NICE supporting quality and safety in social care Deborah O’Callaghan Associate Director – Midlands and East Sector Lead for Public Health 24 th May 2018
Overview • NICE: who we are and what we do • Using NICE guidelines in social care • NICE Quality Standards: supporting safety and quality • Practical help • Finding what you need • Staying up to date and opportunities for getting involved
NICE: Who we are and what we do
What is NICE? The National Institute for Health and Care Excellence (NICE) is the independent organisation responsible for providing national guidance and advice to improve health and social care
Our position in the social care sector Evidence, Guidance, Standards.
NICE Guidelines • NICE guidelines are comprehensive sets of recommendations based on the best available evidence • They describe what is effective (what will result in the best outcomes) • And what is cost effective (best value for money) • They are developed to guide decisions made about health and care (for practitioners, providers, commissioners, service planners and users) • Developed by independent committees • NICE consults on the scope and the draft of the guideline
NICE Guideline SC1: Managing medicines in care homes (March 2014) The starting point for the NICE guideline on managing medicines in care homes is that residents should have the same involvement in decisions about their care and treatment, and should have the right to access appropriate services and support equivalent to those who do not live in care homes.
Managing medicines for adults receiving social care in the community (March 2017) This guideline covers medicines support for adults who are receiving social care in the community. It aims to ensure that people who receive social care are supported to take and look after their medicines effectively and safely at home. It gives advice on assessing if people need help with managing their medicines, who should provide medicines support and how health and social care staff should work together.
Guidance and quality standards supporting quality in social care Topic and pathway Guidance QS Managing medicines in care homes Available Available Due June 18 Managing medicines for adults receiving social care in Available the community Mental wellbeing in older people Available Available Pressure ulcers Available Available Falls Available Available Supporting people to live well with dementia Available Available Infection prevention and control Available Available Delirium Available Available Home care for older people Available Available Nutrition Available Available Transition between inpatient hospital settings and Available Available community or care home settings Oral health for adults in care homes Available Available
Quick Guides: A quick, easy way to access key information from NICE on social care topics.
Includes: Tips to help staff conduct oral health assessment Handy assessment tool Understanding how dental pain can affect residents‟ general wellbeing
Social care trainers resource Help to find content for use in your training. This PDF resource includes: • links to social care related guidance and standards • free resources to download • tips on finding guidance
Why use NICE guidelines? • Improve health and wellbeing outcomes for service users and carers • Ensure that care provided is effective and makes efficient use of resources • Increase national consistency of care provision • Reduce inequalities and unwarranted variation • Supports quality improvement activities (good news stories) • Can help address incidents (action plans) • Demonstrates quality to commissioners and to service users & their families • Help answer questions on quality from CQC • Support professional decision-making and continuous development • Support the case for investment (value for money)
Using NICE guidance Finding what you need and practical help www.nice.org.uk
NICE guideline SC1: Managing medicines in care homes (March 2014)
Managing medicines in care homes key points • People living in care homes have the same rights in relation to NHS care as the rest of us, as set out in the NHS Constitution. • Care homes residents should have the opportunity to make informed decisions about their care and treatment. • Person-centred care is important. • Helping residents to look after and take their own medicines helps them retain their independence . • When a person moves into a care home, staff should assume they can manage their own medicines , unless indicated otherwise. • Each resident should have an individual risk assessment to determine the support they need to manage their own medicines. • Care home providers should have a medicines policy which includes written processes for the safe and effective use of medicines
Care Home Medicines Policy • Assessing mental capacity (legislation) • Storing and sharing information (including transfers) • Keeping accurate records • Problem identification and reporting • Safeguarding residents • Medicines reconciliation and review • Ordering and disposing of medicines • Stock control of medicines • Administration of medicines (by resident, staff and covertly) • Staff training and competency • Non-prescription medicines NICE has published a „ checklist ‟ to help you put a local policy in place
Shared learning case studies • Medicines Awareness, Administration and Competency Assessment in Residential and Domiciliary Care Services (April 2018) • Improving Medicines Optimisation for Care Home Residents and Providing Medicines Management Support to Care Homes - The Wigan Borough CCG Approach (Nov 2017) • Implementing NICE‟s medicines management in care homes guidance in Plymouth (April 2017) • General Practitioners employing Pharmacist Independent Prescriber to jointly optimise care of our care home patients (December 2015) • Peer Support Meetings for Pharmacists Undertaking Medication Reviews for Older People in Care Homes and Domiciliary Settings (August 2015) • Developing and implementing a parent held medicines record for children with complex conditions (February 2014)
Using NICE Quality standards in social care
What are NICE guidance and quality standards? A set of systematically developed recommendations to guide decisions for a particular area of care or health issue Quality Evidence Guidance Standards A NICE quality standard is a Research studies - experimental concise set of statements and observational, quantitative designed to drive and and qualitative, process measure priority quality evaluations, descriptions of improvements. experience, case studies
Regulation - CQC Andrea Sutcliffe, Chief Inspector for Adult Social Care at the CQC “At the CQC we are asking the questions that matter to people. We‟re asking whether services are safe, caring, effective, responsive to people‟s needs, and well led . “And the way that we can do this is by identifying key lines of enquiry – so the questions that we will ask when we go out on inspections. We will also identify what the characteristics are of the services that we see, so whether they are good, outstanding, require improvement or are inadequate. “ This quality standard will inform the questions that we ask, and help us to provide the understanding of what ‘good’ and ‘outstanding’ practice looks like in this area .” https://www.youtube.com/watch?v=RxwHM0JsdyI
Evidence sources • Managing medicines in care homes (2014) NICE guideline SC1 • Care Quality Commission (2015) Guidance for providers on meeting the regulations • Royal Pharmaceutical Society (2014) Pharmacists improving care in care homes • Department of Health (2013) Best practice for ensuring efficient supply and distribution of medicines to patients • General Medical Council (2013) Good practice in prescribing and managing medicines and devices • National Care Forum (2013) Safety of medicines in the care home • National Care Forum (2013) Safety of medicines in care homes: Framework: Making the best use of medicines across all care settings • Royal Pharmaceutical Society (2013) Medicines optimisation: helping patients to make the most of medicines
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