NICE has also produced a series of practical statements to help the NHS and relevant community settings tackle one of the major causes of disability or death in older people: falls.

Professor Gillian Leng, deputy chief executive and director of health and social care at NICE, said: “These two new documents, called quality standards, focus on two specific issues – managing medicines in care homes and falls in older people - where we know inconsistencies exist in the care that people may receive. This can have a detrimental effect on a person’s health and wellbeing, affecting not only their quality of life, but that of their families and carers too.

“The standards contain practical statements to help health and social care providers, practitioners and commissioners assess and improve the quality of care they deliver in key areas. They highlight the need for the health and social care sectors to work together where possible to ensure people receive the best quality care.”

Managing medicines in care homes

More than 350,000 people in England and Wales live in a care home, according to official figures. This includes people of any age with learning disabilities or other disabilities, and the elderly.

However, mistakes in administering medicines are not uncommon. A 2011 study showed that 9 in 10 care home residents were exposed to at least 1 potential medication administration error over a 3-month period.

The new NICE quality standard for managing medicines in care homes highlights this as a key issue in need of urgent improvement. It lists actions that should be taken to ensure that all necessary health and social care practitioners are aware of residents’ needs and can administer the right medicines to the right person at the right time. This includes:

• Health or social care service providers sending a discharge summary, including details of the person’s current medicines, with a person who transfers to or from a care home
• Prescribers who are responsible for people who live in care homes providing comprehensive instructions for using and monitoring all newly prescribed medicines.
• A multidisciplinary team undertaking medication reviews for people who live in care homes

The quality standard also says that residents who wish to self-administer their own medicines should be supported to do so as long as it does not put them or others at risk. It is cited as a key issue to improving the quality of life of people living in care homes.

Leonard Cheshire Disability UK nursing advisor, Juliette Millard said: “We welcome the new NICE quality standard on medicines management, which will support disabled and older people living in care homes to make informed, independent choices about their medication and health.

“Better communication between health professionals, care staff and the people they support will ensure that people get the right medication at the right time in the way they choose. This will not only improve individual health and wellbeing for the thousands of people living in care homes but will increase standards of safety and quality across the system.”

Assessing older people after a fall and preventing further occurrences

Falls and fall-related injuries are a common and serious problem for older people. Three in 10 people over the age of 75 in England – about 2.5 million - will have at least 1 fall each year. This risk rises to 50% for those aged 80 or above.

Most cases will not be serious, but about 5% will either require treatment for a fracture or a hospital stay. A 2011 report by the Royal College of Physicians found that falls and fractures in people aged 65 and over account for more than 4 million hospital bed days each year in England alone.

The new NICE quality standard for assessing older people after a fall and preventing further falls aims to support hospitals and community services to help improve the quality of life of older people and reduce the number of fall-related injuries occurring in people aged 65 and older.

The standard advises that older people who are living in the community and have a known history of recurrent falls are referred for strength and balance training.

It also says that healthcare professionals should carry out a risk assessment for any pensioner who visits hospital because of a fall. Those who need to stay in hospital should be offered a ‘home hazard assessment’ and any necessary help to prevent further incidences before they leave.

Adam Gordon, Honorary Secretary of the British Geriatrics Society and a consultant geriatrician in Nottingham, said: “Both of these standards are very welcome from the perspective of healthcare professionals looking after older people with multiple medical conditions. 

“We know that prescribing and dispensing errors in care homes are common and these guidelines recognise and seek to mitigate against important contributing causes – namely the failure to effectively communicate medication changes within and between care settings and the failure to have structured prescribing policies in place for care home residents. 

“The falls standard, meanwhile, brings together gold standard practice in how to manage older people following falls and, by giving it the NICE seal of approval, ensures that it will be delivered in hospital and community settings around the country."

Ends 

For more information call the NICE press office on 0300 323 0142 or out of hours on 07775 583 813.

Notes to Editors

About NICE quality standards

NICE quality standards aim to help commissioners, health care professionals, social care and public health practitioners and service providers improve the quality of care that they deliver.

NICE quality standards are prioritised statements designed to drive measurable quality improvements within a particular area of health or care. There is an average of 6-8 statements in each quality standard.

Quality standards are derived from high quality evidence-based guidance, such as NICE guidance or guidance from NICE accredited sources, and are produced collaboratively with health care professionals, social care and public health practitioners, along with their partner organisations, patients, carers and service users.

NICE quality standards are not mandatory but they can be used for a wide range of purposes both locally and nationally. For example, patients and service users can use quality standards to help understand what high-quality care should include. Health care professionals and social care and public health practitioners can use quality standards to help deliver high quality care and treatment.

NICE quality standards are not requirements or targets, but the health and social care system is obliged to have regard to them in planning and delivering services, as part of a general duty to secure continuous improvement in quality.

Quality standard topics are formally referred to NICE by NHS England (an executive non-departmental public body, established in October 2012) for health-related areas, and by the Department of Health and Department for Education for areas such as social care and public health.