The importance of culturally appropriate care in home care

What is culturally appropriate care?

According to CQC guidance published in May 2021, culturally appropriate care (also called ‘culturally competent care’) describes care that is sensitive to people’s cultural identity or heritage. It means being alert and responsive to beliefs or conventions that might be determined by cultural heritage.

Cultural identity or heritage can cover a range of things. For example, it might be based on ethnicity, nationality or religion. Or it might be to do with the person’s sexuality or gender identity. Lesbian, gay, bisexual and transgender people have a particular culture. So do Deaf people who use British Sign Language.

Another term for this topic is culturally competent care.

How culturally appropriate care is relevant to the CQC’s regulations

The regulations culturally appropriate care is relevant to are:

The expectations relating to culturally competent care can also be linked to the CQC’s key lines of enquiry:

Safe:

  • Recording and acting on cultural considerations about medicines.
  • Protecting people from discrimination and harassment over characteristics protected by the Equality Act.

Effective:

  • The service takes cultural, ethical and religious needs into account when planning meals and drinks
  • Cultural needs are reflected in how premises are decorated.
  • If someone lacks capacity for a particular decision, the service takes their cultural preferences into account when applying the Mental Capacity Act – for example, by consulting people that know them.

Caring:

  • Staff give help and support in culturally sensitive ways and recognise when people’s preferences are not being taken on board, or properly respected.
  • Knowing and respecting people, and showing them compassion.
  • Making visitors feel welcome.

Responsive:

  • People, their families and carers are involved in developing their care plans. This includes identifying people’s needs on the grounds of equality characteristics and their choices and preferences and looking at how these needs are met. The plans are met and are regularly reviewed.
  • Staff have the right learning and development to help them understand and meet these needs.
  • Helping people take part in activities that are culturally relevant to them.
  • In end-of-life care, people feel their needs relating to equality characteristics have been considered as part of the planning process. People’s religious beliefs and preferences are respected.

Well-led:

  • The service has a positive culture that is person-centred, open, inclusive and empowering.
  • Leaders, managers and staff have a good understanding of equality, diversity and human rights.
  • Leaders, managers and staff encourage people to express views and concerns. They listen and act on them to help shape the service and culture.
  • The service promotes equality and diversity.
  • The service looks into any instances of workforce inequality and takes action. Staff feel they are treated equally. The service makes sure it hears the voices of all staff and acts on them to help shape the service and culture.

Culturally sensitive care contributes to the delivery of good person-centred care, which encourages individualised care that is specific to each client’s circumstances. Everyone is part of a culture. People need their culture to be recognised and their cultural needs met to feel happy and comfortable.

Why culturally appropriate adult social care is more important during the coronavirus (COVID-19) pandemic

People using services may:

  • have less contact with people that understand and affirm their culture – for example, family and friends
  • have no opportunity for contact with their culture or community outside their home
  • spend more time with people who do not share their culture – for example in a care home

experience more life events that have cultural significance – for example, they may be at the end of their life or lose someone close to them

Why is culturally appropriate care important in home care?

  • Allow individual clients to retain some of their independence and fulfil their personal preferences and expressed wants and needs.
  • Maintain a client’s sense of self and personal value, which can give them the best opportunity to lead the life that they want.
  • Positively impact physical and mental health outcomes.
  • Encourage greater engagement with other service providers and the client’s family.

How to provide culturally appropriate care

Often, only small changes are needed to make a big difference to people. The most important things to do are:

  • ask people questions – or ask their representatives – especially if you are unsure
  • try to understand and meet people’s preferences
  • be curious about what the important things are to help people live their fullest lives

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What can care workers do to provide culturally sensitive care?

  • Everyone’s cultural needs should part of their care planning and review, under the relevant sections of the care plan.
  • Cultural needs vary. They’re not just based on ethnicity and religion. They’re also based on things like age, sex, sexual orientation (for example lesbian, gay and bisexual people), gender identity (for example transgender people), disability, neurodiversity, region in the UK, family and employment history.
  • The way people identify with their culture can also change through time. For example, people with dementia may identify more strongly with the culture in their earlier years as they get older.
  • Don’t make assumptions about people’s needs based on generalisations about cultures.
  • Good communication with people and their families is vital to meeting cultural needs.

What can care managers and registered managers do to ensure culturally competent care?

  • Building your staff’s confidence in person-centred care will help them deliver culturally appropriate care.
  • Everyone’s cultural needs should be part of their care planning and review.
  • Good communication with people and their families is vital to meeting cultural needs.
  • It’s important to respect people, treat them with dignity and respect their privacy.
  • It’s good to ask open questions in residents’ meetings to find out whether cultural needs are being met.
  • Staff from minority groups – such as black and minority ethnic staff or lesbian, gay, bisexual or transgender staff – may also face discrimination from some people using the service. Good staff engagement and support are important to solve these issues.
  • If you have a diverse staff team, use the cultural knowledge and skills of your team in a positive way – but this should be a choice, not an assumption.

How can technology help in the delivery of culturally appropriate care?

Consistency is important to care. As software providers, it is our job to provide simple software solutions that unconsciously augment behaviours to help improve the delivery of care and help providers meet the latest CQC guidance. Here’s what we are doing at Unique IQ to help:

  • Digital staff and client records – have a clear and detailed view of all staff and clients’ cultural, linguistic and religious backgrounds (with consent).
  • Carer matching – use the information drawn from digital records to match the right carer with the right client, including language and personal background
  • Client family portal – Allow families to contribute, comment on and engage with a care plan. Allow families to review notes, provide feedback, check documents, and upload useful resources like photographs and digital mementoes that may help carers deliver enhanced care. 
  • Training records – keep ahead of expiring qualifications and identify what other training is required at the touch of a button.
  • Training integrations – integrations with training providers like My Learning Cloud, allow care managers to create bespoke training plans within our software.
  • Setting ‘tasks’ – to act as reminders for culturally-appropriate events or practices as outlined in the care plan

Our society is undeniably diverse in which people with very different ways of life coexist. People from all backgrounds, cultures and ethnicities may require care at some stage or another and everyone has the right to the fundamental standards of care. Culturally appropriate care is a huge part of the care equation, and for providers looking to exceed expectations, it must be carefully considered.

Want to know more about technology and the CQC? Read our comprehensive blog series.