Care Improvement Works | Skills for Care and SCIE

All lines of enquiry related to this area of the CQC inspection are listed below. Visit the CQC website if you need to clarify which ones relate to your service.

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Click on one of the icons related to the Care Quality Commission inspection questions: is it safe, effective, caring, responsive or well-led. This will show the key lines of enquiry (KLOEs) associated with each question.
Choose the KLOEs that relate to the type of service you provide (eg residential adult social care, community adult social care and hospices). This will reveal the resources most relevant to your type of service.
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C1. How does the service ensure that people are treated with kindness, respect and compassion, and that they are given emotional support when needed?

Prompts that may be used by CQC inspectors to explore this…

C1.1 Are people treated with kindness and compassion in their day-to-day care and support?

C1.2 How does the service make sure that people, and those close to them, feel they matter, and that staff listen to them and talk to them appropriately and in a way they can understand?

C1.3 Do staff seek accessible ways to communicate with people when their protected and other characteristics under the Equality Act make this necessary to reduce or remove barriers?

C1.4 Do staff know and respect the people they are caring for and supporting, including their preferences, personal histories, backgrounds and potential?

C1.5 Do staff show concern for people’s wellbeing in a caring and meaningful way, and do they respond to their needs quickly enough?

C1.6 Do staff understand and promote compassionate, respectful and empathetic behaviour within the staff team?

Products that can help include...

Older people and quality of life: better life in residential care (2014)

Older people and quality of life: better life in residential care (2014)

This film shows older people with high support needs who live in a care home. They talk about what is important in their lives and how they like to be treated.

Provided by:

Kindness, compassion and emotional support (Good and outstanding care guide)

Kindness, compassion and emotional support (Good and outstanding care guide)

Recommendations and practical examples from services rated good and outstanding including;

Ensure staff have the right values, ensuring managers lead by example, provide sufficient time to care etc.
Avoid failure to respond to help requests, limited or no stimulation activities etc.

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Finding and keeping workers: Take on the right people and Keep your people

Finding and keeping workers: Take on the right people and Keep your people

Great relationships develop when people have the right values , as well as the time and stability to get to know each other. By finding and keeping the right workers, you will will grow and embed a positive and caring culture in your organisation.

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C2. How does the service support people to express their views and be actively involved in making decisions about their care, support and treatment as far as possible?

Prompts that may be used by CQC inspectors to explore this…

C2.1 Do staff recognise when people need and want support from their carers, advocates or representatives to help them understand and be involved in their care, treatment and support? How do staff help people to get this support?

C2.2 Do staff make sure they give information to people, their families and other carers about external bodies, community organisations and advocacy services that can provide independent support and advice, answer questions about their care, treatment and support, and, where necessary, advocate for them? How does the service support people to contact and use these services?

C2.3 Does the service give staff the time, training and support they need to provide care and support in a compassionate and personal way? Are rotas, schedules and practical arrangements organised so that staff have time to listen to people, answer their questions, provide information, and involve people in decisions?

Products that can help include...

Dementia: independence and wellbeing (2013) (QS30)

Dementia: independence and wellbeing (2013) (QS30)

NICE quality standard on care and support of people with dementia in social care settings. It includes statements and measures on;

discussing concerns about possible dementia
choice and control in decisions
reviewing needs and preferences when circumstances change
leisure activities of interest and choice
maintaining and developing relationships
accessing services to help maintain physical and mental health
design and adaptation of housing.

The statements are specific and concise and focus on priorities for quality improvement. This quality standard should be read alongside the NICE quality standard on Dementia: support in health and social care (see Effective - How are people supported to maintain good health, have access to healthcare services and receive ongoing healthcare support). In particular, please see statements 2, 3 & 9.

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Involving people, providing information and accessing support (Good and outstanding care guide)

Involving people, providing information and accessing support (Good and outstanding care guide)

Recommendations and practical examples from services rated good and outstanding including;

Support people to express their views, communicate effectively, share information etc.
Avoid ineffective feedback opportunities, failure to provide access to advocates etc.

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Code of Conduct

Code of Conduct

The Code of Conduct is a set of standards that all working in adult social care should follow. Free guidance is available from Skills for Care covering the following subjects:

Be accountable by making sure you can answer for your actions or omissions
Promote and uphold the privacy, dignity, rights, health and wellbeing of people who use health and care services and their carers at all times
Work in collaboration with your colleagues to ensure the delivery of high quality, safe and compassionate healthcare, care and support
Communicate in an open, and effective way to promote the health, safety and wellbeing of people who use health and care services and their carers
Respect a person’s right to confidentiality
Strive to improve the quality of healthcare, care and support through continuing professional development
Uphold and promote equality, diversity and inclusion

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Dementia: independence and wellbeing (2013) (QS30)

Dementia: independence and wellbeing (2013) (QS30)

NICE quality standard on care and support of people with dementia in social care settings. It includes statements and measures on

discussing concerns about possible dementia
choice and control in decisions
reviewing needs and preferences when circumstances change
leisure activities of interest and choice
maintaining and developing relationships
accessing services to help maintain physical and mental health
design and adaptation of housing.

The statements are specific and concise and focus on priorities for quality improvement. This quality standard should be read alongside the NICE quality standard on Dementia: support in health and social care (see Effective - How are people supported to maintain good health, have access to healthcare services and receive ongoing healthcare support). In particular, please see statements 2, 3 & 9.

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C3. How are people's privacy, dignity and independence respected and promoted?

Prompts that may be used by CQC inspectors to explore this…

C3.1 How does the service and staff make sure that people’s privacy and dignity needs are understood and always respected, including during physical or intimate care?

C3.2 Do staff respond in a compassionate, timely and appropriate way when people experience physical pain, discomfort or emotional distress?

C3.3 How are people assured that information about them is treated confidentially in a way that complies with the Data Protection Act, and that staff respect their privacy?

C3.4 How does the service take people's preferences and needs and their protected and other characteristics under the Equality Act into account when scheduling staff?

C3.5 Can people be as independent as they want to be?

C3.6 Are people’s relatives and friends made to feel welcome and able to visit without being unnecessarily restricted? Relates to: Services where staff control or influence arrangements for visitors

C3.7 How does the service make sure that young adults have choice and flexibility about their privacy and the amount of parental involvement in managing their care and support after moving into adult services?

Products that can help include...

Dignity in Care Guide (2013)

Dignity in Care Guide (2013)

Using this guide will support service providers and practitioners to improve standards of dignity in care for people who receive health and social care services.
Sections include:

dignity factors
legislation
whistleblowing
complaints
abuse
dignity for care workers

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Dignity in Care

Dignity in Care

Collection of films on different aspects of dignity in care including privacy, personal hygiene, pain management, nutrition, social inclusiuon and communication

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Dignity in Care: practical assistance (2015)

Dignity in Care: practical assistance (2015)

Use this film to see how providing help with small tasks can prevent people from needing a high level of care.
The film shows some innovative schemes which demonstrate how practical assistance can:

help people maintain independence and dignity
keep people safe in their homes
reduce social isolation

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Dignity in care: personal hygiene (2015)

Dignity in care: personal hygiene (2015)

Use this film to see how important it is to support people to maintain their personal hygiene. The film demonstrates how appearance and living environment can:

help people maintain independence and dignity
help people feel safe and comfortable
vary from person to person and needs to reflect the standards they want

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Dignity in Care: pain management (2015)

Dignity in Care: pain management (2015)

Use this film to explore how dignity is achieved in pain management. The film considers:

how import it is for care staff to spot people in pain and that levels vary for every individual
how people are not always able to communicate the pain they in
the role of alternative therapies in alleviating pain

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Dignity for care workers (2011)

Dignity for care workers (2011)

This section of the Dignity Guide looks at ways of improving the role of care workers by:

improving the value and status of care work
supporting mutual respect between people who provide care and people who receive it

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Dignity in Care: pain management (2015)

Dignity in Care: pain management (2015)

Pain levels vary for every individual. Medication is important but is not always appropriate. This film also looks at the role of alternative therapies in alleviating pain.

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Dignity in Care : Choice and control (2014)

Dignity in Care : Choice and control (2014)

This film helps in understanding what staff can do to support people have choice and control in their lives. Factors include:

getting to know people so their needs and preferences are taken into account
supporting people to do things for themselves rather than doing things for them
being flexible about the way they support people

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Privacy, dignity and independence (Good and outstanding care guide)

Privacy, dignity and independence (Good and outstanding care guide)

Recommendations and practical examples from services rated good and outstanding including;

Check what is appropriate by the person or family / advocate, honour and celebrate different beliefs etc.
Avoid making private records publicly available, referring to people in derogatory terms etc.

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Common Core Principles for Dignity Toolkit

Common Core Principles for Dignity Toolkit

Use this toolkit to understand and apply the principles and practice needed to ensure dignity is at the heart of everything you do. Including best practice guidance and examples, this toolkit is available on-line or in paper format for £15.

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Understanding intermediate care, including reablement

Understanding intermediate care, including reablement

This is a short and visually appealing guide for people using intermediate care, containing key information from the relevant NICE guidance.

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