Terms of endearment

Andrea Sutcliffe, Chief Inspector of Adult Social Care at the Care Quality Commission.

Shock, horror headlines on Monday morning — CQC bans care home staff from calling residents “love”. Reaction ranged from:

“This complaint about names is absurd. You could argue that if residents were addressed formally, the atmosphere in the home would be cold and unwelcoming.”

“The use of the word ‘love’ is part of our heritage. There is no malice in it. I’m nearly 80 and I’m quite happy for people to call me ‘love’.”

“Come on, people in Yorkshire often say ‘love’, ‘darling’…I have come across ‘pet’ as well.”

But as ever, a closer look behind the headlines reveals a different picture.

Behind the headlines

The quote came from a report into the Brackenley Care Home which provides services for people with a learning disability which we rated Good for Safe, Effective and Well–led but Requires Improvement for Caring and Responsive.

We had a number of concerns about the lack of person-centred care in the home, for example, ‘rules’ that meant residents were supposed to stay in their rooms between 11pm and 8am. In this context, the comment about the language staff used was an indicator of the lack of respect observed, which included a shower room where the curtain rail was broken and people’s body shapes could be seen through the frosted glass.”

What’s in a name?

The important issue is that people are called what they want to be called. Some will really appreciate affectionate terms of endearment, others will not.

I’m perfectly happy with a variety of names — Yorkshire born and bred my Dad calls me; my mum and my sister all “darling”; my university nickname of Skippy is still used by some friends and family; and I like it when strangers say “have a nice day, love”. But I have always hated anyone shortening my name to Andy (no idea why) and very few people get away with abbreviating Sutcliffe to Sooty.

If it’s all about choice for me in my daily life, how much more important for people who may need to rely upon others for care and support? I was speaking to a domiciliary care manager yesterday who said she was really affected when a client told her that she never used to get undressed in front of her husband and how embarrassed she was about having to rely on others for intimate personal care. At times like this, being made to feel comfortable is essential and what people call you is an important part of that.

Dignity and respect

CQC’s interest is to make sure that services involve people in all aspects of their care, which includes how they wish to be addressed and that this is shared with staff who then respect their wishes. As Debbie Westhead, our Deputy Chief Inspector for the North said yesterday:

“There is absolutely nothing wrong about care home managers and staff using affectionate terms of endearment to address people in their care.

“We recognise and welcome this is part of the compassionate and person–centred care approach that we expect providers to deliver and that people simply deserve.

“But what is most important is that… individual wishes and preferences are always understood and responded to appropriately.”

Good providers do this and I was impressed with the response from the Chief Executive of the company running the service, Stephanie Kirkman Meikle, who was interviewed on Radio 5 Live (1 hour 48 minutes). She clearly highlighted the importance of asking people what they want to be called and making sure that happens.

Storm in a media tea cup?

In that same interview, Adrian Chiles wondered whether the media had made more of the story than there actually was. Respectfully, I think that was probably the case — our comments made for an easy, attention-grabbing headline but did not necessarily reflect the whole picture.

What was welcome though was the opportunity to discuss the importance of language in care, how we can make sure that people are treated with dignity and respect and what we all need to do to make that happen. It also gives me the opportunity to recommend the support and guidance available from the Social Care Institute for Excellence and Skills for Care on dignity and respect — all available on the Caring page of Care Improvement Works.


Originally published at www.cqc.org.uk.