NICE guidance for registered care home managers network Jane Moore (Implementation Consultant

What is NICE? The National Institute for Health and Care Excellence (NICE) is the independent organisation responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill health. Name change and rebranding to support the social care sector.

The role of NICE To improve quality and productivity To identify good clinical, public health and social care practice using the best available evidence To help resolve uncertainty for the public, and professionals To reduce variation in the availability and quality of practice and care.

We produce national guidance covering….. Health technologies: Technology appraisals Interventional procedures Medical technologies NICE Guidelines (NG): Clinical guidelines Public health Social care topics Quality standards NICE produces guidance on technologies and guidelines that address clinical, public health and social care topics as well as safe staffing to improve health and social care

Regulation - CQC Andrea Sutcliffe, Chief Inspector for Adult Social Care 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 And for information, this quote is taken from a video (hyperlinked) of Andrea Sutcliffe talking about how CQC use NICE quality standards to inform review questions.

Guidance relevant to care homes Residential care: Supporting people to live well with dementia Mental wellbeing of older people in residential care Managing medicines in care homes Older people with social care needs and multiple long-term conditions Transition between inpatient hospital settings & community or care home settings Dementia: independence and wellbeing Falls in older people Oral health for adults in care homes Nursing care: End of life care for adults Delirium in adults Pressure ulcers Nutrition Infection prevention and control Learning disability: Challenging behaviour in people with learning disability Department of Health and Department for Education refers topics Initial set of 9 topics Exploratory discussions to clarify the remit and key issues for each topic in Jan – April 2013 DH consultation on possible future topics, with input from NICE’s External Reference Group

Relevant guidance in development Adult social care: improving people’s experience (Feb 18) Adults with complex needs (including LD) and mental health needs; social work interventions (TBC) Advocacy for adults with health and social care needs (TBC) Care and support of older people with learning disabilities (May 18) Decision making and mental capacity (July 18) Independent living: supporting independence and preventing isolation (TBC) Intermediate care including reablement (July 17) Learning disabilities and behaviour that challenges (March 18) Safeguarding adults in care homes (TBC) Supporting adult carers (July 19) Department of Health and Department for Education refers topics Initial set of 9 topics Exploratory discussions to clarify the remit and key issues for each topic in Jan – April 2013 DH consultation on possible future topics, with input from NICE’s External Reference Group

Core principles of all NICE guidance Comprehensive evidence base Expert input Patient and carer involvement Independent advisory committees Genuine consultation Regular review Open and transparent process

Why use NICE guidance? Based on the best available research Effectiveness: what works and in what population Cost-effectiveness: value for money approaches to national and local priorities Reduce variation and inequalities Improve health and wellbeing outcomes Supports quality improvement activities Can help address incidents (action plans) Supports the case for investment Demonstrates quality to commissioners (tenders, contract, quality monitoring) Help answer questions around quality from CQC Demonstrate quality to service users & families Why use? Provides support for decision making at all levels – local policy making, strategic decision making , implementation of local action plans To underpin actions in the Joint Health and Wellbeing Strategy (JHWBS) – provides evidence base to ensure you are doing the right thing ( i.e. what works) and are using public money wisely to give your local population the best chance of having the best outcomes. [“Evidence of cost-effective and efficient interventions may also be useful in planning how the health and wellbeing board members want to take action to meet the agreed priorities” JSNA/JHWBS draft guidance Jan 12] Reduce variation and inequalities – helping to understand how to meet the needs of the most vulnerable and the most in need. Guidance recognises these groups Provides local accountability – helps you define what you expect from services in terms of outcomes – so you know what you are getting. That is, easier to hold providers to account and also to account to the general public (because services commissioned have sound research to support cost and outcomes) Provides a framework for discussion with your partners about what is the best and right thing to do

NG27 Transition between health & social care

What are NICE quality standards? Evidence Guidance Quality Standards A set of systematically developed recommendations to guide decisions for a particular area of care or health issue Guidance – aim is to improve individual or population wellbeing and health – for social care aim is to improve independence and wellbeing Evidence - these are examples to show the breadth of evidence that will be considered depending on the question and the types of evidence available Also have the option of inviting expert witnesses to provide expert advice in the absence of published evidence, and the option to call for evidence (ie ask stakeholders if they are aware of anything) Research studies - experimental and observational, quantitative and qualitative, process evaluations, descriptions of experience, case studies A NICE quality standard is a concise set of statements designed to drive and measure priority quality improvements.

NICE quality standards Include measures to help inform local quality improvement work Typically 6 – 8 statements Based on best available evidence such as NICE guidance and other evidence sources accredited by NICE Define priority areas for quality improvement

How to use NICE quality standards Help to identify local priorities for quality improvement NICE quality standards can highlight key areas for improvement. An initial assessment should consider: relevance to the organisation, how services compare, what evidence is available, actions to improve, risks of not improving Driving quality improvement Once you have identified gaps and priorities, use quality standard measures to improve quality of services: establish a project team, develop an action plan, assess cost and service impact, develop a business case, measure a baseline, deliver actions and evaluate success See Into Practice Guide www.nice.org.uk/intopracticeguide

EG. Ensure wellbeing and safeguarding responsibilities are met NICE Quality Standards can help organisations to: Provide meaningful, person-centred activities Supporting people to live well with dementia Mental wellbeing of older people in residential care Reduce medication errors Medicines management in care homes Monitor for malnutrition Nutrition support in adults Prevent falls Falls guideline and quality standard Reduce healthcare-related infections Infection prevention and control Avoid delirium and monitor for depression Delirium

Tools and Resources to save you effort We provide a range of resources to help maximise uptake and use of evidence and guidance. Into Practice Guide Online learning resources Clinical case scenarios Local practice collection NICE and BNF apps Field team Baseline assessment/ tools Costing reports and templates Medicines Information www.nice.org.uk/about/what-we-do/into-practice

Resources for care homes The Mental wellbeing of older people in care homes film is about how the NICE quality standard can help to improve the lives of older people in care homes.  The Tailored resource for managers of care homes for older people explains how older people can be supported to maintain their mental wellbeing. Tailored resource for care providers on supporting people to live well with dementia Managing medicines in care homes: checklist for care home medicine policy

Accessing the guidance Search bar for free text Or, try NICE Pathways Search by categories, dates, state of development www.nice.org.uk

You can then search for a word or phrase, or by category (e. g You can then search for a word or phrase, or by category (e.g. ‘settings’ or ‘conditions and diseases’)

Population groups http://www.nice.org.uk/guidance/population-groups/older-people However, I advise you to also check the topic landing page for ‘older people’ (under population groups) as you will find potentially useful guidelines and quality standards focusing on independence and wellbeing.

NICE Pathways

NICE Apps – Information at your fingertips Android smartphone and tablets iPhone and iPads Browse function Rapid searches Bookmark for offline use Receive automatic updates Available via: NICE website Apple App Store Google Play Store www.nice.org.uk/apps

Staying up to date with NICE Website www.nice.org.uk NICE News - monthly e-newsletter keeping you up to date consultations, published and forthcoming guidance 100,000+ people now follow us on Twitter for guidance updates @NICEcomms General inquiries nice@nice.org.uk Field team fieldteam@nice.org.uk