Care home standards review

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Consultation has concluded

Introduction 

In May and June 2023 we engaged with 22 care home residents and 49 of their family/friends to help us understand their experiences. Together with feedback from care home providers, their views will be used to shape updated care home standards, that many care homes in Oxfordshire sign up to. 

Food  

You said: You are happy with meals, but would welcome more variety and improved quality and quantity.  

We did: The quality improvement team will ask to see previous menus to ensure the provider is giving nutritional meals. We will ask how individual choice is given, meeting cultural, religious and personal preferences, and we will ask to see evidence of this. 

Activities 

You said: You think activities provided by care homes were good, but there needs to be more for people with disabilities, mobility/bedroom restrictions and high cognitive functioning. 

We did: The quality improvement team will ask to see activity schedules and evidence (such as resident meetings/care plans) that residents are offered choice and a variety of simulating activities (including community involvement and trips out). 

Staffing 

You said: You shared lots of praise and compliments for staff and felt that they did their very best under the constraints of time. You felt that recruitment, retention and turnover of well-trained staff was a major issue. 

We did: We added a new standard that says providers must ensure staff have a level of spoken and written English that is appropriate for their job. We will refresh the Adult Social Care Workforce Strategy for Oxfordshire, to reflect the challenges in recruiting and retaining care staff. 

Safety in bedrooms 

You said: You feel secure at your care home. Some residents and family/friends had concerns about other residents entering people's rooms uninvited. 

We did: We updated the standard for safety. It now says that providers will make sure your care home environment is safe and secure and that care is provided safely. We will encourage care homes to conduct yearly resident/family surveys and respond to concerns. 

Contact with loved ones 

You said: Most family/friends went in person to see their loved ones and felt warmly welcomed by staff. Some said that getting to visit was difficult because of time and/or distance so, having a video call would be appreciated as it would mean they could see their loved one, even for just a few minutes. 

We did: We added a new standard stating that providers, where possible, will facilitate contact with family and friends virtually when it is difficult for family and friends to visit in person. When carrying out monitoring visits the quality improvement team will ask how residents are supported to maintain contact with loved ones. 

Dignity, including housekeeping 

You said: You shared concerns that the dignity of your loved ones was not always considered by all the care home staff. For example, when changing wet clothes/sanitary wear or when speaking to them. Many of you shared frustrations with the loss of and mix up of clothes, despite systems being in place that should prevent this. 

We did: We added "Individuals must be treated with dignity and respect at all times" to the standards. When conducting monitoring visits the quality improvement team will observe interaction between staff and residents, paying attention to whether residents are treated with dignity and respect. Care homes will be encouraged to have a clear process for laundry and this will be observed on visits. 

Access to information 

You said: You struggle with obtaining information about how to deal with finances and benefits, and felt having information such as the care home’s policies would be useful. 

We did: We added a new standard which states that care homes will keep family/friends updated on the resident’s progress/changes and make them aware of the care home’s policies. The quality improvement team will check to ensure that families are involved and documentation is signed/dated showing that they have been part of reviews/care plans. 

Non-verbal communication 

You said: Staff need to better understand non-verbal communication and behavioural cues. You also said that the standards should use more inclusive language than ‘listen to you’.   

We did: We added a new standard stating that care homes will make every effort to involve residents and provide a level of choice appropriate to their cognitive abilities. All residents should be involved in their care and decisions. At visits we will look for documentation that is pictorial, written in a language of choice and large print as needed to meet the needs of residents. 

The new refreshed care home standards will be in place in April 2024. 

Introduction 

In May and June 2023 we engaged with 22 care home residents and 49 of their family/friends to help us understand their experiences. Together with feedback from care home providers, their views will be used to shape updated care home standards, that many care homes in Oxfordshire sign up to. 

Food  

You said: You are happy with meals, but would welcome more variety and improved quality and quantity.  

We did: The quality improvement team will ask to see previous menus to ensure the provider is giving nutritional meals. We will ask how individual choice is given, meeting cultural, religious and personal preferences, and we will ask to see evidence of this. 

Activities 

You said: You think activities provided by care homes were good, but there needs to be more for people with disabilities, mobility/bedroom restrictions and high cognitive functioning. 

We did: The quality improvement team will ask to see activity schedules and evidence (such as resident meetings/care plans) that residents are offered choice and a variety of simulating activities (including community involvement and trips out). 

Staffing 

You said: You shared lots of praise and compliments for staff and felt that they did their very best under the constraints of time. You felt that recruitment, retention and turnover of well-trained staff was a major issue. 

We did: We added a new standard that says providers must ensure staff have a level of spoken and written English that is appropriate for their job. We will refresh the Adult Social Care Workforce Strategy for Oxfordshire, to reflect the challenges in recruiting and retaining care staff. 

Safety in bedrooms 

You said: You feel secure at your care home. Some residents and family/friends had concerns about other residents entering people's rooms uninvited. 

We did: We updated the standard for safety. It now says that providers will make sure your care home environment is safe and secure and that care is provided safely. We will encourage care homes to conduct yearly resident/family surveys and respond to concerns. 

Contact with loved ones 

You said: Most family/friends went in person to see their loved ones and felt warmly welcomed by staff. Some said that getting to visit was difficult because of time and/or distance so, having a video call would be appreciated as it would mean they could see their loved one, even for just a few minutes. 

We did: We added a new standard stating that providers, where possible, will facilitate contact with family and friends virtually when it is difficult for family and friends to visit in person. When carrying out monitoring visits the quality improvement team will ask how residents are supported to maintain contact with loved ones. 

Dignity, including housekeeping 

You said: You shared concerns that the dignity of your loved ones was not always considered by all the care home staff. For example, when changing wet clothes/sanitary wear or when speaking to them. Many of you shared frustrations with the loss of and mix up of clothes, despite systems being in place that should prevent this. 

We did: We added "Individuals must be treated with dignity and respect at all times" to the standards. When conducting monitoring visits the quality improvement team will observe interaction between staff and residents, paying attention to whether residents are treated with dignity and respect. Care homes will be encouraged to have a clear process for laundry and this will be observed on visits. 

Access to information 

You said: You struggle with obtaining information about how to deal with finances and benefits, and felt having information such as the care home’s policies would be useful. 

We did: We added a new standard which states that care homes will keep family/friends updated on the resident’s progress/changes and make them aware of the care home’s policies. The quality improvement team will check to ensure that families are involved and documentation is signed/dated showing that they have been part of reviews/care plans. 

Non-verbal communication 

You said: Staff need to better understand non-verbal communication and behavioural cues. You also said that the standards should use more inclusive language than ‘listen to you’.   

We did: We added a new standard stating that care homes will make every effort to involve residents and provide a level of choice appropriate to their cognitive abilities. All residents should be involved in their care and decisions. At visits we will look for documentation that is pictorial, written in a language of choice and large print as needed to meet the needs of residents. 

The new refreshed care home standards will be in place in April 2024.