Objective assessment on quality of care
We have developed guidelines for providers in objectively assessing the quality of their service provision. These have been done for all 16 key inspectable outcome areas. These are designed to be used in conjunction with the definitions of positive and negative staff behaviours. Currently there are 19 pairs of these. One is shown at the end of this entry. This information and how it can be best used forms the basis of our “How to inspect your own Service like a CQC Assessor”. Should you be interested in attending one of these courses, please call the office on 01325 318 028.
Outcome Areas 1: Respecting and Involving People who use Services
Positive Observations
1. The assessments and support plans / patient records contain more than just standardised, clinical information. Each person’s document is individualised with specific, relevant detail about that person. They are not uniform. Staff are aware of these and use them, and view people as individuals. They are ‘living documents’. This could be picked up through case tracking, observation and talking to staff.
2. Through talking to staff you find evidence that they have good insight and knowledge about the individual. Staff are heard using enabling, positive language when talking about the person. Staff talk directly to the person wherever possible, not over them.
3. People can move around safely and interactions with each other and with staff are encouraged.
4. Staff are mindful to use the preferred language of the person when they are talking to them, but also when they are talking to other staff within the vicinity of that person.
5. You observe during visits that Service Users are encouraged to be active and that this activity has a purpose.
6. Individuals are addressed in the way they wish. Not everyone likes to be addressed using their first name. The service may have a Dignity Champion who is active and able to demonstrate their contribution to improving that service.
7. You observe, that a variety of communication methods are being used where appropriate e.g. the use of visual aids, touch, etc.
8. You observe that staff make the effort to communicate with the person while at their level physically e.g. kneeling down beside their chair to talk to them, or sitting next to their bed, rather than standing over them.
9. Staff are aware of what the individual is still able to do, not just what they cannot do or what they struggle with.
10. Where English is not the first language for the person, the provider demonstrates they have made arrangements, wherever practically possible, to ensure a member of staff is available who speaks their language, seeks independent translation services where necessary, or seeks advice or support from family, friends or local community who do speak the language, to aid communication, especially when important decisions need to be made.
Negative Observations
11. You observe people being ignored, left aside, and not included in conversation or activity. There is a limited level of communication and interaction between people using the service and staff.
12. Staff seem rushed and unable to spend time talking or responding to the person. This may indicate inadequate staffing levels to meet the needs of those using the service at that time and could require further questioning.
13. The language being used by staff is negative, disabling, could be viewed as ‘labelling’ – the general tone and culture of the setting can be a good indication of the culture of the service, about the likelihood that peoples dignity and respect are not being respected, and may indicate a lack of understanding, or confidence working with people.
14. Assessments and support plans appear uniform. They lack individualised, personal details relevant to each person.
15. Observation that people are repeatedly told they cannot do things or cannot have things they ask for.
Definition of Behaviour Type
| Infantalisation: | Patronising the Service User, treat them as a child | Respect | Treating the Service User as a mature, reasoning adult |