Quality standard
Quality statement 2: Personal identity
Quality statement 2: Personal identity
Quality statement
Older people in care homes are enabled to maintain and develop their personal identity.
Rationale
It is important that staff working with older people in care homes are aware of the personal history of the people they care for and respect their interests, beliefs and the importance of their personal possessions. Older people should be involved in decision making and supported and enabled to express who they are as an individual and what they want. They should be able to make their own choices whenever possible. Enabling older people to maintain and develop their personal identity during and after their move to a care home promotes dignity and has a positive impact on their sense of identity and mental wellbeing.
Quality measures
Structure
Evidence of local arrangements to ensure that older people in care homes are enabled to maintain and develop their personal identity.
Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by provider organisations, for example from care protocols.
Outcome
Feedback from older people in care homes that their personal identity is respected.
Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records. The following documents from the Adult Social Care Outcomes Toolkit (University of Kent) include questions about choice and control, personal cleanliness and comfort, social participation and involvement, occupation and dignity: CHINT3 care home interview schedule and CHOBS3 care home observation schedule.
NHS Digital Personal Social Services Adult Social Care Survey (England) collects data on service users' views and opinions over a range of outcome areas, including satisfaction with social care and support and quality of life.
What the quality statement means for different audiences
Organisations providing care work to embed a culture built on dignity and choice in care homes and ensure that staff are trained to work in partnership with older people in care homes in order to enable them to maintain and develop their personal identity.
Social care, health and public health practitioners work with older people in care homes to tailor support and opportunities to their needs and preferences, with the aim of maintaining and developing their personal identity.
Local authorities and other commissioning services ensure that they commission services from providers that can produce evidence of the actions they have taken to embed a culture of dignity and choice, and that staff are trained to work in partnership with older people in care homes in order to enable them to maintain and develop their personal identity.
Older people in care homes are given support and opportunities to express themselves as individuals and maintain and develop their sense of who they are.
Source guidance
GP services for older people: a guide for care home managers. Social Care Institute for Excellence (SCIE) guide 52 (2013), residents' entitlements and requirements: being seen as an individual
Personalisation: a rough guide. SCIE guide 47 (2012)
Dignity in care. SCIE (2006, updated 2020), Recognising the individual
Definitions of terms used in this quality statement
Care homes
This refers to all care home settings, including residential and nursing accommodation, and includes people accessing day care and respite care. [Expert opinion]
Enabled
'Enabled' refers to actions taken by staff working with older people in care homes to ensure that older people can maintain and develop their personal identity. This may include using life history to tailor support and opportunities to the needs and preferences of the individual. Staff should ensure that older people are able to choose their own clothes, have their most valued possessions with them and choose where to sit while they are eating. It may be necessary to adapt the older person's environment and provide access to outdoor spaces. Staff should facilitate social inclusion by promoting and supporting social interactions and access to social networks, involvement with the community, and existing and new relationships. [Adapted from SCIE's support on dignity in care, Recognising the individual, and expert opinion]
Personal identity
This refers to a person's individuality, including their needs and preferences, and involvement in decision making in all aspects of their life. Maintaining a sense of personal identity can involve using life history to maintain and build a meaningful and satisfying life, as defined by the person themselves. Central to personal identity is the feeling of having a purpose in life, feeling valued, having a sense of belonging and a feeling of worth. Relationships, including those with family, carers and friends, are an important aspect of a person's identity and can have a significant impact on mental wellbeing. An individual's personal identity may change as their circumstances alter. [Adapted from SCIE's guide on personalisation: a rough guide; Joseph Rowntree Foundation's My Home Life: promoting quality of life in care homes, chapter 2: 'Voice, choice and control' in care homes; and expert opinion]
Equality and diversity considerations
Staff working with older people in care homes should identify the specific needs arising from diversity, including gender and gender identity, sexuality, ethnicity, spirituality, culture, age and religion.
When ensuring that older people are enabled to maintain and develop their personal identity be aware of any learning disabilities, acquired cognitive impairments, communication or language barriers or cultural differences. Staff should ensure that they are aware of the needs and preferences of older people who are approaching the end of their life.
When collecting feedback from older people about whether they have been enabled to maintain and develop their personal identity staff should consider using alternative methods for older people who find it difficult to provide feedback. For example, tools such as the University of Bradford's Dementia care mapping can be used, and/or feedback from people who are considered suitable to represent the views of the older person such as family members, carers, or an advocate.