Communication in care standards

Also called CQC communication, Regulation 9, Regulation 10, Fundamental standards, Care inspection communication

What the regulator expects a care service to do about communication, and how to raise it when a provider is not doing it.

What it is

Every registered care provider in the UK is inspected against standards, and communication runs through them. In England the Care Quality Commission inspects against the fundamental standards in the 2014 regulations: person-centred care (regulation 9), dignity and respect (regulation 10), and consent (regulation 11) all depend on a service being able to communicate with the person, and the Accessible Information Standard applies directly.

Elsewhere the regulator differs: the Care Inspectorate in Scotland inspects against the Health and Social Care Standards, Care Inspectorate Wales against the 2016 Act's regulations, and RQIA in Northern Ireland against its minimum standards. All of them expect communication needs to be known and met.

Who it can help

Anyone receiving care at home, in a care home, in supported living or in a day service, and anyone who supports them. In practice it is people whose communication is easiest to ignore who most need the standards: people with a learning disability, people with dementia, people who use AAC, Deaf people, people with aphasia.

The standards are not a promise that care will be good. They are a floor, and a lever. A provider that has not recorded how a person communicates, has not trained staff in it, or leaves a device uncharged in a cupboard, is below the floor, and the regulator is entitled to hear about it.

How it works

In England, the CQC looks at whether the service knows and meets each person's communication needs, whether staff can communicate with the people they support, whether people are involved in their care planning in a way they can take part in, and whether the service meets the Accessible Information Standard. Inspectors talk to residents and families and look at records. A service that cannot show a person's communication method in the care plan, see communication needs in the care plan, or cannot show that staff know it, will be marked down.

Raising a concern: the provider first, in writing, then the regulator. CQC accepts concerns from anyone, and will not tell the provider who raised it. In Scotland the Care Inspectorate takes complaints directly.

Getting started

If you are a family member, ask the manager to show you the communication section of the care plan and ask how new staff learn it. If the answer is thin, write it yourself, as a communication passport, and ask for it to be attached to the plan and for every staff member to sign that they have read it. Ask whether the person's device or board is used every shift and who charges it.

If you are a care worker, this is the part of the standards you can meet on your own shift: use the person's method, wait for them, record what they told you in their own words, and flag it when a colleague talks over them. If you are a manager, put communication into induction and into supervision, and make communication partner training a standing item.

Where to get help

The Care Quality Commission publishes the fundamental standards in plain language and takes concerns online. SCIE has good practice guides on communication in care. BILD trains care staff in communication and positive behaviour support. Mencap and Alzheimer's Society advise families. For how to complain formally, see complaints and communication needs.