What is dignity in care? A former care home manager's guide

Dignity in care, and in health and social care generally, means caring for someone in a way that protects their self-respect: respecting their privacy, using the name they prefer, asking before you do anything for them, and letting them make their own choices. In practice it's the small things on every shift: knocking before you go in, closing the curtains for personal care, covering people up, and never talking over someone. In England, Regulation 10 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 requires care homes to treat people with dignity and respect.

I was a registered manager for 15 years, running care homes. This guide is what dignity looked like in the homes I ran: how we taught it, how we protected it in personal care, what staff get wrong and why, and how I checked it was really happening. After that come choice and risk, what the regulations say, and a few questions people ask.

What does dignity mean in care?

To me, dignity is about protecting people's privacy. The people we care for are older and more frail, and they can't do these things for themselves anymore. So when it comes to showers, washing and bathing, we always taught staff to respect their privacy and dignity.

It's also in how you speak to someone. We never said "can you do this?" We'd always use their name and ask: "Hello, Mrs Smith, can we do this for you?" We respected their names, their wishes and their desires.

CQC's guidance on Regulation 10 says the same thing in its own words: people should be addressed in the way they prefer. For a lot of older residents that's Mr or Mrs and their surname. For others it's their first name or a nickname. Ask, and write it in the care plan, so every member of staff gets it right.

How we taught it: the buddying system

In the homes I ran, every new member of staff was buddied with a top carer, usually someone who'd been with us about a year or two. That carer would show them, from day one, "this is how we do things, and this is about dignity".

Buddying lasted up to about three days: two or three, depending on the person. And then that buddy is there for life. If the new member of staff ever wants to ask a question, they can go to their buddy, or straight to the manager. I've written more about how we chose buddies in our guide to person-centred values.

Dignity in personal care: washing, dressing, toileting and continence

This is where it matters most. What we always insisted on:

Close the door and close the curtains.
Knock before you go in.
Cover people up.
Ask before every step. "Can I do this? Can we turn you around? Can we put this on for you?"
Tell them what's happening. "Mrs Smith, I'm about to do this."
Give them options, and listen to them.

CQC's Regulation 10 guidance adds two points worth building into every care plan:

People must be supported to wash, bathe and use the toilet in privacy.
Their preferences about who gives them intimate care should be respected wherever reasonably possible, including whether they want a male or female carer.

Record both in the person's care plan, and check them at reviews.

What staff get wrong, and why it's not their fault

The main thing we found staff getting wrong was not using people's names. They'd talk over people, rush their words, and get on with the task.

We're not going to hide it: staff who've been in the job for many years can become desensitised. It's not their fault. They're working 12-hour shifts, and they might have been doing it for years.

So it's actually the management's responsibility. Keep their training up to date. Do one-to-one sessions with members of staff. Keep on top of it, because without that, people naturally slip.

Small things, big difference

Dignity isn't only about personal care. In our guide to person-centred values I've told the story of one resident who was very distressed when she first came to us.

The change came when staff swapped the TV noise for her own music and sat with her. She was a different person within about a month. Respecting what someone loves, and what they don't want around them, is part of their dignity too.

How I checked dignity was really happening

Checking it was really, really important. Members of the management team, including me, did spot checks.

Sometimes, at mealtimes in the dining room, I'd just take a seat and do nothing. No work. I wasn't talking to any member of staff or any resident. I'd just sit there, observe and make my notes. Then on another day I'd do it again, maybe on the Monday and then the Wednesday. Another time I'd sit in the back lounge on my phone, looking like I was ignoring everyone.

If staff see you there with a pen and paper, they think "he's spot-checking us, let's all be on our best behaviour". If you're there regularly and look busy, they get used to you, and you see what really happens.

I didn't tell staff on the day. I saved the notes. The following week, when the same team was back in, I'd sit them all down: "Right, I've been watching for the past week. This is what I found, and this is how we're going to improve it." Then we'd put an action plan in place.

That's for everyday practice: names, tone, rushing. If you ever see something unsafe, or something that could be abuse, don't wait for the meeting. Step in straight away and follow your safeguarding procedure.

This is watching in person, in shared areas like the dining room and lounge. It isn't recording: filming or audio-recording people counts as surveillance, and CQC has separate guidance on that. It's also fairer if staff know from induction that managers do unannounced observations, even if they don't know which day.

Inspectors work in a similar way. CQC sorts its evidence into six categories, and observation is one of them, alongside people's experience, feedback from staff and leaders, feedback from partners, processes and outcomes. So dignity has to show in what an inspector sees on the floor, not just in the care plan.

Choice: what to wear, and other everyday decisions

Getting dressed is one of the biggest everyday choices someone has left, so we never just picked clothes for people. We'd bring out their clothes and ask: "Is this nice? Is this okay? What colour do you like?" How we asked depended on the person's mental capacity. For some people, a simple choice of colour was the right way in.

In our homes we used a wardrobe designed for people living with dementia: one side open, one side a traditional closed cupboard. Once the person had chosen their clothes, we'd put them in the open side. So when the next member of staff came in the morning to help them wash and dress, the clothes they'd chosen were ready.

Choice and risk: the dignity of risk

Respecting someone's choices sometimes means accepting a risk. This is often called the "dignity of risk": the idea that people have the right to make choices that carry some risk, as everyone else does.

The law (England and Wales): the Mental Capacity Act 2005 says a person isn't to be treated as unable to make a decision merely because they make an unwise one.
CQC's Regulation 10 guidance: staff should respect people's wishes to act independently, while identifying and reducing risks, so they can stay independent as safely as possible.

In practice that means talking the risk through with the person, recording their choice and what you've done to make it safer, and reviewing it. A choice shouldn't be overruled just to make the shift easier. If you think the person may lack capacity for a specific decision, assess capacity for that decision and follow the Mental Capacity Act.

What the regulations say

In England, CQC regulates care homes. These are the main requirements (this is general information, not legal advice; Wales, Scotland and Northern Ireland have their own regulators and rules):

Regulation 10 (dignity and respect) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 says people must be treated with dignity and respect. It includes:
- ensuring their privacy;
- supporting their autonomy, independence and involvement in the community;
- having due regard to their protected characteristics under the Equality Act 2010.
CQC's guidance on Regulation 10 says privacy must be maintained at all times, including when people are asleep, unconscious or lack capacity. All reasonable efforts should be made so that conversations about someone's care can't be overheard.
CQC's quality statement "Kindness, compassion and dignity" (under Caring) expects people to be treated with kindness, empathy and compassion, with their privacy and dignity respected. Among the best-practice guidance CQC lists for it is the European Convention on Human Rights. CQC also lists the Human Rights Act 1998 as additional legislation. The Act gives effect in UK law to Article 8 of the Convention, the right to respect for private and family life. A care home is directly bound by it for residents whose care a council arranges or pays for (Care Act 2014, section 73); for every resident, Regulation 10 still requires their privacy to be respected.

The Dignity in Care campaign's "10 Dignity Do's" make a good checklist for staff meetings. In our own words, they cover:

never tolerating abuse of any kind;
seeing each person as the individual they are;
protecting people's privacy;
helping people stay as independent as they can, and in control of their own choices;
listening, and helping people say what they need;
working with families and carers as partners;
helping people feel less lonely and isolated.

How Kiwi handles this

Kiwi (our product) has a "Preferred name" field in each person's care plan. Its Personal care section includes fields for washing, bathing, dressing, toileting and continence products, plus the person's preferred gender of carers and their privacy preferences. For staff, Kiwi's HR records supervisions with a set list of questions, who carried them out and when the next one is due.

If you'd like to see how Kiwi records preferred names, privacy preferences and staff supervisions, book a demo.

Frequently asked

What is dignity in care?

Dignity in care means caring for someone in a way that protects their self-respect: respecting their privacy, addressing them the way they prefer, asking before doing anything for them, and supporting their choices and independence. In England, Regulation 10 requires care providers to treat people with dignity and respect, including ensuring their privacy and supporting their autonomy.

How do you promote dignity in a care home?

Knock before entering, close doors and curtains during personal care, cover people up, and ask before each step. Use the name the person prefers, give them choices, and never talk over them. Then keep it going: buddy new staff with a good carer, keep training up to date, hold regular one-to-ones, and observe practice on the floor, especially at mealtimes.

What is privacy and dignity in care?

Privacy is a key part of dignity. It means people can wash, bathe, use the toilet and have private conversations without being seen or overheard, and that information about them is kept confidential. CQC's guidance says privacy must be maintained at all times, including when people are asleep, unconscious or lack capacity.

Why is dignity important in care?

Because people in care depend on others for very personal things, and how that care is given affects their self-respect, wellbeing and trust. It's also a legal requirement: in England, Regulation 10 requires care providers to treat people with dignity and respect, and CQC looks for it in what people say and in what inspectors observe.

Is dignity in care a legal requirement?

Yes. In England, Regulation 10 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 requires registered care providers to treat people with dignity and respect, and CQC can take regulatory action if they don't. Wales, Scotland and Northern Ireland have their own care regulators and rules. The "Dignity in Care" campaign and its 10 Dignity Do's are guidance, not law.

What is the dignity of risk?

The dignity of risk is the idea that people have the right to make choices that carry some risk, as everyone else does. In England and Wales, the Mental Capacity Act 2005 says a person isn't to be treated as unable to make a decision merely because they make an unwise one. Care staff should talk the risk through, record the person's choice and what's been done to make it safer, and review it. If there's doubt about whether the person has capacity for that decision, assess their capacity for that specific decision.

Sources

Sources last checked: 3 November 2026.

What is dignity in care? A former registered manager's guide