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GO Online: Inspection toolkit

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Independence, choice and control

People have a right to their independence and choice and control over the care that they receive. The CQC wants to see evidence regarding how you support them on these matters and that you don’t restrict peoples’ personal preferences.

The following film provides a summary of this area of inspection. It can help you and your teams learn about what will be inspected and what is important to demonstrate to deliver good or outstanding care.

Introducing Independence, choice and control

Duration 02 min 08 sec

Supporting people to have choice and control over their own lives is central to this area of CQC inspection. Your service will need to be able to demonstrate how you enable this to happen, as well as how you support people’s independence.

There should be documented evidence of how you have supported people to make decisions about their living arrangements, their home environment, and the care and treatment they receive. However, much of the focus is likely to be around their independence and social connections.

For many people, the ability to maintain close links with their community will be important to them, so the CQC will want to look at how your service enables that to happen. This will be less about providing one-off activities, and more about the regular ways in which you enable people to retain their independence and meets their social needs.

The CQC may look at how you are using technology and adaptive equipment to support their independence and help people stay connected with those important to them.

During the inspection, the CQC may want to interview people about their experiences and how the service supports them to manage their choice, control, and independence. Managers and staff should be ready to share examples of what has been achieved.

Staff training records, policies and procedures and evidence of various activities and social engagements in the community may be looked at as evidence.

For residential services, the inspection will also look at how you support visiting rights and enable people to keep in close, regular contact with those important to them.

To help you to meet these areas of CQC inspection, GO Online includes related resources, practical examples and recommendations.

Watch the film here: https://vimeo.com/787631275

Practical examples

The examples below provide insight into how other Good or Outstanding rated services are succeeding in this area of inspection. Use the filter to choose different types of examples or select based on related prompt.

If you have an example you would like to share, please e-mail employer.engagement@skillsforcare.org.uk.

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18 example(s) found

Involving people in the running of the home

People were involved in the running elements of the service. One person was responsible for growing and maintaining indoor plants and planned to grow vegetables outside in the new year. The chef planned to use any suitable vegetables for people's meals.

During they inspection, the CQC saw people helping to prepare tables for dinner. Another person had helped the management team complete the 'first impressions' environment audits. This had made them feel more involved with running their home, and afforded managers the opportunity to see a different perspective on the service and the environment.

Read more about this service here.

Care provider: Eglantine Villa

  • Case study

Date published: February 2023


Widening social circles and leisure activities in homecare

Staff routinely sought leisure activities and widening of social circles, they discussed how they kept alert to events that the person/people they supported may enjoy.

Staff were focussed on the benefits of people's involvement in their communities and in activities that brought them joy. They had a solution focussed approach, considering potential challenges and triggers, to ensure people had the best chance of success.

Read more about this service here.

Care provider: Dimensions Dorset West

  • Case study

Date published: January 2023


Tailoring a garden to individual needs

The provider had award schemes in place, to encourage staff and people to be actively involved in the service. For example, Hepworth House had recently won a gardens in bloom award. People had been involved in creating a sensory garden and a fairy garden which were also lit up at night so people could see them. This was a lovely space for them to spend time in that they had helped create.

Diversity was celebrated by the service, some people were provided with raised flower beds to enable them to join in the activity and people living with dementia were provided with a sensory flower bed, such as mixed herbs, colours and windmill sounds. People felt the service was their home. 

Read more about this service here.

Care provider: Hepworth House

  • Case study

Date published: November 2022


Connecting people and reducing the risk of loneliness

The management team concentrated their efforts on reducing the risk of loneliness amongst the people they supported.

The provider recognised this and therefore, now hold monthly social events in a building in the community to provide this opportunity and social interaction. This has proved to be a huge success with immeasurable benefits for people. Now people who may live around the corner from each other and had never had chance to meet or know about each other can do so.

Read more about this service here.

Care provider: Westmorland Homecare

  • Case study

Date published: September 2022


Safe Places scheme

In this blog, we hear how funding from Stockport Council, helped Future Directions CIC to launch a Safe Places scheme across Stockport Borough, to help keep local community safe.

Read more about this service here.

Care provider: Future Directions CIC

  • Case study

Date published: August 2022


Supporting people with a learning disability to use technology and stay connected

In this Blog, Jane Seale of the Open University conducted research examining how people with a learning disability were being supported to use technologies to keep connected during the pandemic.

Care provider: Open University

  • Case study

Date published: May 2022


How people and relatives visits contribute to the home

Our relatives develop our policies and procedures with us where required e.g. visitors policy and we have regular open and honest meetings with staff, residents and relatives where people can speak freely cementing our open door policy. We have relatives who take part in quality assurance ‘walk arounds’ at the home and residents’ feedback back to the managers on a regular basis about what they want from their home.

One gentleman wanted to design his own bedroom so we arranged someone to come in and they worked together on the plan, ordering the furniture and arranging the room when it arrived. Our relatives meeting during COVID have been virtual on a regular basis, Healthwatch attend most meetings and if we need someone to talk about a particular subject we endeavour to get a specialist along which has included a pharmacist, financial expert and we are now looking to have the new Care Home Matron attend the meetings to explain their role within the home.

Read more about this service here.

Care provider: Valerie Manor

  • Case study

Date published: November 2021


How staff support people to maintain community connections and life outside of the home

The relationship between staff and the person receiving care was considered as important as the physical care provided. Staff were encouraged and supported to spend time getting to know people and develop meaningful relationships which transcended the actual service.

For example, a member of the administration team had built a close relationship with a person who lived at the service and the person had spent Boxing Day at their home. Another person and member of staff discovered a mutual connection with a local pub. A visit was arranged to the pub which has now become a regular outing.

The registered manager stated: "The pub is well known to many people to be a massive social engagement opportunity. It fulfils residents' social needs and helps them to feel they’re still very much part of a community, despite living in a care home, thus losing the stigma that living in a care home may bring."

Read more about the service here.

Care provider: Davers Court - Care UK Community Partnerships Ltd

  • Case study

Date published: March 2020


Co-designing a digital app to help people with learning disabilities connect with each other

A group of people with disabilities from Gloucestershire noticed the growing use of tablets and smartphones amongst their peers, but many felt anxious about using social networking sites due to complexity and perceived risks associated with sharing personal information.

Keen to explore how digital technology could enhance the lives of disabled people, CVT commissioned Made Open to help co-design a digital app that would allow people to stay informed, share ideas and develop digital skills in a safe environment.

The app, CVT Connect, encourages people to network digitally but with additional safeguards of local administrators. The co-production approach to developing the app has helped people further develop digital skills, and they are now able to influence the direction of their community and the charity through the use of digital media.

Click here to read the rest of this case study.

Read more about the service here.

Care provider: Camphill Village Trust

  • Case study

Date published: December 2018


Helping people make choices about their health

Staff supported one person to conserve their energy to ensure they could access the things they want and need to. They took the person’s bloods before appointments, thus reducing the time they needed to spend at the hospital. This meant the person was able to conserve their energy and be able to take part in activities they enjoyed on their return from hospital.

Care provider: Anonymous

  • Case study

Date published: April 2018


Enabling people with complex needs to make choices around food

One person living with a visual impairment and learning difficulties was unable to verbally communicate. In order to best support the person's communication, staff learned their individual signs and supported these with smells and taste. For example, if the person signed that they would like a drink, staff then gave them the options by enabling them to taste and smell them. They also did this using taster pots prior to supporting them with meals, to support them to choose.

Care provider: Anonymous

  • Case study

Date published: April 2018


Encouraging independence around meals

The registered manager organised for a mobile fish and chip van to park outside the home for people who said they enjoyed fish and chips. They were able to go out independently and place their own orders.

Care provider: Anonymous

  • Case study

Date published: April 2018


Adapting environments to promote independence for people with dementia

A service providing dementia care adapted the premises to help promote independence. This involved developing clear dementia-friendly pictorial signage to communal areas and bathroom facilities. There were points of interest around the service and ‘landmarks’ to help support people to navigate their way around, both inside and outside.The environment had a variety of sensory objects available for people to engage with, such as soft cuddly toys, dolls and prams, a wealth of items of memorabilia from different eras and musical instruments. There were also points of interest that contained objects people could easily recognise and relate to.

Care provider: Anonymous

  • Case study

Date published: April 2018


Encouraging independence through design

The service had designed each corridor with a colour theme and all toilet doors were painted bright blue which helped people to orientate themselves and maintain their independence.

Care provider: Anonymous

  • Case study

Date published: April 2018


Building people’s confidence in the use of technology

The homecare agency was actively promoting using mobile phones, tablet computers and the use of text messaging and email. To help raise awareness and confidence amongst the people who needed care and support, they found a local mobile telephone store which provided a room and equipment for free lessons to older adults for ‘discovering’ technology. Staff would accompany people to these sessions to help build their confidence in communication methods they weren’t previously using.

Care provider: Anonymous

  • Case study

Date published: April 2018


Supporting people to prepare meals

People who use the service had the opportunity to access the kitchen and were supported in helping to prepare meals and cook for others.

Care provider: Anonymous

  • Case study

Date published: April 2018


Engaging people with dementia in activities

Spare Tyre, a participatory arts charity which works with marginalised groups, aimed to develop a new activity workshop for care home residents with late-stage dementia and link this to a training activity for staff. The key objective was to provide a multisensory activity for residents, thereby improving the care delivered to this group, who often have few opportunities like this.

By involving staff in the delivery of the activity, Spare Tyre aimed to ensure that they can continue to put the new ideas/methods into practice at the end of the programme. Findings from this activity showed that it engaged residents effectively, with most able to actively take part, and with many of the 80 taking part normally being quite isolated due to their condition, not regularly taking part in activities. For the 76 staff that took part, the main benefit reported was that it engaged them in training which could easily be adapted into practice.

Click here to read the full case study.

Care provider: Various

  • Case study

Date published: December 2014


Consenting to changes to environment

People were actively encouraged to make decisions about their lives and staff were innovative in the way they approached people to make decisions. For example, to help a person improve the environment they lived in, the staff shared pictures of objects and different room designs for them to express their likes and dislikes. The person's wellbeing was enhanced as their environment was improved.

Read more about the service here.

Care provider: Consensus Community Support Limited

  • Case study



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