The CQC in England has introduced a transformative approach to its single assessment inspection framework through the integration of 'we' and 'I' statements, marking a significant shift towards more personalised and accountable care.
Here, we’ll explain what 'we' and 'I' statements are, how you can use them in your care home’s documentation and practices, and give examples of what they look like in action.
The evolution of care assessments: embracing 'we' and 'I' statements
The CQC's new single assessment framework has incorporated 'we' and 'I' statements as a core element of its evaluation process.
This development is designed to foster environments where dignity, respect, and compassion are paramount, emphasising the collective and individual commitments to excellence in care.
While the specific adoption of 'we' and 'I' statements is a unique aspect of the CQC's approach in England, the underlying principles of enhancing person-centred care, accountability, and compassion resonate across the regulatory landscape of the UK.
Each other regulatory body (CI, CIW and RQIA), within its jurisdiction, is exploring and implementing strategies to uplift care standards, though the mechanisms and frameworks may vary.
Why the focus on 'we' and 'I' statements?
The introduction of 'we' and 'I' statements by the CQC is a response to the evolving landscape of care, which calls for a more nuanced, reflective approach to assessing and delivering care services.
These statements have two functions:
- 'We' statements: Highlight the collective efforts of care home teams, fostering a culture of unity, mutual respect, and shared responsibility in delivering high-quality care.
- 'I' statements: Emphasise the role of individual staff members in upholding and embodying the values and standards of care, spotlighting personal accountability and the impact of individual actions on the overall care environment.
How and when will these statements be used?
The CQC will use 'we' and 'I' statements as part of its assessment process under the new single assessment framework.
These statements are expected to be integrated into the care home's documentation, training materials, and daily practices.
Inspectors will seek evidence that these statements are not just written commitments but are actively reflected in the care environment, interactions with residents, and the overall approach to care delivery.
During inspections, evidence of 'we' and 'I' statements in action will be key indicators of a care home's alignment with the CQC's standards for compassionate, person-centred care.
Care homes are encouraged to start incorporating these statements into their operational and cultural fabric ahead of inspections, ensuring that they are deeply ingrained in the ethos of the home
Examples of 'we' and 'I' statements
Here are some examples of “we statements” and “I statements” set out by the CQC, and how they can be applied in real life:
1. Learning culture (Safe KLOE)
- We statement: We have a proactive and positive culture of safety based on openness and honesty, in which concerns about safety are listened to, safety events are investigated and reported thoroughly, and lessons are learned to continually identify and embed good practices.
How to apply at your care home:
- Hold regular safety training sessions for staff, encouraging them to share insights and experiences openly.
- Establish a transparent incident reporting system that is non-punitive, where staff and residents can report safety concerns without fear of retribution.
- Hold monthly meetings to review incidents, discuss the outcomes of investigations and share lessons learned to prevent future occurrences.
- I statement: I feel safe and valued here. The team listens to my concerns, investigates any issues thoroughly, and learns from them. It's comforting to know my voice contributes to a culture where safety and dignity come first.
How to apply at your care home:
- Create a feedback loop where residents and their families can express safety concerns directly to management through suggestion boxes (online or in your home) or regular, informal catch-ups.
- Highlight stories in newsletters or meetings where feedback has led to positive changes, reinforcing the value of every individual's voice in maintaining a safe environment.
2. Monitoring and improving outcomes (Effective KLOE)
- We statement: We routinely monitor people’s care and treatment to continuously improve it. We ensure that outcomes are positive and consistent and that they meet both clinical expectations and the expectations of the people themselves.
How to apply at your care home:
- Implement comprehensive care plan reviews that involve multidisciplinary teams, including healthcare professionals, caregivers, and, where appropriate, residents themselves.
- Use a digital tracking system to monitor the progress of each resident's care plan, making adjustments based on new data or feedback to ensure continuous improvement.
- I statement: I see how my care is regularly reviewed and improved upon. It reassures me that the team is committed to not just meeting my clinical needs but also exceeding my personal expectations. They make sure I'm part of every decision, which makes me feel truly cared for.
How to apply at your care home:
- Have regular one-on-one meetings between residents and their primary caregivers to discuss the progress of their care, any new concerns and adjustments to care plans.
- Regularly update residents and their families on how their care is evolving to meet their needs and preferences better.
3. Independence, choice, and control (Caring KLOE)
- We statement: We promote people’s independence, so they know their rights and have choice and control over their own care, treatment, and wellbeing.
How to apply at your care home:
- Offer a variety of daily activities that cater to different interests and abilities, allowing residents to choose how they spend their day.
- Train staff on the importance of promoting independence, ensuring they provide support that empowers residents rather than doing things for them whenever possible.
- I statement: I feel empowered here, fully aware of my rights, and actively involved in making decisions about my care and wellbeing. It's liberating to have such control and choice, affirming my independence every day.
How to apply at your care home:
- Personalise care plans to include residents' preferences for daily routines, from waking times to meal choices and activities.
- Regularly consult with residents to make sure their wishes are reflected in their care and living conditions, making adjustments as their preferences evolve.
4. Person-centred care (Responsive KLOE)
- We statement: We make sure people are at the centre of their care and treatment choices and we decide, in partnership with them, how to respond to any relevant changes in their needs.
How to apply at your care home:
- Build a partnership approach to care planning, involving residents, their families and healthcare professionals in decision-making processes.
- Use care planning meetings to discuss and adapt to changes in residents' needs, making sure these plans are living documents that evolve as the residents do.
- I statement: I feel truly seen and heard, with my needs and preferences taking centre stage in my care plan. The team and I work together to adapt to any changes, ensuring my care is always tailored to me. It's comforting to know I'm supported by people who treat me as a whole person, not 'just a resident'.
How to apply at your care home:
- Assign a key worker or advocate to each resident who acts as their main point of contact, ensuring that they feel seen and heard. This person would be responsible for regularly checking in with the resident, discussing any changes in their needs or preferences and advocating for these changes to be reflected in their care plan.
Embracing change together
This evolution in the regulatory approach, spearheaded by the CQC in England with its introduction of 'we' and 'I' statements, marks a pivotal moment in the journey towards more compassionate, person-centred care.
It's a step forward that not only aligns with the regulatory standards but also with the aspirations of care providers and recipients alike for a care system that dignifies every individual's journey.
As we navigate this transformative path, the focus remains steadfast on creating care environments that are not just compliant but also nurturing, respectful, and inclusive.
The journey towards integrating 'we' and 'I' statements into the very DNA of care practices is a profound commitment to this vision, promising a future where care is synonymous with dignity, collaboration, and a deep sense of belonging for all.
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You may also be interested in:
- 4 tips for managing internal assessments at your care home
- How to gather, present and store evidence for UK care regulators
