When did it become wrong to call care home residents “love” and “darling”?

A recent CQC Inspection report questioned the use of care home staff referring to residents by pet names such as "love" and "darling". This generated a storm of protest in the press, with headlines implying that the CQC were all for banning the use of such terms of endearment within residential settings.

Here, Andrea Sutcliffe, Chief Inspector of Social Care at the CQC, attempts to quell the storm by explaining the circumstances of the comment.

Shock horror headlines on Monday morning – the Care Quality Commission (CQC) bans care home staff from calling residents “love”.

Reactions to the news included...

“This complaint about names is absurd. You could argue that if residents were addressed formally, the atmosphere in the home would be cold and unwelcoming.”

“The use of the word ‘love’ is part of our heritage. There is no malice in it. I’m nearly 80 and I’m quite happy for people to call me ‘love’.”

“Come on, people in Yorkshire often say ‘love’, ‘darling’… I have come across ‘pet’ as well.”

But, as ever, a closer look behind the headlines reveals a different picture. The quote came from a report on the Brackenley care home that provides services for people with a learning disability, which we rated good for safe, effective and well-led, but requires improvement for caring and responsive.

We had a number of concerns about the lack of person-centred care in the home. For example, “rules” that meant residents were supposed to stay in their rooms between 11pm and 8am, and the kitchen being locked and inaccessible during the day. In this context, the comment about the language staff used was an indicator of the lack of respect shown, which included a shower room where the curtain rail was broken and people’s body shapes could be seen through the frosted glass.

The important issue is that people are called what they want to be called. Some will appreciate affectionate terms of endearment, others will not.

I’m perfectly happy with a variety of names. Yorkshire born and bred, my dad calls me, my mum and my sister “darling”. My university nickname of Skippy is still used by some friends and family, and I like it when strangers say “have a nice day, love”. But I have always hated anyone shortening my name to Andy (no idea why) and few people get away with abbreviating Sutcliffe to Sooty.

If it’s all about choice for me, how much more important is it for people who may need to rely on others for care and support? I was speaking to a domiciliary care manager recently who said she was really affected when a client told her that she never got undressed in front of her husband and how embarrassed she was about having to rely on others for intimate personal care. At times like this, being made to feel comfortable is essential and what people call you is an important part of that.

CQC’s interest is to make sure that services involve people in all aspects of their care, which includes how they wish to be addressed, and that this is shared with staff who then respect their wishes.

As Debbie Westhead, our deputy chief inspector for the north of England, said yesterday: “There is absolutely nothing wrong about care home managers and staff using affectionate terms of endearment to address people in their care. We recognise and welcome this is part of the compassionate and person-centred care approach that we expect providers to deliver and that people simply deserve.

“But what is most important is that … individual wishes and preferences are always understood and responded to appropriately.”

Good providers do this and I was impressed with the response from the chief executive of the company running the service, Stephanie Kirkman Meikle, who was interviewed on Radio 5 Live. She highlighted the importance of asking people what they want to be called and making sure that happens.

In that same interview, presenter Adrian Childs wondered whether the media had made more of the story than there actually was. I think that was probably the case. Our comments made for an easy, attention-grabbing headline, but did not necessarily reflect the whole picture.

What was welcome, though, was the opportunity to discuss the importance of language in care, how we can make sure that people are treated with dignity and respect, and what we all need to do to make that happen.

Andrea Sutcliffe is chief inspector of adult social care at the CQC. This is an edited version of an article first published on the CQC website.