NICE publishes first quality standards for social care

Our first social care quality standards will help support people with dementia, and improve the health and wellbeing of looked-after children

From April 2013, NICE became known as the National Institute for Health and Care Excellence and officially began producing guidance and quality standards for the social care sector.

We have set up the NICE Collaborating Centre for Social Care, which uses NICE's methods and processes to develop social care guidelines. NICE then uses these as a basis for its quality standards for social care. The NCCSC also provides NICE with support for adoption and dissemination of social care guidelines and quality standards by developing innovative tools for social care audiences, with involvement of service users, carers and practitioners.

Our first quality standards for social care were published in April 2013 and will help support people with dementia to live well, and improve the health and wellbeing of looked-after children and young people.

The dementia quality standard contains ten statements which are high-priority areas that will help people with dementia to live well.

Professor Gillian Leng, Director of Health and Social Care at NICE said: “Followed in its entirety, it will enable individual care practitioners, care homes, agencies and other social services to ensure that people with dementia have an enhanced quality of life, a positive experience of their care and are protected from avoidable harm.”

NICE's second quality standard for social care contains eight statements that will improve the health and social, educational and emotional wellbeing of looked after children and young people in care.

In December 2013, we published a quality standard on the mental wellbeing of older people in care homes which marked a “bold step forward” in terms of improving care.

More than 400,000 older people currently live in care homes, a figure set to rise given the UK's ageing population.

While many older people in care homes are well looked after, recent high-profile cases have highlighted instances of substandard care, which suggests standards can vary.

A reason for this is the prevalence of mental health issues among older people, which can often complicate care. With loneliness, depression and low levels of life satisfaction widespread among residents in care homes, it can be hard for staff to offer the support they need.

This quality standard - NICE's 50th - aims to address these issues through six measurable statements.

The first statement calls for older people in care homes to be offered opportunities during their day to participate in meaningful activity that promotes their health and wellbeing.

NICE recommends that older people should be encouraged to take an active role in choosing and defining activities that are meaningful to them. These can range from reading, gardening and arts and crafts, to group activities that involve family, friends and carers.

Another statement says that older people in care homes should have the symptoms and signs of mental health conditions recognised and recorded as part of their care plan.

While mental health conditions such as dementia are very common among older people in care homes, they are often not recognised, diagnosed or treated.

Consequently, NICE recommends that symptoms and signs of mental health conditions should be recognised and recorded by staff who are aware of GPs' roles in the route of referral. This can help ensure early assessment and access to appropriate healthcare services.

The positive impact of enabling people to maintain and develop their personal identities is also highlighted in the quality standard.

George McNamara, Head of Policy at the Alzheimer's Society, welcomed the quality standard. It will help care home staff respond to the needs of people with mental health conditions such as dementia.

"Given the significant population of people residing in care homes with dementia or severe memory problems, it's a bold step forward, he said."

Read more from George McNamara on the quality standard and the ways it can help improve the quality of care and experience of older people in care home settings.

Addressing challenges in the diganosis and treatment of autism 

In January 2014, we issued a quality standard on autism to help services address the current variation in diagnosis and treatment of the disorder.

Autism is a lifelong condition affecting than half a million people in the UK. Of these 80,000 are thought to be children of school age.

In recent years, initiatives such as the Autism Act and the National Autism Strategy have aimed to address the complex needs that people with this condition have.

However, the type and quality of care for autism continues to vary across England and Wales meaning that people do not always receive a quick diagnosis or the services they require.

To help reduce this variation in care, our quality standard on children, young people and adults with autism contains eight measurable statements, which together can improve the quality and consistency of care for people with the condition.

The first statement recommends that people with possible autism who are referred to an autism team for a diagnostic assessment have the diagnostic assessment started within 3 months of their referral.

To ensure people have a swift diagnosis, we recommended that it is important that this assessment is conducted as soon as possible so that appropriate health and social care interventions, and advice and support can be offered.

People with autism often have symptoms or aspects of other conditions that, if unrecognised or untreated, can have a significant impact on their lives and their families and carers. Such conditions include attention deficit hyperactivity disorder (ADHD), depression, anxiety and motor coordination problems.

Consequently, the second statement calls for people having a diagnostic assessment for autism to be also assessed for coexisting physical health conditions and mental health problems.

The needs of people with autism are varied, with some people needing complex levels of support from a range of professionals, while others may not want or need such support.

As a result, a further statement calls for people with autism to have a personalised plan that is developed and implemented in a partnership between them, their family and carers if appropriate, and the autism team.

Jonathan Green, Professor of Child and Adolescent Psychiatry at the University of Manchester, and member of the quality standard committee, said: "Across England, there is real variation in the type and quality of care people with autism receive, which can have lasting effects on both the person and their families and carers.

"It is important, therefore, that there are clear standards in place - based on the best available evidence and expert consensus - which specifically focus on key areas needing improvement.

"These will aid health and social care professionals and commissioning bodies to deliver the very best for people with autism."