Deborah O’CallaghanAssociate Director – Midlands and East

Sector Lead for Public Health

24th May 2018

NICE supporting quality and safety in social care

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

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

What is NICE?

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

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 supportequivalent to those who do not live in care homes.

NICE Guideline SC1: Managing medicines in care homes (March 2014)

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.

Managing medicines for adults receiving social care in the community (March 2017)

Topic and pathway Guidance QS

Managing medicines in care homes Available Available

Managing medicines for adults receiving social care in

the community

Available Due June 18

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

community or care home settings

Available Available

Oral health for adults in care homes Available Available

Guidance and quality standards supporting quality in social care

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

• 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)

Why use NICE guidelines?

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

• 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)

Shared learning case studies

Using NICE Quality standards in social care

What are NICE guidance and quality

standards?

Evidence Guidance Quality

Standards

A NICE quality standard is a

concise set of statements

designed to drive and

measure priority quality

improvements.

A set of systematically developed

recommendations to guide decisions for

a particular area of care or health issue

Research studies - experimental

and observational, quantitative

and qualitative, process

evaluations, descriptions of

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

Evidence sources cont.• The King's Fund (2013) Polypharmacy and medicines optimisation: making it safe

and sound

• Care Quality Commission (2012) Meeting the health care needs of people in care homes

• Department of Health (2012) Action plan for improving the use of medicines and reducing waste

• Royal Pharmaceutical Society (2012) Improving pharmaceutical care in care homes

• Royal Pharmaceutical Society (2012) Keeping patients safe when they transfer between care providers – getting the medicines right

• Social Care Institute for Excellence's (SCIE) (2012) Commissioning care homes: common safeguarding challenges

• Centre for Policy on Ageing (2011) A report for the project: Working together to develop practical solutions – an integrated approach to medication in care homes

• Report to the Patient Safety Research Portfolio, Department of Health (2009) Care home use of medicines study (CHUMS): prevalence, causes and potential harm of medication errors in care homes for older people

Evidence sources cont.• National Prescribing Centre (2009) A guide to good practice in the

management of controlled drugs in primary care (England)

• Department of Health (2008) Medicines management: everybody's business

• National Prescribing Centre (2008) Medicines reconciliation: a guide to implementation

• Nursing and Midwifery Council (2007) Standards for medicines management

• Royal Pharmaceutical Society (2007) The handling of medicines in social care

• Department of Health (2003) National service framework for children, young people and maternity services: medicines for children and young people

2

Suggested service review questions:How do we ensure that a list is made of a person’s medicines on the day that

they transfer into our care?

1. Who is responsible for listing a person’s medicines on the day that they

transfer into our care?

2. At what stage is the list made?

3. Do we use a template?

4. Does the person completing the list of medicines routinely provide their

details (name, job title) and the date the list was recorded?

5. Once written up, where is the list kept?

The initial assessment

A positive assessment can:–provide assurance –could be included in the organisation‟s quality profile

An assessment indicating areas requiring quality improvement can:

–inform local quality improvement –support discussions with commissioners–Inform local risk management

Keeping up to date and getting involved

• 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

NICE Apps – Information at your fingertips

• Website www.nice.org.uk

• NICE News - monthly e-newsletter

• NICE in social care – monthly bulletin

• 120,000+ people follow us on Twitter @NICEcomms

• General enquiries nice@nice.org.uk

• deborah.ocallaghan@nice.org.uk

Staying up to date with NICE

Any questions?