Culturally Appropriate Care: What CQC Expects and How to Evidence It
Culturally appropriate care means being alert and responsive to people’s cultural identity and heritage. Here is how CQC frames it and how to show it in your service.
Culturally appropriate care, also called culturally competent care, is care that is sensitive to people’s cultural identity or heritage, such as ethnicity, nationality, religion, sexuality or gender identity, and responsive to the beliefs and conventions that go with it. CQC links it to Regulation 9 (person-centred care), Regulation 10 (dignity and respect) and Regulation 11 (consent) and to all five key questions. Inspectors look at care planning, food, staff learning, activities, end of life care and a positive, inclusive culture.
Culture shapes how people want to eat, dress, pray, grieve, be touched and be spoken to. CQC’s guidance for adult social care providers (CQC: culturally appropriate care) explains the term and shows where it fits in the regulations and key questions.
This guide turns that into practical steps for a registered manager aiming for Good or Outstanding. It builds on person-centred care and dignity in care.
Key takeaways
- Cultural identity can be based on ethnicity, nationality, religion, sexuality, gender identity or, for example, Deaf culture and British Sign Language.
- Relevant regulations: 9 (person-centred care), 10 (dignity and respect), 11 (consent), plus Regulation 14 on food.
- Care plans should identify needs linked to the protected characteristics and how they are met.
- Staff need learning and development to understand and meet cultural needs.
- Evidence includes care plans, food and activity records, staff training and feedback from people and families.
In this guide
What Does Culturally Appropriate Care Mean?
CQC describes it as care that is sensitive to people’s cultural identity or heritage: being alert and responsive to beliefs or conventions determined by cultural heritage. That can cover ethnicity, nationality or religion, and also sexuality or gender identity. CQC says lesbian, gay, bisexual and transgender people have a particular culture, as do Deaf people who use British Sign Language.
CQC notes some people may have less contact with people who understand and affirm their culture, for example when living in a care home among people who do not share it, and may experience life events of cultural significance such as end of life and bereavement.
How It Links to the Regulations and Key Questions
CQC names Regulations 9 (person-centred care), 10 (dignity and respect) and 11 (need for consent) as the regulations culturally appropriate care is relevant to. Regulation 14 also matters because meals must take account of religious, cultural and ethical needs. See Regulation 14.
| Key question | What CQC looks at |
|---|---|
| Safe | Recording and acting on cultural considerations about medicines, and protecting people from discrimination and harassment over protected characteristics |
| Effective | Considering people’s needs overall, cultural, ethical and religious needs in meals and drinks, how premises are decorated, and cultural preferences in Mental Capacity Act decisions, for example by consulting people who know them |
| Caring | Staff supporting people in culturally sensitive ways, recognising when preferences are not respected, and making visitors feel welcome |
| Responsive | Involving people and families in care plans, identifying needs linked to equality characteristics, regular reviews, relevant staff learning, culturally relevant activities and end of life care that respects religious beliefs |
| Well-led | A positive culture that is person-centred, open, inclusive and empowering |
The Protected Characteristics to Consider
CQC lists the characteristics protected under the Equality Act 2010: age, disability, ethnicity and nationality, religion and belief, sex, sexual orientation, gender reassignment, and pregnancy and maternity. Care plans should consider each, in ways the person is comfortable with. See CQC’s human rights approach.
Putting It Into Practice
- Ask at admission and review. Record cultural identity, faith, language, dietary needs, preferred names and forms of address, important dates, and how the person wants to be cared for, especially intimate care and end of life.
- Food and drink. Provide culturally and religiously appropriate meals, understand fasting and festival needs, and discuss any clinical risks with the person so they can make informed choices.
- Communication. Use interpreters or BSL where needed, and meet the Accessible Information Standard.
- Environment and activities. Provide spaces and activities that reflect people’s culture, such as prayer space, music, books, films and festivals.
- Connection. Help people stay in touch with their communities and welcome visitors. See visiting.
- End of life. Plan with people and families so religious and cultural wishes are known and followed.
- Capacity decisions. Consult people who know the person so cultural preferences inform best interests decisions. See MCA and DoLS.
- Staff learning. Provide training and supervision on cultural awareness and discrimination, and challenge poor behaviour.
Evidence to Keep
- Care plans showing cultural, religious and communication needs and how they are met.
- Menus and food records reflecting dietary requirements.
- Activity programmes and records of cultural and religious observances.
- Staff training records and supervision notes.
- Feedback from residents and families, and changes made.
- Policies on equality and diversity, which CQCLogic’s audit schedule includes as a pre-loaded audit.
CQCLogic’s audit tracker includes an equality and diversity audit with findings and re-audit dates, and the policy register holds your equality policy and review dates. Care plans themselves belong in your care records system.
Audit equality and diversity and track the actions
CQCLogic includes an equality and diversity audit in its pre-loaded schedule, with findings, actions and re-audit dates. See a sample improvement plan, view pricing or get started free.
Frequently Asked Questions
What is culturally appropriate care?
Care that is sensitive to people’s cultural identity or heritage and responsive to beliefs or conventions linked to it, including ethnicity, nationality, religion, sexuality and gender identity. It is also called culturally competent care.
Which CQC regulations cover culturally appropriate care?
CQC names Regulation 9 (person-centred care), Regulation 10 (dignity and respect) and Regulation 11 (need for consent). Regulation 14 also requires food and drink to reflect religious and cultural needs.
How do inspectors assess it?
Across the five key questions, for example whether cultural needs are recorded and acted on in care plans, meals reflect cultural and religious needs, staff are trained, activities are culturally relevant and the service has an inclusive culture.
What are the protected characteristics?
Under the Equality Act 2010: age, disability, ethnicity and nationality, religion and belief, sex, sexual orientation, gender reassignment, and pregnancy and maternity.
Does culturally appropriate care include LGBT and Deaf people?
Yes. CQC says lesbian, gay, bisexual and transgender people have a particular culture, as do Deaf people who use British Sign Language.
How should end of life care reflect culture?
CQC says people should feel their needs relating to equality characteristics were considered in end of life planning, and that their religious beliefs and preferences are respected.