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What is Culturally Appropriate Care?

Culturally appropriate care (also called 'culturally competent care') 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 and is the bedrock of meeting need and happiness.


Everybody belongs to a culture and needs this culture to be recognised in order to feel happy and comfortable and we all have cultural values. Informed by the cultures we most associate ourselves with, cultural values are neither positive nor negative but are just differences. Cultural values are an individual’s core beliefs about what is good or right and can influence the way we treat others and want others to treat us.


Being sensitive to cultural values makes a difference to people’s care. Acknowledging the differences of individuals can help us all to understand others better. Having an awareness of your own and others’ cultural values affects:

  • Relationships (between service users and staff)

  • The take-up of activities

  • Whether people will speak up when they are unhappy


How can cultural differences affect care?

Religious or spiritual practice is a major area where diversity can be seen, as well as food and drink, clothing and personal presentation. Activities, relationships and communication can also show variation in different cultures while responses to emotional support, healthcare and end of life support are also affected by differing cultural values.


How can you bridge differences between your own cultural values and those of others? Ask questions and be curious about the feelings of others, listen without judgement and be aware of assumptions or judgements that could come from bias or stereotypes. Being aware of stereotyping others is particularly important as there can be differences within cultural groups as well as between them.


Acknowledging and understanding cultural differences is of key importance and the regulatory framework recognises this.


Safe

  • Cultural considerations about medicines need to be recorded and acted upon.

  • People are protected from discrimination and harassment over Equality Act protected characteristics.


Effective

  • People's needs are looked at overall and they are protected from discrimination.

  • Services take 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.

  • Staff should have the right learning and development to help them understand and meet these needs.


Caring

  • Staff support people in culturally sensitive ways. They recognise when people’s preferences are not being taken on board or properly respected.

  • People are known, respected and shown compassion.

  • Visitors are made to feel welcome.


Responsive

  • People, their families and carers should be involved in developing their care plans. This includes identifying their needs on the grounds of equality characteristics and looking at how those needs are met. It also includes finding out about their choices and preferences and reviewing plans regularly.

  • People are helped to 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 should have a positive culture that is person-centred, open, inclusive and empowering.

  • Leaders, managers and staff require a good understanding of equality, diversity and human rights.

  • Leaders, managers and staff should encourage people to express views and concerns. They listen and act on them to help shape the service and culture.

  • The service actively promotes equality and diversity.


A key point for all care staff to remember is that cultural needs vary. They are based not only on ethnicity and religion but also on things like age, sex, sexual orientation, gender identity, region, family, education and employment history.


How people identify with their culture can change through time, for example, people with dementia may identify more strongly with the culture from their earlier years as time goes on and good communication with people and their families is vital to meeting cultural needs.


As well as building confidence in person-centred care, it’s important to look at the shared culture of the service and how this is reflected in for example an individual’s activities and environment. Being an inclusive leader means being aware of your own cultural values and the potential impact that they have on others. Make use of the cultural knowledge and skills of your team in a positive way but do be aware that staff from minority groups may face discrimination from some service users, and good engagement and support is important to solve these issues.


Finally, ensure that everyone's cultural needs are part of their care planning and review, under the relevant sections of the care plan. It is essential to respect people, treat them with dignity and respect their privacy while remaining cognisant of cultural needs.

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