mental Capacity Act 2005, the service’s Mental Capacity and Deprivation of Liberty Safeguards procedures, and any relevant best-interest decision-making process. Restrictions must not be used for staff convenience or as a substitute for person-centred care.

An individual must not be deprived of their liberty without lawful authority. Any restriction, supervision, restraint, locked door, sensor, bed rail, lap belt, medication practice or other measure that may restrict liberty must be assessed, justified, proportionate, recorded, reviewed and authorised where required.

10. Preventing Neglect, Abuse, and Discrimination

Dignity in care includes safeguarding service users from harm, neglect, and discrimination. Staff must:

• Undertake mandatory safeguarding training to understand their role in protecting service users.
• Immediately report any concerns regarding potential abuse, neglect, or poor treatment.
• Encourage an open culture where service users feel safe to express concerns about their care.
• Follow the Whistleblowing Policy, ensuring all concerns are investigated in a confidential and non-punitive manner.

Staff must understand that poor dignity, humiliation, rough handling, ignoring call bells, leaving individuals in soiled clothing, failing to support eating or drinking, failing to respect privacy, unlawful restraint, discriminatory language, intimidation, financial abuse, institutional practice and failure to act on concerns may amount to abuse, neglect or improper treatment.

Any concern that an individual is experiencing, or is at risk of, abuse, neglect or improper treatment must be reported immediately in line with the Safeguarding Adults from Abuse and Improper Treatment Policy, Wales Safeguarding Procedures, CIW notification requirements, local safeguarding arrangements and the Whistleblowing Policy.

Individuals and their representatives must be given information about how to raise a safeguarding concern and how to access advocacy or other support to do so.

11. Duty of Candour and Openness When Things Go Wrong

{{org_field_name}} will promote a culture of openness, honesty and learning. Where something goes wrong, or may have gone wrong, in a way that affects an individual’s dignity, safety, well-being, rights or experience of care, staff must report this promptly to the Registered Manager or person in charge.

The service will be open and honest with the individual and, where appropriate, their representative. This includes explaining what happened, what immediate action has been taken, what investigation or review will take place, what the outcome is, and what will be done to reduce the risk of recurrence. Where appropriate, an apology will be offered.

No member of staff, agency worker, volunteer, manager or responsible person may obstruct another person from raising a concern or acting in accordance with the duty of candour. Any obstruction, victimisation, bullying or failure to act openly may be addressed through safeguarding, disciplinary, whistleblowing or professional referral processes.

12. Effective Communication and Active Listening

Respectful and effective communication is a key part of dignity in care. Staff must:

• Use clear, compassionate, and respectful language when addressing service users.
• Adapt communication styles to meet individual needs, such as using Makaton, sign language, or picture-based aids where required.
• Give service users the time they need to process and respond to information, ensuring they do not feel rushed or ignored.
• Avoid using infantilising, patronising, or dismissive language.

• Never use discriminatory, humiliating, stigmatising, threatening, abusive or disrespectful language.
• Never speak about an individual as though they are not present.
• Never discuss an individual’s personal care, diagnosis, continence, behaviour, finances, family circumstances or private matters in communal areas or where others may overhear.
• Use the individual’s preferred name, pronouns and form of address.
• Check whether the individual wishes a representative, advocate, interpreter or communication supporter to be involved in important discussions.
• Record important communication preferences in the personal plan and handover information.
• Actively listen to service users’ feedback, emotions, and preferences, acknowledging their perspectives in care planning and daily interactions.

13. Equality, Diversity and Protected Characteristics

{{org_field_name}} will ensure that dignity is upheld for every individual regardless of age, disability, gender reassignment, marriage or civil partnership, pregnancy or maternity, race, religion or belief, sex, sexual orientation, language, nationality, culture, social background, health condition, mental health need or cognitive impairment.

Staff must challenge and report discriminatory practice, harassment, bullying, exclusion, stereotyping or assumptions. Care and support must be adapted where reasonable adjustments are required to meet the individual’s needs and to support equal access to dignity, privacy, communication, activities, relationships, spiritual support, personal care and complaints processes.

14. Intimate Personal Care

Intimate personal care must always be provided in a way that protects the individual’s dignity, privacy, comfort and personal preferences. Staff must explain what support is being offered, seek consent, encourage the individual to do what they can for themselves, use appropriate coverings, close doors or curtains, and maintain a calm and respectful approach.

Staff must be alert to signs of discomfort, embarrassment, pain, distress, fear or refusal. Any change in the individual’s response to personal care must be recorded and reported. Where an individual has specific preferences about gender of care worker, timing, products, routines, cultural requirements or communication during personal care, this must be recorded in the personal plan and followed wherever reasonably practicable.

15. Technology, Call Systems and Privacy

Technology must be used to enhance independence, safety, communication and dignity, not to replace human interaction or restrict rights without lawful authority. Call bells, alarms, sensors, monitoring equipment, communication devices and assistive technology must be appropriate to the individual’s needs, accessible, maintained and understood by staff.

Any use of monitoring technology, sensors or equipment that may affect privacy or liberty must be assessed, agreed where possible with the individual, recorded in the personal plan, reviewed regularly and used in accordance with mental capacity, deprivation of liberty, data protection and confidentiality requirements.

16. End-of-Life Dignity

Where appropriate, {{org_field_name}} will identify and record the individual’s wishes and preferences for end-of-life care, including comfort, privacy, spiritual or religious support, cultural needs, Welsh language needs, visitors, preferred place of care, advance statements, advance decisions, and any lasting power of attorney for health and welfare.

Staff must provide end-of-life care with compassion, privacy and respect. Individuals must be supported to have significant people with them where this is their wish. The service will work collaboratively with GPs, nurses, palliative care teams and other professionals to ensure that comfort, symptom management, dignity and family communication are maintained.

17. Staff Training and Development

All staff must receive training on dignity in care, including:

• Comprehensive induction training covering principles of respect, autonomy, and privacy in care.
• Ongoing professional development to stay updated on best practices in dignity and person-centred care.
• Workshops and reflective practice sessions to encourage critical thinking about dignity in care situations.
• Training in cultural competency to ensure all staff can support service users from diverse backgrounds appropriately.

• the Regulation and Inspection of Social Care (Wales) Act 2016 and the Regulated Services Regulations relevant to dignity, respect, personal outcomes, personal plans and safeguarding;
• the Social Services and Well-being (Wales) Act 2014 and the well-being duty;
• the Mental Capacity Act 2005, best-interest decision-making and Deprivation of Liberty Safeguards;
• Welsh language awareness, Active Offer principles and communication needs;
• equality, diversity, anti-discriminatory practice and protected characteristics;
• safeguarding adults, improper treatment, neglect, whistleblowing and duty of candour;
• privacy, confidentiality, data protection and respectful record keeping;
• positive behaviour support, restrictive practice and positive risk-taking where relevant to the service;
• dementia, cognitive impairment, sensory impairment, communication aids and distress responses where relevant to individuals using the service;
• end-of-life dignity and compassionate communication where relevant.

Staff competence in dignity and respectful care will be reviewed through induction, supervision, observation of practice, appraisal, reflective learning, complaints, compliments, safeguarding outcomes, audit findings and feedback from individuals and representatives.

18. Monitoring and Compliance

The Registered Manager is responsible for ensuring that this policy is implemented in daily practice. The Responsible Individual must maintain oversight of the service and ensure that dignity, respect, rights and well-being are considered through governance, quality assurance and improvement arrangements.

Monitoring will include:

• observations of staff practice, including mealtimes, activities, communication, personal care and interactions in communal areas;
• review of personal plans to ensure dignity, preferences, communication needs, Welsh language needs, equality needs, risks and personal outcomes are recorded and followed;
• review of complaints, compliments, safeguarding concerns, incidents, whistleblowing concerns and duty of candour records;
• feedback from individuals, representatives, staff, visiting professionals and commissioners;
• supervision and appraisal discussions about dignity and respectful practice;
• checks that individuals know how to raise concerns and access advocacy;
• audits of privacy, confidentiality, room entry, call bell response, continence support, mealtime dignity and end-of-life care where applicable;
• review of staff training, competence and conduct.

Where monitoring identifies poor practice, the Registered Manager must take prompt action. This may include immediate guidance, supervision, retraining, amendment of personal plans, safeguarding referral, complaint investigation, disciplinary action, professional referral or notification to CIW where required.

Findings from dignity-related monitoring will inform the service’s quality assurance, improvement planning and quality-of-care review.

19. Related Policies

This policy should be read alongside:

• CHW07 – Person-Centred Care Policy to ensure holistic and tailored approaches to individual care.
• CHW11 – Safe Care and Treatment Policy to ensure safety and dignity in care provision.
• CHW13 – Safeguarding Adults from Abuse and Improper Treatment Policy to maintain robust safeguarding measures.
• CHW30 – Equality, Diversity, and Inclusion Policy to ensure fairness and respect in service delivery.
• CHW34 – Confidentiality and Data Protection Policy to safeguard service users’ private information and uphold their dignity.

• Mental Capacity and Deprivation of Liberty Safeguards Policy.
• Duty of Candour Policy.
• Welsh Language and Active Offer Policy.
• Advocacy Policy.
• Complaints Policy.
• Whistleblowing Policy.
• Positive Behaviour Support and Restrictive Practice Policy.
• Consent to Care and Treatment Policy.
• End-of-Life Care Policy.
• Communication Needs Policy.
• Service User Guide / Written Guide to the Service.
• Personal Planning and Review Policy.
• Care Planning, Assessment and Review Policy.
• Visiting and Relationships Policy.
• Information Governance and Records Management Policy.

20. Policy Review

This policy will be reviewed at least annually, or sooner where there are changes to legislation, Welsh Government statutory guidance, CIW requirements, Social Care Wales Codes of Professional Practice, safeguarding procedures, organisational practice, inspection findings, complaints, safeguarding concerns or quality assurance outcomes.

Individuals, representatives and staff will be given appropriate opportunities to contribute to the review of this policy where changes may affect the way care and support is delivered. Any changes that directly affect individuals will be communicated in a timely and accessible way. Staff will receive additional guidance or training where required.

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Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
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