National standards

One particular NHS hospital sensitively handles breast screening among women of a particular minority ethnic group.

Because many of the women attending the screenings don’t speak English, and some have particular concerns about the procedure, the hospital makes sure that an interpreter is always available to check that everyone understands what to expect.

Everyone is treated with dignity and is able to decide whether to give their permission.

Harpal has autism, which affects his communication and social skills. He recently took part in a pilot scheme for young people preparing to move to adult residential care. A personal care plan was designed in collaboration with Harpal and his mother.

Harpal’s communication skills were helped by having a ‘buddy’ of a similar age to take him out for leisure activities, including to a local youth club, so Harpal could form friendships with other young people from the Sikh community. He was also assigned a keyworker – a member of staff from the care home – to help him become more independent.

Peter, a widower, is 80 and lives alone. He recently went into hospital after he fell twice in one month. The hospital arranged for him to meet an occupational therapist who asked him how well he was managing to look after himself at home. Peter agreed that he needed daily help with personal care and household tasks.

He and his daughter were invited to consider several home-care agencies provided by their local council. The agency they chose met Peter in his own home for a discussion about his needs before he made his decision. Peter and his daughter were consulted about how many hours of support he needed each day, and a care plan appropriate to Peter’s needs was agreed between them.

Gunes and his family belong to a large Turkish community in the south east of England. They are regular patients of a local dental practice which has employed a Turkish-speaking dental nurse in response to demand.

Gunes’ family have a basic knowledge of the English language but communicate more effectively in Turkish. When Gunes’ nine-year-old son needed to have a tooth out, he and his son could understand what was involved and why the procedure was necessary, so they agreed for the dentist to go ahead with the treatment.

The care plan of an older patient showed that he was at risk of falling and he needed to build up his strength through a high-protein diet.

When he was transferred from an acute hospital to his local community hospital for rehabilitation, the community hospital was told about his needs before he arrived. They made sure that his bed was set up with protective rails and that he continued to get the special diet he needed.

Alice was diagnosed with Alzheimer’s disease four years ago. After a long spell in hospital, she and her husband George were given the choice of Alice staying in hospital or moving to a residential care home. They both chose the care home.

The care home they chose was fully briefed by the hospital about Alice's medical and personal needs – her room was adapted to keep her safe, and her GP was consulted and involved throughout. As Alice is a vegetarian, this was also included in her care plan and a vegetarian option was added to the daily menu. Her husband told us how satisfied he was with the support Alice received during the move from hospital to the care home.

Yasmin, 55, has had multiple sclerosis since 1980. She receives help from her agency carer, Josephine, who has looked after Yasmin’s needs at her home for the past five years. She also values the support of her family, who visit her regularly.

Yasmin’s care was recently reviewed by the agency that Josephine works for, and Yasmin asked for Josephine to be included in the consultation. Together they agreed that the agency would ask the council to provide equipment, such as handrails, to help keep Yasmin safe, and to install a shower to replace her bath.

The council and home-care agency worked with Yasmin to make sure that, although her health condition was changing, her independence and mobility were maintained as far as possible.

June is 80 and can no longer get to her regular dentist. A care worker provides June with personal and nursing care in her own home.

June’s doctor contacts the local PCT, which has an arrangement with a local dental practice to visit people in their own homes. June contacts them and finds it easy to book an appointment for treatment in her own home because the practice agrees to send a dentist to her home at a time which fits in with June’s care schedule.

When the dentist arrives at June’s home, she knows about June’s dental history as June’s regular dentist has shared this with her.

An NHS hospital has a strict policy about keeping clean and controlling infection. All staff are trained in controlling infection, particularly in how to handle equipment such as air-masks that are designed to be used once and then thrown away.

People receiving care in the hospital and visitors are told about the policy and are asked to say what they think about how the hospital maintains its high standards. The hospital’s infection control policy is regularly reviewed and updated as needed.

Olive had been partially sighted all her life and began to lose more of her sight. Residential care was recommended but Olive was anxious about moving to a new environment and not being able to properly see the people who were caring for her. She decided to move in for a trial period.

Olive’s care home was well adapted to meet the needs of residents with poor sight. She found she had all the equipment she needed, such as task lighting and magnifiers, and there were trained staff to help her feel secure in the home and trust the people around her. She decided to move into the home.

Alan, 70, was diagnosed with a muscle disease five years ago and gradually lost the ability to walk and to handle and lift things. Until six months ago, Alan’s partner, David, cared for Alan but David died suddenly. Alan’s GP recommended that a home-care agency should provide support.

Alan was very nervous about having people he did not know in his house. He was also worried about other people dealing with his money, e.g. drawing his pension from the post office for him. The agency that Alan chose talked to him about all the checks they make on staff to make sure they are suitable. This included getting references and making a Criminal Records Bureau (CRB) check which checks to see if people have criminal convictions. Alan was reassured by this and felt more confident about people being in his home.

A dental practice is not accessible for people who use a wheelchair or have severe difficulty walking because it is on the second floor of a building and can only be reached by a narrow flight of stairs. It is not possible to have a lift installed in the building.

The practice met with a local disability group, and on their advice made improvements such as fitting secure handrails to the staircase and installing a buzzer at the door to call for help. Since the practice is still not accessible for some people, it has agreed to provide a basic home treatment and assessment service for any existing patients with disabilities.

Patients who want to make an appointment at the practice are told about the stairs and, if necessary, referred to an NHS Helpline for advice about more accessible services.

The managers at a large hospital encourage all their staff to keep up to date with developments in their field. All staff members have an individual 12-month training plan and there are enough staff at the hospital to make sure that they can attend training courses.

The hospital has also introduced a mentoring programme where junior staff can learn from more senior staff to develop their skills and do their job better. People who are treated at the hospital and their families say they are happy with the standard of care and support they receive.

An individual occupational therapy service is provided to people with complex needs who live in a residential care home. Therapists are always available to support residents to be as independent as possible. Managers work in partnership with both the local authority and the local university to make sure their therapists develop their skills to the highest level.

At the same time, occupational therapy graduates from the university are given training placements within the care home and have a chance to network and share best practice. Their placements include training on how to promote equality and the rights of people living in the care home.

The managers of an agency that provides home care for young adults with a learning disability know that the workers they recruit are vital to the independence and wellbeing of the people who use the agency’s services. The managers make sure that their staff are trained, well supervised and able to meet a wide range of personal needs.

All staff must complete introductory training, which includes how to promote equality and people’s rights, as well as first aid, food hygiene, giving medication, and moving and lifting people. Staff are encouraged and given time to improve their skills through courses in health care and social care.

Dental nurses and hygienists at a dental practice with two large surgeries are encouraged to develop their professional skills. The practices have a rota that allows all staff to schedule time for training into their week.

Each dentist has a plan for Continuing Professional Development and is up to date with the requirements of the General Dental Council. Managers of the group keep a record of all the training their staff take. They are confident that everyone who visits the practices is cared for and treated by staff who have the right knowledge and skills to do their jobs properly.

A particular hospital’s maternity unit has good clinical practice in place to make sure that mothers and their babies are protected from any risks of harm. When a serious incident happens, there is an immediate case review, chaired by a representative of the hospital’s management board. An action plan is put in place as a result of this and all staff in the unit are told about it. The mother concerned is involved throughout the process.

We regularly make unannounced visits to the hospital, speak to pregnant women in the unit and independently review the hospital’s action plan for improvement. Once we are happy that the hospital is meeting this standard, we share what we have found with the public by publishing a report.

We inspected a care home after several people living there and their families contacted us with concerns. We asked the managers to take steps to improve their service and we published this information on our website. When we inspected the home again we found that managers put in place monthly meetings with residents and their families to get feedback on the quality of care. If a complaint is made the managers take it seriously and settle it quickly.

People who live in the care home, their families and their friends now tell us that concerns are acted on quickly. They find the meeting with the care home very useful and are satisfied with the high standard of care they receive.

Mohammed, who is 22, has cerebral palsy and a learning difficulty so he needs care at home.

The agency that provides Mohammed’s care gave him their complaints and compliments procedure in an easy to read format. They also gave a version of the same booklet to Mohammed’s family and friends.

The booklet clearly sets out how Mohammed can complain if he is not happy with any part of his care. His family know what steps they should take if they do not think that the agency has promptly responded to their or Mohammed’s concerns.

A dental practice run by two partners recently took over another local, private practice.

When the practice changed hands, the partners found there was no process in place for reviewing and learning from patients’ complaints and feedback. They quickly set up a new procedure for dealing with complaints. They wrote to all regular patients to explain the new procedure and how to make a complaint.

When we inspected the practice under its new management, we were satisfied that it was meeting this national standard of quality and safety and we shared this information with the public on our website.