National care standards - care homes for people with physical and sensory impairment

12-19 Day-to-day life

12 Lifestyle - social, cultural and religious belief or faith
13 Eating well
14 Keeping well - healthcare
15 Keeping well - medication
16 Private life
17 Daily life
18 Staying in touch
19 Support and care in dying and death

Day-to-day life

Introduction to standards 12 to 19

The standards in this section focus on the ways in which the service promotes your general health and wellbeing. They are an important means of making sure that your quality of life is maintained or improved, and that you feel part of the everyday activities that are going on around you and can join in if you want to.

Lifestyle - social, cultural and religious belief or faith

The principle of valuing diversity means that you are accepted and valued for who you are. The standards in this section make it clear that you can continue to live your life in keeping with your own social, cultural or religious beliefs or faith when you are in the care home.

Eating well

Good, nutritious food and drink are important in keeping and improving your health. Individual choices of food and drink vary, as do dietary needs. Having your own needs and choices met is an important part of the quality of day-to-day life.

Keeping well

Keeping healthy or regaining your health are important to your wellbeing and quality of life. You have a right to have your healthcare needs met and to have support in using the full range of healthcare services. You also have a right to have your medication arranged efficiently and safely.

Private life

How you spend your day is up to you. You do not have to be with other people all the time. Staff will respect your wish to be on your own. You can entertain your friends and relatives in your own room.

Daily life

Living in a care home, you continue to be very much part of your own community, and to enjoy ordinary daily life.

Supporting communication

People may use different languages or methods of communication for a variety of reasons. As a result, they may have difficulty in making themselves understood. However, being able to communicate is an essential part of letting staff know what your needs are and playing an active part in the life of the care home.

Support and care in dying and death

The staff at the home should care sensitively for people who are dying, with extra services brought in if they are needed. The staff should handle each person's death with dignity and sensitivity, in line with their spirituality, culture and faith, and those of their family.

Friends, carers and relatives also need help and support at these times. They should be welcome to visit the care home while the person is being cared for, and after his or her death as part of their grieving process.

Lifestyle - social, cultural and religious belief or faith

Standard 12

Your social, cultural and religious belief or faith are respected.
You are able to live your life in keeping with these beliefs.

1 You are given the opportunity and support you may need to practise your beliefs, including keeping in touch with your faith community.

2 You know that staff make sure they are properly informed about the implications of your social, cultural and religious belief or faith for you and other people living in the care home.

3 Your holy days and festivals, birthdays and personal anniversaries are recognised and ways found to make sure you can mark or celebrate these as you choose.

4 The social events, entertainment and activities provided by the care home will be organised so that you can join in if you want to.

Eating well

Standard 13

Your meals are varied and nutritious. They reflect your food preferences and any special dietary needs. They are well prepared and cooked, and attractively presented.

1 Catering and other staff get to know your food choices and any ethnic, cultural, faith or other preferences you have. Any special diet (for example, vegetarian, low fat or high protein) is recorded in your personal plan.

2 You are offered a daily menu that reflects your preferences. The menu varies regularly according to your comments and will always include fresh fruit and vegetables.

3 You have a choice of cooked breakfast and choices of courses at the midday and evening meals.

4 Meals are nutritionally balanced for your dietary needs, for example, if you have diabetes or poor kidney function.

5 You can have snacks and hot and cold drinks whenever you like.

6 If you can't check for yourself that you are getting enough of the right things to eat or drink staff can check this for you. If there are concerns, staff will explain them to you or your representative. With your agreement, staff will take any action needed, such as seeking advice from a dietician or your GP.

7 Your meals are well prepared and presented. All food handling follows good food hygiene practices.

8 You are free to eat your meals wherever you like, for example in your own room or in the dining room. You can take them in your own time.

9 You must be able to eat and enjoy your food. If you need help to do so (for example, adapted cutlery or crockery, a liquidised diet, or help from a staff member), staff will arrange this for you in a discreet manner and in a way that respects your dignity.

10 If you are unable to take food or drink by mouth you get these by other means, for example PEG or parenteral feeding, in a way that best suits you and respects your privacy and dignity.

11 Staff will regularly discuss with you anything that may affect your ability to eat or drink, such as your dental health. If you want, they will arrange for you to get advice.

Keeping well - healthcare

Standard 14

You are confident that the staff know your healthcare needs and arrange to meet them in a way that suits you best.

1 You continue to be registered with your usual GP and dentist. If this is not possible, staff will help you to register as quickly as possible with a new GP and dentist of your choice from those providing services in the area of the home.

2 If you have been receiving community healthcare services (for example, physiotherapy, speech and language therapy, occupational therapy, chiropody or advice on your diet) and still need them, you will continue to receive them in the home. Otherwise if you want them to, the staff will give you advice and information about making new arrangements or make these for you.

3 If you want, during your first week in the home, and at least every six months after that, you will be able to have a full assessment to find out all your healthcare needs and the staff will make sure that these needs are met. Staff will record all assessments and reviews of your healthcare needs in your personal plan.

4 If your review shows that you need health advice from a speech therapist, dentist, GP, dietician or someone else, staff will arrange this for you and help you to follow any advice you have been given if you want them to.

5 You can see your GP or other healthcare professional in private.

6 You can be confident that the provider is aware of your nutritional state and will, with your agreement, arrange for this to be regularly assessed and checked. This assessment will take account of any changes in your health.

7 If you want to, you will be able to take part in physical activities in or outside the home which help you maintain a healthy lifestyle.

8 If you become ill or your health is not improving, either physically or emotionally, and if you want them to and you cannot do so yourself, you know that the staff will call your doctor or other relevant healthcare team member.

9 You will receive information about preventive healthcare (for example breast, cervical, and prostate cancer screening, blood pressure screening, immunisation and regular check-ups). If you want to take part in any of these, staff will help you to do so.

10 If you have any problems, or need advice, about intimate aspects of your health, for instance your sexual health, you can ask your key worker or other member of staff where to get information and help for this.

11 If you want to use complementary therapies or peer counselling ¹⁰ (see note below) you can ask your key worker where to get information about these and to help and support you to use them.

Keeping well - medication

Standard 15

If you need to take medication, staff know this and there are arrangements in place for you to take your medication safely and in the way that suits you best.

1 You can choose whether to manage your own medication, unless there are specific legal provisions applying to you that prevent this.

2 If you are managing your own medication, you will be given your own lockable storage to keep your medication in your room. If you need it, you will also have special storage somewhere else (for example, in a fridge) that is secure and accessible.

3 You can get help from the staff with ordering and collecting your prescriptions if you want or need it.

4 If you are on medication that someone else needs to administer (for example, an injection), the staff will do this in a way that recognises and respects your dignity and privacy.

5 If you have any questions or need advice about your medication which the staff cannot answer, they will help you to get the advice from your community pharmacist, GP or another member of the primary care team.

6 If you have your medication managed for you, you can be confident that the home has comprehensive systems in place for ordering medication and for its safe storage and administration, and for the safe disposal of unused medicines.

7 You know that any medication you receive will have been prescribed for you.

8 If you have your medication managed for you, you are confident that staff will monitor this and the condition for which it has been prescribed. If there are any changes or concerns about the medication or the condition, they will get medical advice if you agree.

9 You are confident that the home keeps accurate, up-to-date records of all the medicines that it has ordered, whether or not they have been taken and how they have been disposed of.

10 If you are capable of understanding the need to take medication and what will happen if you do not do so, but you refuse to take it, staff must respect your wishes.

11 You may not understand that you need to take medication and what will happen if you do not do so. If so, there are legal powers ¹¹ that allow other people to give permission for you to receive treatment if it is necessary for your health and welfare. Staff will not give medication except in accordance with the law. Even where the law allows medication to be given without consent, it will not be given in a disguised form unless you have refused it and your health is at risk because of this. This will be recorded.

12 You know that if any drugs go missing, the staff will take the necessary action to report this to the relevant authorities.

Private life

Standard 16

Your rights to privacy are respected.

1 You have control over who goes into your room or living space, and when this happens. Your door will have a locking system that you can use but staff will be able to open it if there is an emergency.

2 You have a lockable space for personal belongings in your own living space.

3 You can entertain family friends and other visitors in private.

4 If you are a parent you will be supported to retain and fulfil your parental responsibilities and if you wish can receive help and support with parenting skills.

5 Young children coming to visit you have somewhere safe to play and to be looked after.

6 You can discuss your needs in confidence and in private with whoever you choose.

7 Staff recognise that your sexuality, sexual needs and preferences are important to you. They accept and support your right to have intimate relationships that you have consented to in the privacy of your home and if it is legal to do so.

8 Intimate physical care or treatment will be carried out sensitively and in private, in a way which maintains your dignity.

9 You can make and receive phone calls in private and receive mail, including e-mails, in private, unless there are specific legal reasons to prevent this. If this is the case, staff must explain these reasons to you and record them.

10 Where you cannot attend to your own daily living needs you will have a choice in who does. Wherever possible and practical you will be able to choose if a male or female member of staff carries out these tasks.

11 Your personal possessions and clothing are treated with respect. Your clothing will be clearly identified as yours and it will not be acceptable for you to have to share your possessions unless you choose to do so.

Daily life

Standard 17

You make choices and decisions about day-to-day aspects of your life and about how you spend your time.

1 You can choose what activities you want to be involved in, both inside the home and elsewhere. You can, if you need it, get help to take part in them.

2 You know that the staff must explain, justify and record any limits on your independence in your personal plan and know that these will be reviewed regularly.

3 You know that the staff are trained to listen to people living in the care home.

4 You can keep up relationships with friends and relatives and links with your own community. If you want, the staff will support you to do this.

5 You have no restrictions placed on the time you get up or go to bed.

6 You are supported and encouraged to use local services such as hairdressers, shops and banks.

7 You have access to information about local events, facilities and activities.

8 Staff can help you to arrange meetings with visitors, and make sure the access needs of your disabled friends and relatives are met and that you are able to offer them refreshments.

Supporting communication

Standard 18

You have help to use services, adaptations and equipment for communication if your first language is not English or if you have any other communication needs.

1 Your communication needs are regularly assessed and reviewed and you will always have communication support if you need it.

2 Staff will help you get and use specialist communication equipment if you ask for their help.

3 Staff will know how to arrange for your personal care equipment to be repaired and maintained. This will be recorded in your personal plan.

4 You are supported by your named worker or trained communication support workers, including trained interpreters.

5 You can ask your key worker to use the knowledge and experience of your family, carers, friends or other people to support him or her in 'listening' and understanding you.

6 You can prepare for important events (for example, reviews and hospital appointments) and have time to communicate your feelings, views and answers.

7 You will be able to use a range of communication methods of your choice at any time and be able to communicate at the pace and in the style of your own choosing.

8 You know what the home's contingency plan is to cover alternative communication support in the event of equipment failure or other emergency.

Support and care in dying and death

Standard 19

You are confident that the staff will be sensitive and supportive during the difficult times when someone dies.

1 You are confident that any death in the care home will be handled with dignity, sensitivity and discretion.

2 If you lose someone close to you, you will be fully supported. You will have the opportunity to say goodbye or go to the funeral if you want. The staff will be available to help and support you.

3 If you wish you can say what you want to happen and who should be informed about your physical, personal and spiritual care in dying, death and funeral arrangements. You can be confident that your wishes will be carried out.

4 If you want them to, staff will discuss where you want to die with you, and those important to you. They will make every effort to achieve your wishes.

5 The staff will ensure that your death is as free of pain as possible. You will be able to choose whether or not you wish to have someone with you when you die and who that person should be. Staff will make every effort to ensure this happens.

6 There will be somewhere for those important to you to stay with you during your last few days and hours, if that is your wish and their wish.

7 When you die, your body will be treated with dignity, sensitivity and respect, in accordance with your expressed social, cultural and religious preferences.

8 The staff will make sure that your bereaved relatives, friends and carers can spend as much time with you after your death as they need to. They will support your relatives and friends through the formal processes relating to death, such as arrangements about belongings.