PRIVACY AND DIGNITY IN HEALTHCARE

This course, developed to meet the relevant standards within the

Care Certificate Framework, is issued as a stand-alone version for
those wishing to understand the key knowledge elements within
Privacy and Dignity.
Online training programmes of this kind support employers and
managers to confidently release key information to colleagues when
seeking to ensure they have "the required values, behaviours,
competences and skills to provide high quality, compassionate care".
The areas that will be covered in the course include:
 Understand the principles that underpin privacy and dignity in
care
 Maintaining the privacy and dignity of those in your care
 Supporting an individual's right to make choices
 Supporting an individual's right to make choices about their
care
 Understanding how to support active participation
 Supporting an individual in active participation in their own
care
Once you have completed the course and passed the multiple choice
exam at the end of the course, the completion certificate will be
released to the payee centrally and each is uniquely referenced by
Red Rock Training within this online system and can be tracked
accordingly using the unique reference number on each certificate.

1
The Principles of Privacy and Dignity
Person-centred approaches to care aim to provide care and support
that is centred or focused on the individual and their needs.
Ensuring that the individual’s privacy and dignity are respected and
maintained at all times is an essential aspect of being able to provide
care that is always person-centred.
Article 8 of the Human Rights Act (1998) gives each person the right
to respect for private and family life, home and correspondence.
Under Article 8, individuals being supported and cared for in Adult
Health and Social Care settings are entitled to have their human
rights met – especially with respect to privacy and dignity.
The 6C's
Compassion in Practice, the vision for nurses, midwives and care
staff couldn't be more relevant within this topic and the 6Cs are
referenced throughout the Care Certificate Framework. The 6Cs are
highlighted in the following points:
"Care - Care is our core business and that of our organisations and
the care we deliver helps the individual person and improves the
health of the whole community. Caring defines us and our work.
People receiving care expect it to be right for them consistently
throughout every stage of their life.
Compassion - Compassion is how care is given through
relationships based on empathy, respect and dignity. It can also be
described as intelligent kindness and is central to how people
perceive their care.
Competence - Competence means all those in caring roles must
have the ability to understand an individual’s health and social
needs. It is also about having the expertise, clinical and technical

2
knowledge to deliver effective care and treatments based on
research and evidence.
Communication - Communication is central to successful caring
relationships and to effective team working. Listening is as
important as what we say and do. It is essential for “no decision
about me without me”. Communication is the key to a good
workplace with benefits for those in our care and staff alike.
Courage - Courage enables us to do the right thing for the people we
care for, to speak up when we have concerns. It means we have the
personal strength and vision to innovate and to embrace new ways
of working.
Commitment - A commitment to our patients and populations is a
cornerstone of what we do. We need to build on our commitment to
improve the care and experience of our patients. We need to take
action to make this vision and strategy a reality for all and meet the
health and social care challenges ahead."
Source - NHS England
The Care Act 2014
The Care Act 2014 represents the most significant reform of social
care in more than 60 years as it puts the service user/individual and
carers in control of their care and support.
The main aim of the Health and Social Care Act 2008 was to create a
new regulator whose purpose was to provide registration and
inspection of health and adult social care services and ensure the
safety and quality of care. This led to the creation of the Care Quality
Commission (CQC) who had responsibility for regulating primary
care services including hospitals, GP practices, dental practices and
care homes.

3
The Health and Social Care Act 2012 made minor changes to the
2008 Act and forged the relationship between the CQC and Monitor
(the independent regulator of NHS foundation trusts). Since the
2008 Act was passed, updated legislation has been passed to give
greater clarity. For example, the Health and Social Care Act 2008
(Regulated Activities) Regulations 2010, concentrating on defining
the types of services which were to be regulated and the activities
being provided which must be registered.
The Care Act 2014 has since introduced a statutory framework for
safeguarding adults in England. This saw the introduction of the
Duty of Candour and Fundamental Standards by which all service
providers are now inspected against. It was fully implemented in
2015.
What is Privacy and Dignity?
In order to fully appreciate the importance of this topic within
healthcare setting, we should first understand the meaning of
privacy and dignity and be able to put this into context within our
working roles.
Individuals in health and social care settings deserve and have the
right to be respected, which means that privacy and dignity go hand-
in-hand with each other.
Privacy: Means to be able to have the right to have the time, space
and support to a private space; privacy when taking medication;
privacy when dressing/bathing/intimate care etc. Your role must
ensure that personal space is respected; privacy is maintained in
personal care; and that confidential information is not disclosed
without the consent of the individual to others.

4
Dignity: Means the feelings we have when we are respected and the
feelings of being valued and important at all times during our lives.
Preserving an individual’s dignity means that you will need to
consider their wishes, needs and preferences in all aspects of care
and involve them. It is important that dignity is not compromised by
making assumptions or guessing about the individual and their
needs.
Protected Characteristics
Similarly, respecting the individual as a person in their own right
and as a unique individual, helps to support them in terms of what
they believe and is important regardless of the person's:
 age
 culture
 disability
 gender
 beliefs
 marital status
 sexual orientation
The above are protected characteristics under the Equality Act 2010
and by adhering to this guidance, you will treat individuals fairly,
equally and without prejudice or discrimination.
Maintaining Privacy and Dignity
An individual’s privacy and dignity can be compromised in a
number of different situations. Some of these are simple to spot and
actions such as closing doors or using screens may help. Others are
more complex but often avoidable, especially if you take time to
think through your own or others actions.
5
The following headings look at different aspects of care and support
and offer suggestions as to how you can maintain privacy and
dignity of the individual:
 Giving personal care
 Entering private spaces
 Discussing confidential/personal information with others
We will look at each of these in turn over the coming pages
Giving Personal Care
Personal care involves a range of supportive situations which will
require you to consider the feelings of each individual and ensure
you respect them at all times. From bathing to feeding, assisting
with toileting or medication, it is important to maintain their
privacy and dignity.
Examples of best practice include:
Using screens, curtains or close doors or ensure they are in the
correct position before commencing the delivery of or giving
personal care.
 Attending to the clothing that the individual is wearing so that
they are not overly exposed unnecessarily.
 Positioning the individual carefully so that they are not
exposing themselves to others unnecessarily.
 Asking permission and explaining to the service user the
support you are to carry out before you start.
 Focussing on the individual throughout – e.g. avoid talking to
other members of staff or ignoring the individual.
6
  Encouraging the individual to be an active participant in their
care to maintain independence.
 Providing the individual with their right to choice (according to
the risk assessment and their level of capability).
Entering Private Spaces
Often we forget to enter personal or private spaces carefully,
especially if distracted or are used to having easy and quick access
to an environment. It may be that personal care is being given or a
private conversation is taking place behind a closed door or
screened area. Avoid making the assumption that you can simply
walk into a room or private space to complete your tasks or
responsibilities.
Examples of best practice include:
 Knocking before entering private spaces or when entering an
area where an individual is being supported with personal care
by another member of staff.
 Gaining permission to enter a private/personal space from the
individual before entering.
 Respecting Do-Not-Disturb or Engaged signs.
 Using door knockers where provided on internal and external
doors.
 Reminding others including staff, to respect private spaces.
 Following your organisations code of practice in relation to
privacy and space.
 Considering privacy and dignity when monitoring an
individual.
7
Discussing Confidential or Personal Information with Others
Some information about an individual and their care may be
confidential which means that you should not discuss it or disclose it
to someone who is not in a position to receive it. At times, this may
also mean not disclosing confidential information to relatives and
friends of an individual.
However, other information such as personal information or details
about an individual’s care may be frequently discussed with others
but it is important to always maintain privacy and not disclose this
in public areas, staff rooms or other areas such as corridors, as this
still compromises the individual’s right to privacy, dignity and
respect.
Confidentiality policies may be in place in your organisation for all
support workers, carers, domestic staff, nurses and managers to
offer clear guidelines associated with sharing information.
Best Practice
Confidential information which must not be disclosed unless the
individual gives permission to do so may include details about their:
 Health
 sexual orientation
 personal and current history
 social circumstances
 financial information
 care plans and medications
You may find that there are many more confidential topics in your
workplace, so if you are unsure, check with colleagues.

8
Examples of best practice associated with confidentiality and
dealing with a person's personal information include:
 Discussing an individual with authorised others in a private
space.
 Ensuring only those people who have authority can access
confidential information such as care plans, personal records
or records of meetings etc.
 Avoiding discussing an individual with authorised others in
areas where you may be overheard.
 Checking with the individual or their care plan as to what
information may be disclosed to relatives and/or close friends.
 Using appropriate levels of volume when discussing
information and care with authorised others in passing or in
private.
Supporting Individual Choice
It is important as a health and social care worker to be able to
support a service user's right to make their own choices.
The service user may be faced with many choices, some of which
may be difficult for them to understand or to be able to make the
right choice as what to do.
Service users may wish to make certain choices as to how they are
cared for or how they wish to live. You will need to ensure that they
are fully aware of all the choices available to them but also the
implications and possible consequences of certain choices.

9
It is also important to consider and understand whether the service
user has the capacity to make an informed choice under the Mental
Capacity Act 2005.
Approaches to Supporting Choice
There are many different approaches which you can use to support
a service user to make an informed choice:
 you can communicate the various choices available to a service
user and also outline potential consequences all possible
outcomes of choices made
 you can discuss with the service user their preferences, needs
and wishes in relation to a choice that they may be required to
make
 you can ask that others such as friends, family, colleagues, etc
offer input into choices which could be made by a service user
 you can provide advice and guidance on choice in the form of
written materials such as leaflets or other resources.
It is important that you are able to provide support to a service user
in making choices such as providing relevant information and
communicating this with them. If you are unsure as to how to
support them in making a choice, you could seek support by gaining
advice from family and friends or by using an advocate or support
service.
Risks and Risk Assessment
Risk-taking can be a part of the service user's right to make choices
as long as the risk assessment process is used to support their care.
There are different uses of risk assessment in adult social care
settings. These include

10
visual checks - checking areas and locations for hazards and risks
checking the suitability of activities for service users and ensuring
that they are aware of the risks and potential consequences of
certain actions
in assessing the capabilities of service users with others such as a
colleague, supervisor or line manager.
You will also use the risk assessment process to assess the capability
of a service user.
The role of risk assessment therefore in enabling a person centred
approach to care will be one that safeguards the service user and
others.
Risk assessment needs to take place in accordance with an
individual person's rights and responsibilities.
For example:
If the service user wishes to move to an independent flat, then that
is their choice. However, their right to this choice must be agreed by
using the risk assessment process. Certain questions must be asked
in order to determine their capability for living alone. Can the
service user live independently? Can they manage? What risks do
they face? What is the level of impact of that risk?
A service user does have rights, but it is the responsibility of the care
service provider and care worker to ensure the service user’s safety
at all times.
Risks and Person Centred Care
Risk taking is also an important part of the person centred approach
to care. Risk-taking means being aware of all the potential hazards
associated with an activity or choice, but still making the choice to
carry on with that activity or choice.
11
Risk assessments need to be regularly revised and reviewed in
order to incorporate any changes or developments which may have
occurred since the last risk assessment took place.
It is important to use agreed risk assessment processes in order to
support service user's choices as these are the foundations on which
legislation relating to care are established. The risk assessment
process is an important one as it ensures the safety of individuals
but also demonstrates that the responsibilities of the social care
worker have been taken seriously and are fully understood.
Personal Influence
It can be easy to allow your own personal views and opinions to
creep into your working life, however as a healthcare worker, your
personal views should NOT influence a person’s choices, especially
someone who may be more vulnerable than yourself. Instead,
service users should be encouraged to make their own choices
(without being influenced by others in order to make what might be
considered the 'right choices').
The possible consequences of allowing your own personal views (or
those of others) to influence a person's choices could be numerous
and may result in the person:
 making choices which make them unhappy
 making choices under duress (which they would not normally
make)
 making choices which affect their life in negative ways
 making the wrong choice
Freedom of choice that supports people to make their own decisions
(for example about the future and their support), is important, but
to do that, the person should have the relevant information and have
12
been assessed as having the capacity to make an informed choice. It
is part of your duty of care to enable individuals to make their own
choices. You should also ensure that they are supported to
participate in their own care, and your personal views should NOT
have an impact on a this aspect of the support you provide either.
We will look at Active Participation a little later in this module
though.
Supporting an Individual to Question or Change Decisions
Sometimes, service users will have choices presented to them which
have been made by others. Examples of these may include
medication or treatment choices, lifestyle choices and relationship
choices. Although they may have been made in the best interests of
the service user, occasionally you may find that these choices are
wrong or have been forced upon them.
You can support the service user in questioning or challenging
decisions concerning them that have been made by others by:
 listening to the concerns of the service user
 discussing with them options and choices available to them
 encourage them to question or challenge decisions with
appropriate others
 assist the service user in asking for a second opinion where
appropriate
 speaking to or referring the service user to a senior member of
staff
 supporting the service user to use complaints procedures if
making a formal complaint about their care
 working with the service user and an advocate in order to
challenge and question choices made on their behalf.
13
The Involvement of Others
Other people who may be involved with service users and the
choices they make can include:
 Colleagues
 Social Workers
 Occupational Therapist
 GPs
 Speech and Language Therapist
 Physiotherapist
 Psychiatrist
 Advocate
 Dementia Care Adviser
 Family or carers.
Where you have any concerns associated with an individual that you
work with, support or care for concerning choices or decisions being
made, this should be brought to the attention of the appropriate
person immediately. This could be any of the above or a
supervisor/senior member of staff in your work place. You should
also make sure that the appropriate records/documentation are
kept associated with the concerns.

14
Supporting Active Participation
When a person is actively participating they are taking part in
everyday activities but also in the planning of their own care. Active
participation is a way of working that recognises a service user's
right to participate in the activities and relationships we find in
everyday life, as independently as possible. Examples of activities
and relationships would include social activities, physical activities,
employment activities and mental activities.
Active participation in a social care setting would mean that the
service user is regarded as an active partner in their own care or
support. This would mean that the service user would not be
regarded as a passive recipient, but can make choices in relation to
their care.
Examples of Active Participation
Example 1:
A service user in a social care setting is provided with daily bathing.
Although the service user has a physical disability, the care worker
understands that they prefer to bathe themselves intimately
whenever possible. At this point the care worker leaves the room
and waits outside in order to respect the service user's privacy and
dignity
Example 2:
A service user in a social care setting enjoys taking part in social
activities which are held on a daily basis. This enjoyment is recorded
on their care plan and it is also noted that the service user likes to be
as independent as possible whilst taking part in these activities

15
Encouraging Active Participation
You can address the holistic needs of a service user by encouraging
them to actively participate and support them in active
participation.
You could:
 support service users in taking part in activities and the
planning of their care by assisting them when requested
 encourage service users to try to be as independent as possible
by not assuming control
 develop other supportive strategies to engage service users in
active participation.
Making Choices
It is important to agree with service users and others as to how
active participation will be implemented. Although the benefits of
active participation are numerous, not all service users will wish to
participate in particular activities. This may be due to their being too
shy, scared, unhappy or concerned. There may also be other
underlying issues such as ill-health, lack of energy etc.
Other barriers to active participation may include:
 a lack of opportunity to take part in activities or in the planning
of their care
 a lack of staff available to support with active participation
 a lack of confidence in being able to actively participate.
You can work with the service user and others in agreeing how
active participation can be implemented and making informed
choices about their lives by:

16
  discussing and encouraging active participation
 providing useful information which can be reviewed by the
service user and others
 supporting friends and family with encouraging the service
user to actively participate
 Highlighting the benefits of activities in which service users
can take part in
 Highlighting the benefits of actively participating in the
planning of care.
Other Ways You Might Support Active Participation
You can promote the understanding and use of active participation
by working with service users and others closely and
communicating the benefits clearly. Although this may take some
time, it is important to recognise that communication is a valuable
mechanism for support.
Service users and others will also see these benefits once actually
participating in activities and planning. It is essential to remember
never to force a service user to actively participate, but to encourage
them and enable them to see that they can work as independently as
possible even in a small way.
Within your local area there will be a number of social and
community networks who can support active participation for a
service user, with other means also being available through the use
of assistive technology or adaptive technology. This could include
mobility and disability living aids which help a person to better
access opportunities available to them.
Knowledge Point
Important Point to Remember!
17
Service users who take part in social activities can benefit in so
many different ways, so make sure you are aware of these and how
you can support the choices being made.
Enabling Individuals to Develop Skills in Self Care
Supporting a person to develop skills in self-care will help them to
take control over aspects of their lives and also help them (and
those who provide support to them) to ensure they have the best
opportunity to maintain and enhance their own feeling of well-being
and sense of independence. The process will also include helping
them to understand the importance of managing any risks that
might surround aspects of their daily living.
A service user can develop skills in self-care by being encouraged to
take responsibility for their own health and well-being. You will
need to work in partnership with the service user and others
involved in their care by communicating, negotiating and
contributing to decisions which are person centred. This ensures
that the best possible outcomes for the service user are maximized.
Skills for Care and Skills for Health in partnership with the
Department of Health, have created a working document which you
can use in order to help support service users in developing and
maintaining skills in self-care and their own social and community
networks. The document is called the Common Core Principles to
Support Care and there are seven principles which should be
followed.

18
The 7 Principles Explained
 Principle one: Ensure individuals are able to make informed
choices to manage the self-care needs.
 Principle two: Communicate effectively to enable individuals
to assess their needs and develop and gain confidence in self-
care.
 Principle three: Support and enable individuals to access
appropriate information to manage their self-care needs.
 Principle four: Support and enable individuals to develop
skills in self-care.
 Principle five: Support and enable individuals to use
technology to support self-care.
 Principle six: Advise individuals how to access support
network and participate in the planning, development and
evaluation of services.
 Principal seven: Support and enable risk management and
risk taking to maximise independence and choice.
For further information you can refer to the Department of Health at
the website www.dh.gov.uk
Reporting Concerns and Issues
This section refers to all concerns and issues you may have whilst
undertaking your role and carrying out your duties, tasks and
responsibilities but with particular reference to privacy and dignity.
If at any time, you become aware of a problem, issue or breach of
security in your workplace, you will need to report it to the relevant
person. This is also a responsibility you have in your Duty of
Care and is an expected, professional standard.
19
The people you may provide information to including discussing or
reporting concerns include:
 Senior members of staff
 Carer
 Relative or friend
Reporting to Senior Members of Staff
Where a situation arises as a result of the actions of a colleague;
other staff member; medical professional; other external
body/person/organisation – you should immediately report the
issue directly to a senior member of staff. By avoiding doing so or
delaying the report, you may compromise the health and well-being
of an individual, your organisation or even yourself/colleagues.
The following is an example:
Your organisation uses the services of a laundry company. Each day,
the same driver who is well known to everyone collects soiled linen
and delivers new. However, the driver has unauthorised access one
day to the social care environment and you find them in the room of
a service user. You report this immediately to your senior member
of staff who deals with the situation.
Reporting to a Carer, Relative or Friend
Sometimes it is necessary to report your concerns to people who are
close to or are caring for an individual. It is best practice to check the
care plan to understand what can and cannot be disclosed and
discussed beforehand. If you are still unsure, speak to a senior staff
member. Concerns you may wish to raise could be related to the
welfare of the individual; their health; social issues; or even their
personal effects and belongings.

20
The following are two examples for you to consider:
Example A:
Your colleague has been away on annual leave and you have been
assisting by working as a carer for a service user they normally
support. On their return to work, you inform them of the care plan
changes and report any issues or concerns you have had over the
time they have been away.
Example B:
A service user whom you are supporting who has a type of
dementia, becomes distressed frequently and paces up and down
the room in an agitated manner, often before visiting time. You
spend time with them and when their relative arrives you mention
your concerns to them as they may be able to assist and determine if
there is anything causing the individual to become upset.
Additional Considerations
Each individual has the human right to privacy and dignity. If you
always work to maintain these rights, you will be demonstrating
respect for the individual at all times. There are two additional
points which you could also consider to support you in your
professional practice are as follows:
 Never allow your own personal views to sway or influence the
decisions of an individual nor their relatives and friends as
these are your views and opinions.
 Support the individual with their rights to make informed
choices so that their privacy and dignity is not compromised.

21
  It is a part of your duty of care to ensure that you respect the
rights of the individual and their uniqueness so that you do not
make assumptions about their needs, preferences and wishes.
Knowledge Check
Now you have completed your review of the Care Certificate
Standard 7 covering Privacy and Dignity, let's take a moment to
check what you have remembered.
There might be some additional evidence you may need to gather in
terms of assessment evidence or simulation, so you should make
sure you have completed this too (where/if required).
This section review is designed to check your understanding of
important points within this Standard and you must answer all
questions before moving on.
You also need to be aware that although these questions allow you
to practice for the questions that come later, when you do the final
exam, you MUST get all of these questions right to pass!

22