Amanda Partington-Todd is Deputy Director of Adult Social Care at CQC. Here she describes the importance of person-centred care.
In my role as Deputy Director of Adult Social Care, I’m sure it won’t come as a surprise to learn that I think about the adult social care sector and its potential a lot. I know how important high quality and compassionate care is for people and their families. It’s something that we register and assess against. We make sure that people’s voices are heard during the inspection process and in the enforcement of regulations.
As well as doing my best for the people using care every day, I’m also inspired by Nettie, my late maternal grandmother.
Nettie’s life really seemed to start after the age of 65. Despite her age and periods of ill-health, she was always seeking to learn new things. She would help others and be actively involved in her community. Those around her could see the sense of self-worth, value and motivation that these activities gave her.
Just like for Grandma Nettie, ageing and ill-health shouldn’t mean leaving behind things that make us feel part of humanity. Things like connection and contribution. Like learning, caring for others, and having a sense of belonging.
Good care is person-centred. It’s enabling — helping people live their best and fullest lives. Good care takes account of a person’s past, present, and future. It sees people as individuals with a unique history and unique contributions to make.
Earlier this year, I spoke at an event to mark the launch of a new toolkit from the Open University. The toolkit comes from their research into relational care. The team defined this as “recognition that everyone needs somewhere that gives them a feeling of home. A place where they can be secure, comfortable, and have a sense of belonging, control, and ownership.” The research looked at the relationships we have with our homes and the people we share that space with. The toolkit looks at how people who provide care can help create feelings of security and belonging.
Relational care is a natural progression from person-centred care in that it recognises the importance of mutuality, enabling all participants to be valued and empowered. It looks to prioritise care environments where people feel at home. Relational care is not transactional, flowing in one direction from care giver to receiver, but is where people contribute as much as they can and want to, in the lives of those around them. It’s about encouraging meaningful interdependence in an environment of respect, inclusivity, trust, and nurture.
Some of the best care that we see in our regulatory and inspection work is care that embeds people at its centre. At the launch event, I had the pleasure of meeting the team from care provider, Nightingale Hammerson. Their adoption of a relationship-centred care approach has helped them achieve and maintain an Outstanding rating for Nightingale House in Wandsworth. Nightingale House cares for older Jewish people, many of whom are living with dementia.
I was grateful for the opportunity to visit Nightingale House over the summer and left inspired by the relational care I saw in practice. They treated people not as a checklist of needs to be met but as a whole person with needs for connection, purpose and ambition. Similarly, care staff were enabled and encouraged to form meaningful relationships with each other and with residents. They form part of the atmosphere of trust and support, are valued for their contribution and accepted as individuals.
There was palpable joy and purpose in the inter-generational Shabbat service. Residents and children from the affiliated nursery shared prayer, song and reflection at the end of the week. The residents were active in leading the service and there was genuine warmth between them and the children as they did so. One gentleman commented that he had never had grandchildren of his own and this unique opportunity was particularly meaningful to him.
A dedicated and skilled on-site therapies team offered inspiration and hope to people in meeting their physical goals at any age, no matter how big or small. There were also continuous opportunities for the local community to be involved in their work. Whether that was their Research, Innovation and Community engagement team leading the conversation on care home research or offering their therapy services to the wider community. It felt less like a nursing home and more like a vibrant community hub with residents at the centre.
It was the sort of place that Grandma Nettie would have loved, either as a community volunteer or as a resident if she ever needed it. I could see her running a competitive game of Mahjong in one of the many lounges to choose from or taking pride in her appearance after an important visit to the hair salon.
Becoming a resident of a care or nursing home can be a scary thing for people, families and carers to navigate. It can sometimes feel like an ending. An end to independence, purpose and contribution. Places like Nightingale House, that adopt a relational care or relationship-centred care approach, show us that being in receipt of care need not be an ending, but a beginning. A beginning of new opportunities, new experiences, new relationships and revived intentions for one’s future.
I left with a question. How can CQC encourage innovation and adoption of care philosophies which improve outcomes and experiences for people?
It’s a question I will keep asking as we deliver on one of our key strategy ambitions to accelerate improvement. We’re in a unique position to shine a spotlight on opportunities for the whole sector to improve. We’ll use our various levers for improvement internally and externally to achieve this aim.