Dignity & Respect Audit - Care Homes

Evidence to check

• • Current policy is available and reviewed
• • Policy covers privacy, dignity, consent, MCA, equality, human rights, choice and independence
• • Policy is accessible to staff and reflected in induction and refresher training
• • Staff can explain what dignity and respect mean in everyday care

Evidence to check

• • Leaders role model respectful communication and person-centred care
• • Values are visible in staff meetings, supervision, observations and resident engagement
• • Disrespectful or task-focused practice is challenged promptly
• • There is a clear zero-tolerance approach to abuse, humiliation, discrimination or neglect

Evidence to check

• • Dignity audits or observation tools are completed regularly
• • Resident and family feedback includes questions about dignity, respect, choice and involvement
• • Findings lead to action plans with owners and timescales
• • Improvements are reviewed for impact

Evidence to check

• • Training records show completion of dignity, person-centred care, MCA, equality and safeguarding training
• • New staff receive dignity and respect training during induction
• • Refresher training is provided where required
• • Training impact is checked through observation, supervision and feedback

Evidence to check

• • Staff know how to escalate dignity concerns through safeguarding, complaints, whistleblowing or line management
• • Concerns are recorded and acted on promptly
• • Staff feel safe raising concerns about poor practice
• • Leaders respond without blame or retaliation

Evidence to check

• • Complaints and concerns are categorised for dignity, privacy, communication, choice and respect themes
• • Themes are reviewed in governance meetings
• • Apologies, learning and corrective actions are documented where needed
• • Actions are shared with staff and monitored

Evidence to check

• • Observation confirms staff knock and wait before entering
• • Staff explain who they are and why they are entering
• • Residents' private space is respected
• • Poor practice is challenged immediately

Evidence to check

• • Observation confirms privacy is protected during intimate care
• • Doors and curtains are closed where appropriate
• • Staff check the resident is comfortable with the level of privacy
• • Shared rooms have appropriate screening

Evidence to check

• • Towels, blankets or clothing are used to protect modesty
• • Only the area being supported is exposed where possible
• • Staff avoid rushing or leaving residents uncovered
• • Residents' preferences around modesty are recorded and followed

Evidence to check

• • Continence products, laundry and personal care items are handled privately
• • Staff do not discuss intimate care in public areas
• • Residents are supported without embarrassment or humiliation
• • Personal care records use respectful language

Evidence to check

• • Staff respond discreetly to call bells
• • Personal needs are not announced loudly in communal areas
• • Residents are not made to feel they are a burden for calling
• • Call bell delays or repeated dignity concerns are reviewed

Evidence to check

• • Private spaces are available for calls and visits
• • Staff support residents to use phones, video calls or communication aids where needed
• • Visits are not unnecessarily interrupted
• • Confidential or emotional conversations are respected

Evidence to check

• • Private areas are available for health, financial, family or personal discussions
• • Staff avoid discussing sensitive issues in corridors, dining rooms or lounges
• • Residents with hearing or communication needs are supported discreetly
• • Privacy is considered during professional visits and care reviews

Evidence to check

• • Care notes are not left unattended
• • Screens are locked when not in use
• • Handover and clinical discussions take place away from public areas
• • Staff understand need-to-know information sharing

Evidence to check

• • Observation confirms staff avoid public conversations about residents
• • Staff do not discuss residents in front of others without involvement or consent
• • Confidentiality is covered in training and supervision
• • Breaches are recorded, investigated and used for learning

Evidence to check

• • Consent, best-interest decision or other lawful basis is documented where required
• • Privacy impact assessments are completed where applicable
• • Monitoring is proportionate and regularly reviewed
• • Residents, families and staff are informed appropriately

Evidence to check

• • Observation confirms staff ask before providing care
• • Staff explain care tasks clearly and calmly
• • Communication is adapted to the resident's understanding
• • Staff pause or re-approach if the resident refuses or becomes distressed

Evidence to check

• • Staff seek consent for washing, dressing, medication, moving and handling, photographs and activities
• • Residents are offered choices, not just told what will happen
• • Consent is treated as ongoing and can be withdrawn
• • Care records reflect consent decisions where required

Evidence to check

• • Capacity assessments are decision-specific
• • Assessments are completed at the right time and with appropriate support
• • Records show how the resident was supported to understand and communicate
• • Capacity is not assumed based on diagnosis or age

Evidence to check

• • Best-interest records identify the decision, people involved and rationale
• • Resident wishes, feelings, values and past preferences are considered
• • Family, representatives or advocates are involved where appropriate
• • Decisions are reviewed when circumstances change

Evidence to check

• • Records show less restrictive options were considered
• • Restrictions are proportionate and time-limited
• • Care plans include how restrictions will be reviewed or reduced
• • DoLS implications are considered where liberty may be restricted

Evidence to check

• • Refusals are respected and recorded
• • Staff use calm re-approach strategies rather than pressure or force
• • Care plans include resident-specific refusal strategies
• • Repeated refusals with health risks are escalated appropriately

Evidence to check

• • Consent records state who information may be shared with and what can be shared
• • Consent is reviewed when relationships or circumstances change
• • Staff understand confidentiality boundaries with relatives
• • Information sharing without consent is justified only where legally appropriate

Evidence to check

• • Care plans record intimate care preferences
• • Staff seek consent before intimate care
• • Gender preference is respected where possible and safe
• • Any inability to meet preferences is explained sensitively and reviewed

Evidence to check

• • Consent or best-interest decision is recorded
• • Technology use is risk assessed and proportionate
• • DoLS implications are considered where technology restricts liberty
• • Use is reviewed for effectiveness and continued need

Evidence to check

• • Advance care planning discussions are offered sensitively
• • Resident wishes are recorded and reviewed
• • DNACPR or treatment escalation decisions are supported by appropriate documentation
• • Families or representatives are involved where appropriate and lawful

Evidence to check

• • Care plans record preferred routines
• • Observation and records show routines are followed where possible
• • Staffing or task routines do not override resident choice unnecessarily
• • Changes in preference are recorded and communicated

Evidence to check

• • Residents choose clothing, hair, shaving, make-up, jewellery or cultural dress where they wish
• • Staff support personal presentation respectfully
• • Clothing is clean, appropriate and belongs to the resident
• • Preferences are recorded and followed

Evidence to check

• • Residents are offered real meal and drink choices
• • Preferences, dislikes and dietary needs are recorded
• • Residents can eat in their room or dining area where safe and preferred
• • Mealtime support protects dignity and independence

Evidence to check

• • Residents choose activities, social time, quiet time, outdoor access and rest where possible
• • Choices are individual and not limited to group options
• • Residents who are quieter or less verbal are supported to express preferences
• • Daily records reflect meaningful engagement and choice

Evidence to check

• • Staff encourage residents to do what they can safely do themselves
• • Care plans identify abilities as well as needs
• • Observation shows staff are patient and enabling
• • Independence goals are reviewed and celebrated

Evidence to check

• • Residents have essential aids accessible
• • Staff check aids are clean, working and used
• • Call bells are within reach and suitable for the resident
• • Missing or broken aids are escalated promptly

Evidence to check

• • Care plans record support needs and preferences around money and belongings
• • Consent, capacity and safeguarding are considered
• • Records are maintained where staff support purchases or finances
• • Residents retain autonomy wherever possible

Evidence to check

• • Care plans include relationships, outings, hobbies, faith groups or community interests
• • Staff support visits, calls and social contact
• • Barriers such as mobility, anxiety or transport are addressed
• • Community involvement is reviewed as part of wellbeing

Evidence to check

• • Residents are not lined up unnecessarily or treated as a group task
• • Names are not called out loudly in ways that embarrass residents
• • Bathing, toileting and care routines are personalised
• • Staff challenge institutional habits and promote normality

Evidence to check

• • Residents have personal items and familiar objects where they choose
• • Personalisation supports identity, memory and comfort
• • Health and safety risks are managed proportionately
• • Residents and families are involved in room choices

Evidence to check

• • Preferred names and titles are recorded
• • Observation confirms staff use residents' preferences
• • Tone is respectful, warm and adult-to-adult
• • Poor language or tone is challenged

Evidence to check

• • Staff avoid terms such as 'dear', 'sweetie' or 'good girl/boy' unless clearly welcomed by the resident
• • Communication remains respectful and adult
• • Residents' communication preferences are recorded
• • Supervision addresses language that undermines dignity

Evidence to check

• • Staff do not speak over residents or only to relatives/professionals
• • Residents are included in conversations about their needs and preferences
• • Staff check understanding and agreement
• • Residents with communication difficulties are supported to participate

Evidence to check

• • Interpreters, picture prompts, hearing aids, glasses, communication boards or easy-read materials are used where required
• • Care plans describe communication needs
• • Staff adapt pace, language and environment
• • Communication barriers are reviewed and addressed

Evidence to check

• • Observation shows staff listen patiently
• • Residents are given time to respond
• • Staff avoid finishing sentences unnecessarily
• • Care routines allow enough time for meaningful communication

Evidence to check

• • Staff use respectful language for all residents
• • People living with dementia or distress are not dismissed or mocked
• • Continence and disability support is discreet and dignified
• • Disrespectful behaviour is challenged and recorded where appropriate

Evidence to check

• • Care plans identify triggers, preferred approaches and reassurance strategies where known
• • Staff offer predictability, choice and control
• • Staff avoid unnecessary touch, confinement or rushed approaches
• • Distress is understood as communication, not wilful behaviour

Evidence to check

• • Care plans record dietary, worship, clothing, modesty, festivals, language and identity needs
• • Staff support religious and cultural practices where residents wish
• • Kitchen, activities and care staff understand relevant preferences
• • Residents are not pressured to take part in practices they do not want

Evidence to check

• • Staff use correct names, pronouns and respectful language
• • Residents can discuss relationships and identity without fear
• • Discriminatory behaviour from staff, residents or visitors is challenged
• • Policies and training include LGBTQ+ inclusion

Evidence to check

• • Adjustments are recorded in care plans
• • Equipment, communication aids, environmental changes or staff support are provided where needed
• • Residents are involved in decisions about adjustments
• • Adjustments are reviewed for effectiveness

Evidence to check

• • Discriminatory incidents are recorded and investigated
• • Staff know how to intervene safely
• • Residents affected are supported
• • Learning and prevention actions are documented

Evidence to check

• • Continence care is discreet and timely
• • Products are stored and handled privately
• • Residents are not left wet, soiled or embarrassed
• • Care plans promote independence and toileting routines where possible

Evidence to check

• • Locks, private areas, screening and bathroom facilities are appropriate
• • Residents can receive visitors privately
• • Shared rooms have privacy arrangements
• • Environmental issues affecting dignity are logged and addressed

Evidence to check

• • Rooms are not labelled by diagnosis, continence status or behaviour risk
• • Signage supports orientation without embarrassment
• • Resident names and information are displayed only with consent and purpose
• • Dementia-friendly signage remains respectful

Evidence to check

• • Private information cannot easily be overheard by residents, visitors or unauthorised staff
• • Screens and paperwork are not visible to unauthorised people
• • Handover spaces support confidentiality
• • Confidential waste is disposed of securely

Evidence to check

• • Lockable storage is available where appropriate
• • Personal property inventories are maintained where used
• • Residents can access their belongings unless restrictions are risk assessed and lawful
• • Lost property concerns are investigated

Evidence to check

• • Surveys, meetings, reviews or one-to-one discussions include dignity and respect questions
• • Feedback from residents with communication needs is sought using suitable methods
• • Feedback is analysed and acted on
• • Residents and relatives are told what changed as a result

Evidence to check

• • Complaints are acknowledged and investigated promptly
• • Outcomes and learning are recorded
• • Apologies are offered where appropriate
• • Actions are monitored to prevent recurrence

Evidence to check

• • Dignity breaches are reviewed for safeguarding thresholds
• • Neglect, humiliation, discriminatory abuse or unlawful restriction is escalated
• • Rationale is recorded where safeguarding is considered but not referred
• • Immediate protective actions are taken

Evidence to check

• • Staff know internal and external whistleblowing routes
• • Whistleblowing is covered in training and supervision
• • Staff report feeling safe to raise concerns
• • Concerns are handled confidentially and without retaliation

Evidence to check

• • Observation includes day, night, weekend and mealtime practice where possible
• • Staff knock, close curtains or doors, cover residents and use respectful language
• • Residents appear comfortable and respected
• • Observed concerns are acted on immediately

Evidence to check

• • Staff can explain consent in everyday care
• • Staff understand refusal must be respected unless urgent legal or safety considerations apply
• • Staff can describe re-approach, escalation and documentation
• • Answers reflect MCA and least-restrictive principles

Evidence to check

• • Care plans include routines, meals, activities, personal care, communication and privacy preferences
• • Daily records and observations show preferences are followed
• • Changes in preference are updated promptly
• • Staff know resident preferences without relying only on written records

Evidence to check

• • Residents and families describe positive examples of involvement and choice
• • Any gaps are recorded and acted on
• • Feedback includes people with dementia or communication needs where possible
• • The home can evidence changes made from resident or family feedback

Evidence to check

• • Audit includes direct observation, resident feedback, family feedback, staff questioning and record review
• • Audit checks privacy, consent, language, choice, independence and equality in practice
• • Findings are compared with complaints, safeguarding, incidents and care observations
• • Actions lead to visible improvement in residents' daily experience

Evidence to check

• • Governance reviews dignity themes across multiple sources of evidence
• • Dignity concerns inform training, supervision, staffing, care planning and environmental improvements
• • Senior leaders monitor repeat dignity risks
• • The service can evidence a culture of learning, respect and continuous improvement