Understanding the NICE social care guidelines Webinar
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NICE has a long track record of producing guidelines for health and in 2013 expanded its responsibility to include social care. It is important that social care colleagues are aware of the forthcoming NICE Social Care Guidelines and Quality Standards. As part of our work with the National Collaborating Centre for Social Care (NCCSC) which is responsible for developing the NICE Social Care Guidelines, RiP/fA are holding a free webinar for colleagues across the social care sector.
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Understanding the NICE social care guidelines Webinar
- 1. Understanding the NICE social care guidelines This webinar is not due to start until 12pm on Thursday 24th September 2015 Please make sure you have tested your sound before this webinar starts If you need support with this please email: events@rip.org.uk or call 01803 847264
- 2. 2 NICE Collaborating Centre for Social Care Guidelines and Quality Standards for Social Care Research in Practice and Research in Practice for Adults Kath Wilkinson – Research and Evaluation Officer Esther O’Brien – National Policy Officer Lisa Smith – Research and Development Manager
- 3. Learning Objectives • Awareness of the NCCSC, and NICE guidelines and quality standards relevant to social care • Understand the rationale for developing guidelines and the process • Consider how practice expertise can contribute to the guideline development process • Explore enablers for the social care sector engagement of NICE guidelines
- 4. Q1: How familiar are you with the NICE quality standards and guidelines for social care overall? • Select one option in the box on your screen now Question
- 5. What are the NICE Guidelines for social care ? • About NICE Collaborating Centre for Social Care (NCCSC) • Who the guidelines are for • Rationale and principles for guidelines • Guidelines and quality standards
- 6. Existing Frameworks • Care Quality Commission • Ofsted
- 7. Existing Guidelines & Quality Standards Adult Social Care Guidelines • Managing medicines in care homes • Autism • Dementia • Challenging behaviour and learning disabilities • *Domestic violence and abuse: how health services, social care and the organisations they work with can respond effectively • *Falls: assessment and prevention of falls in older people Quality Standards • Mental wellbeing of older people in care homes • Supporting people to live well with dementia • Autism • Falls in older people: assessment after a fall and preventing further falls Children’s Social Care Guidelines • Autism • Challenging behaviour and learning disabilities Quality Standards • Health and wellbeing of looked-after children and young people • Autism
- 8. Guidelines in development Title Anticipated publication date Home care September 2015 Social care of older people with complex care needs and multiple long- term conditions November 2015 Transition between inpatient hospital settings and community or care home settings for adults with social care needs November 2015 Transition between inpatient mental health settings and community and care home settings August 2016 Transition from children's to adult services February 2016 Intermediate care including re-ablement July 2017 Service model for people with learning disabilities and challenging behaviour 15 July 2015 - 02 September 2015; published Sept 2017 Child abuse and neglect September 2017 Care and support of older people with learning disabilities October 2017 Service user and carer experience January 2018
- 9. Guidelines in development specifically relevant to Children’s services • Transitions between adults and children’s services • Child Abuse & Neglect
- 10. Consultation for Future Topics • Adoption in looked-after children and young people • Safeguarding in care homes • Disabilities and complex needs in adults, children and young people • Fostering in looked-after children and young people • Maintaining independent living and preventing isolation in adults
- 11. Link to Consultation • https://www.nice.org.uk/Media/Default/About/what -we-do/NICE-guidance/NICE-guidelines/social-care- guidelines/sc-topic-consultation-information-2.pdf
- 12. Homecare Recommendations: • Ensuring care is person centred • Providing information about care and support options • Planning and reviewing home care and support • Delivering home care • Joint working between health and social care • Ensuring safety and safeguarding people using home care services • Recruiting, training and supporting home care workers
- 13. How to Implement • Delivering services that support the aspirations, goals and priorities of the person • Integrated working • Working in partnership to deliver high quality and integrated home care
- 14. Process of Development • Topic Selection • Referral and Set-up • Scoping • Guideline Committee • Development – evidence review • Consultation and redraft • Validation and Publication
- 15. Examples of engagement • https://www.youtube.com/watch?t=19&v=7V g35ii5uVs • https://www.youtube.com/watch?v=6y2YH_6 ULoY
- 16. How can you get involved? • Topic consultation • Guideline development committee • Contributing to consultations on draft guidelines • Take part in webinars
- 17. Q2: How likely are you to get involved with the development of these guidelines in one way or another? • Select one option in the box on your screen now Question
- 18. Discussion questions 1. What do you think would encourage and enthuse social care practitioners to engage with the NICE social care guidelines? • what can you do as professionals? • what can the sector do? • what can the NCCSC do to help? 2. What are the main barriers that need overcoming?
- 19. Next steps Another webinar to support awareness-raising and engagement with the guidelines and their development, which focuses on a particular topic • What would be most useful for you?
- 20. Q3: Which topic would you like us to focus on for the next webinar? A) Adults • Select one option in the box on your screen now Question
- 21. Q4: Which topic would you like us to focus on for the next webinar? B) Children • Select one option in the box on your screen now Question
- 22. Questions/ comments 22 Contact: Kim Rutter kim.rutter@scie.org.uk
Editor's Notes
- The NCCSC is a consortium led by the Social Care Institute for Excellence (SCIE) with: Research in Practice; Research in Practice for Adults; Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre); and Personal Social Services Research Unit (PSSRU). We are delivering this webinar on behalf of the NCCSC with the aim of increasing the profile of the Guidelines and QS across the sector- and enabling you to understand what the opportunities are to get involved
- Following learning objectives, show Poll 1: Q: How familiar are you with the NICE quality standards and guidelines for social care overall? (please select one) Very familiar Quite familiar Vaguely familiar Not very familiar Not at all familiar This will give us an idea of how aware you all are of these guidelines currently. A recent survey we sent out told us that out of 73 respondents, a third were quite/very familiar with the guidelines, and just over a third were not very/not at all familiar. Does this reflect that also?
- Following learning objectives, show Poll 1: Q1: How familiar are you with the NICE quality standards and guidelines for social care overall? (please select one) Very familiar Quite familiar Vaguely familiar Not very familiar Not at all familiar This will give us an idea of how aware you all are of these guidelines currently. A recent survey we sent out told us that out of 73 respondents, a third were quite/very familiar with the guidelines, and just over a third were not very/not at all familiar. Does this reflect that also?
- The NICE Collaborating Centre for Social Care (NCCSC) develops guidance about social care for children and adults on behalf of NICE. The NCCSC also helps to ensure that people who commission, provide and use care services know about the NICE guidance and related quality standards and are supported to put them into practice. NICE have been developing guidelines in health for some time, so we are pleased to be part of this process in social care. The National Collaborating Centre for Social Care uses NICE's tried and tested methods and processes to develop the social care guidelines. The NCCSC also provides NICE with support for adoption and dissemination of social care guidelines and quality standards. The social care guidelines aim to improve outcomes for people who use social care support by ensuring that social care services and interventions are effective and cost-efficient. They do this by making recommendations about best practice, drawn from current research. This is gathered through a very rigorous process, which we will talk though in a moment. The social care guidelines are primarily aimed at social care practitioners and providers (including in the independent and voluntary sector). Depending on the topic, the guidelines may also be relevant to: healthcare practitioners and providers, health and social care commissioners, and people who user services and their families or carers (including people who buy their own care). NICE develops guidelines according to the same core principles used for all their guidance: Guidance is based on the best available evidence of what works, and what it costs. Guidance is developed by independent and unbiased Committees of experts. All Committees include at least 2 lay members (people with personal experience of using health or care services, or from a community affected by the guideline). Regular consultation allows organisations and individuals to comment on the recommendations. Once published, all NICE guidance is regularly checked, and updated in light of new evidence if necessary. They are committed to advancing equality of opportunity and ensuring that the social value judgements made reflect the values of society. They ensure that their processes, methods and policies remain up‑to‑date. NICE also considers dissemination and implementation when developing guidelines. The terms ‘guidelines’ and ‘quality standards’ are distinct and different, although sometimes they are mistakenly used inter changeably. The main difference between them is…. Guidelines Our guidelines make evidence-based recommendations on "what works" in terms of both the effectiveness and cost-effectiveness of social care interventions and services. Social care quality standards Quality standards for social care focus on the services and interventions to support the social care needs of service users. Topics include supporting people to live well with dementia, looked-after children and young people, autism and the mental wellbeing of older people in care homes. They are for people using social care services and their families and carers to find information about the quality of services and care they should expect. They are also for social care providers, and those that commission them, to assess the performance and make improvements based on evidence. Qs are made up of quality statements- see screenshot. NICE develop the qs based on the guidelines that the NCCSC develops
- NICE social care guidelines and quality standards are not mandatory. However, they can be used for a wide range of purposes both locally and nationally, to improve the quality of health and care services, including to: Support the provision of care that has been shown to work and to be cost-effective Ensure a more consistent approach to social care provision across the country Support the development of joined-up working between agencies and professionals Help the social care sector demonstrate its importance as a key partner in the provision of care Raise the profile of social care. So there are strong links to integration of the workforce, working effectively in times of austerity, ensuring respect and value for the profession within the integrated workforce, and empowering the sector as well as doing the right thing by service users. The strategic planning and day-to-day delivery of social care is carried out by local authorities, the organisations they commission and others that provide services. Statutory frameworks already exist to regulate this. NICE quality standards are intended to build on and go beyond these frameworks, providing a practical tool for local authorities and other to help deliver good health and wellbeing for users of adult and children's social services. ADULTS: NICE quality standards which cover adult social care complement and reinforce CQC Essential Standards for regulating adult social care. NICE quality standards and social care guidance will show providers how they can continually improve the quality of care above and beyond CQC standards and aspire to deliver high quality care. There is a mapping tool to support the links between CQC and the NICE guidelines. CHILDREN: There has been some work to align the guidelines with existing frameworks in adult social care, such as the CQC standards. The guidelines for children’s social care relate to Ofsted in a different way, and there are conversations underway about how the guidelines and quality standards may link with the inspection criteria. The key point to remember here, is not whether we have to work to these guidelines and standards, but why we wouldn’t. They are built on gathering robust evidence of what works best, for whom, under what circumstances, and help us do our jobs as well as we possibly can – so there is a moral imperative there rather than a legal obligation. Ensuring that people receive high quality care relies on a complex set of responsibilities and relationships between practitioners, provider organisations, commissioners, service users, regulators such as Ofsted and the Care Quality Commission (CQC) and other national bodies including NICE, government departments, professional bodies such as the Association of Directors of Adult Social Services (ADASS), provider national bodies such as the Care Providers Alliance and other national bodies. NICE quality standards that cover the care of children and young people complement and reinforce DfE's National Minimum Standards, which are used by Ofsted and other agencies to regulate and make recommendations for care homes, adoption and fostering services.
- As you can imagine there is a quite a lot of cross over between topics, and many span both adults’ and children’s social care - just as individuals do not fit into individual categories, neither do the guidelines. Those with asterisks were not developed by the NCCSC, but are relevant to adult social care. Esther – did you want to talk about care pathways here?
- These guidelines are currently in development. Those in blue are relevant to adult social care Dark blue– children’s SC White – both *SCIE – please can you check categorisation here
- Transitions between adults and children’s services Currently consultation is out on the draft guideline with stakeholders; the draft scope went through consultation last year Publication date February 2017 GDG is chaired by Swaran Gingh, Head of Mental Health and Wellbeing Division, Honorary Consultant Psychiatrist, and Commissioner for the Wquality of Human Rights Commission Topic expert – Bryony Beresford, Research Director Uni of York Other members include carers, physiotherapists, service users, endocrinologist and a development officer for transition for the council of disabled children Child Abuse & Neglect Last year there was a consultation on the draft scope with stakeholders The consultation on the draft guideline will take place Feb-April 2017 Publication date Sept 2017 GDG chaired by Corinne May-Chalal, Professor & Researcher of Social Science at Lancaster Uni Other members include psychiatrists, children’s service managers, academics, service users, and care workers The Guideline Development Group oversees the development of the development process for each of these guidelines.
- We are now consulting on the first draft guideline developed by the NICE Collaborating Centre for Social Care (NCCSC).It focuses on older people receiving home care and their carers. It does not cover younger adults (although many of the recommendations may also be relevant to younger adults). The guideline is for commissioners of home care in local authorities and CCGs, health and social care practitioners, providers, home care managers and home care workers. The guideline is being published for consultation at a time of significant and far-reaching legislative change in social care. This guideline focuses on older people receiving home care and their carers. It does not cover younger adults (although many of the recommendations may also be relevant to younger adults). This is because the largest group of people using home care is older people. This guideline considers how person-centred home care should be planned and delivered. It addresses how those responsible for managing and providing home care should work together to deliver safe, high-quality home care services that promote independence.
- Many services are built on a ‘one size fits all’ model and changing this will be a complex process and take time. To do this, home care provider organisations could: Review how they deliver services to see whether improvements are needed to ensure that they meet individual needs. Ensure support focuses on what people can or would like to do to maintain their independence, not only on what they cannot do. Work across boundaries and be flexible so that they can move away from a ‘one size fits all’ model to one that can offer personalised services. Working effectively together Carers, health and social care practitioners and volunteers could: Work across traditional boundaries and professional specialisms. Respect that everyone involved provides a different element of a person’s package of support, and each has expertise to draw on when needed. Identifying a named coordinator Commissioners and home care provider organisations could: Change the way they work together. Identify a single named care coordinator to facilitate effective collaborative working. Commissioners, providers and other organisations could: Work together when negotiating contracts to ensure that workers have enough time to provide the best care and support for people without compromising their dignity or wellbeing. Use service specifications to allow services to be delivered flexibly so that these can be tailored to the person’s needs and priorities. Work with a range of organisations, such as voluntary sector and community organisations, to help people benefit from maintaining family and local community links. Visit the NICE website for resources to help you to address these challenges and achieve best practice.
- The process of development for each guidelines is very thorough - it’s not based on opinion, its based on a rigorous and robust process to gather research evidence around what works. Topic selection NICE guidelines are a key source for the development of NICE quality standards and therefore new guidelines developed by NICE are usually chosen from a library of topics for quality standards and then agreed with the relevant commissioning body (NHS England or the Department of Health). Decisions on which library topics to develop guidelines on, and in what order, are based on factors such as: whether there is existing NICE-accredited guidance on which to base a quality standard that encompasses the whole of the topic the priority given to the topic by commissioners and professional organisations, and organisations for people using services, their families and carers (identified through consultation) A topic selection oversight group at NICE considers topics for guideline development, taking these factors into account. NICE then discusses topics identified in this way with NHS England, the Department of Health and Public Health England, and a prioritised list is agreed by these 3 bodies. Topics are then formally referred to NICE and scheduled into NICE's guideline development plans. Referral and set-up Review topic referral information received from NICE and pass to a programme manager Establishment of project team to include project managers, Information Specialists (IS), Systematic Reviewers (SRs), Economists (E), Project Administrator (PA), Research Assistant (RAsst), Stakeholder Engagement and Dissemination Manager (SEDM) Scoping Scoping of research takes around 16 weeks, and includes: Defining search terms Identifying breadth of possible scope Identifying priorities for systematic review, narrative reviews, health economics, including searches Identifying potential topics for modelling Setting out a timescale and project plan Identifying potential constituency/guideline committee members Identifying patient/ carer organisations for PPIP to approach to recruit potential service users and carers The scoping report goes out to consultation for 4 weeks onto the NICE website Recruitment of Guidance Committee members – NICE committees and working groups are made up of health, social care and other professionals and practitioners, patients, service users, carers and members of the public, and technical experts these are recruited via application and interview. LISA to talk a bit here about the experience of this. Development of guideline Guideline development during this time is centred on reviewing the evidence base in order to answer the questions around best practice. The structure of this period depends upon the topic and evidence base available, and whether the GC have split into topic groups to review the evidence on specific topics. Systematic Reviews, economic, evidence, Care pathways and general. GC then helps with implementation. Initial draft of guideline, and this is then discussed at each meeting. First draft then submitted. Editorial check then out for consultation, Consultation This goes out onto the NICE website for a formal 6 week consultation upon end of consultation GC meet to discuss and agree any changes Submit second draft plus quality assurance check. Validation – Final NICE guideline goes to editing and quality assurance Publication.
- LAC film or the Mental wellbeing of older people film- inclusion of Chelsea pensioners A film has been made by the NICE collaborating centre for social care to support the NICE quality standard The film focuses primarily on an a roundtable event which took place in March 2014 at the Royal Hospital Chelsea, and included key organisations from the health and social care sector discussing each of the six quality statements; what they mean and how they can be put into practice. Also in attendance at the event were some of the older people resident at the Royal Chelsea Hospital infirmary who discussed what the quality statements meant to them and recounted their own experiences of living in a care home. The NICE Collaborating Centre for Social Care (NCCSC) has produced a short film aimed at children and young people in care to help them understand and use the NICE quality standard on the Health and Wellbeing of Looked After Children and Young People in Care.
- There are many ways in which you can get involved with the development of the guidelines… Poll 2 Q How likely are you to get involved with the development of these guidelines in one way or another? Very likely Quite likely Somewhat likely Not very likely Not at all likely
- There are many ways in which you can get involved with the development of the guidelines… Poll 2 Q How likely are you to get involved with the development of these guidelines in one way or another? Very likely Quite likely Somewhat likely Not very likely Not at all likely
- Prompt questions: What’s the best way to get the right people involved in guideline development? How can the guideline development process operate in a way that enthuses social care and makes people want to get involved? What might the barriers to involvement be and how can they be overcome?
- Poll 3 Q. Which topic would you like us to focus on for the next webinar? Adults: Mental wellbeing of older people in care homes Supporting people to live well with dementia Managing medicines in care home Autism Challenging behaviour and learning disabilities Delirium Children’s: Health and wellbeing of looked-after children and young people Autism Challenging behaviour and learning disabilities *SCIE - is it correct that we can only do this on a topic developed by the NCCSC?
- Q. Which topic would you like us to focus on for the next webinar? Adults: Mental wellbeing of older people in care homes Supporting people to live well with dementia Managing medicines in care home Autism Challenging behaviour and learning disabilities Delirium
- Q. Which topic would you like us to focus on for the next webinar? Children’s: Health and wellbeing of looked-after children and young people Autism Challenging behaviour and learning disabilities