This resource helps shape high quality adult social care services and improve the well being of adults using social care.
Aimed at commissioners, it brings together NICE quality standards and guidelines in an easy to use format, mapped against Care Quality Commission key lines of enquiry*. It may also be useful to provider organisations and people who fund their own care.
It can help you to:
- find quality statements (from our quality standards)
- look at recommendations (from our managing medicines guidelines)
- start conversations with provider colleagues to agree ways to improve quality of care in your area
- agree ways to measure quality improvements.
* New key lines of enquiry to be used from November 2017.
NICE in the adult social care sector
How would the resource help you?
You can adapt the content to fit your local work, such as in contract specifications, quality dashboards or self-assessment tools.
The resource is an independent source of guidance on practical ways to improve quality. Our guidance is drawn from current evidence-based research. This means you can be confident that it's based on the best available evidence.
Most of the improvements in the resource rely on partnership working between:
- local authority commissioners
- health commissioners
- provider organisations.
We have included examples to show that great things can be achieved where people work in partnership to find a solution.
How was it developed?
The resource is part of the shared committment to Adult social care: Quality matters.
We co-produced this tool with representatives from:
- local authority commissioners
- provider organisations
- The Care Quality Commission (CQC)
|Jane Bowie||Director Joint Commissioning||Buckinghamshire County Council|
|Peter Chapman||Head of Safeguarding Adults||East Lancashire CCG|
|Terry Clark||Head of Social Care Commissioning||Sutton Council|
|Karen Culshaw||Policy Manager, Adult Social Care Policy Team||Care Quality Commission (CQC)|
|Michelle Greenwood||Operational Manager||Warrington Borough Council|
|Dominique Kent||Chief Operating Officer||The Good Care Group|
|Rosie Mainwaring||Locality Manager||Skills for Care|
|Angela McNamara||Programme Manager Integrated Commissioning||Liverpool City Region Combined Authority|
|Sarbjit Rai||Contacts Manager, Strategic Commissioning and Community||London Borough of Newham|
|Cheryl Reynolds||Joint Commissioner||London Borough of Lewisham|
|Simon Spoerer||Design Team Leader, Adult Social Care Policy Team||Care Quality Commission (CQC)|
|Jim Thomas||Programme Head, Workforce Innovation||Skills for Care|
|Mandy Thorn||Vice Chair||National Care Association|
|Adele Thornburn||Nursing and Quality Manager||Lancashire and South Cumbria STP|
|Frank Ursell||Chief Executive Officer||Registered Nursing Home Association|
|Michael Varrow||NICE quality standard advisory committee member||N/A|
|Max Wurr||Director of Policy and Communications||City and County Healthcare Group|
Case studies: how our guidance has helped improve quality of care
Helping Hands provide practical support to help people maintain independence. Following feedback from a user group, Helping Hands developed a new ‘welcome pack’. This contains information about standards of care, the role of regulatory bodies and how the adult social care system works. They used our Home care: delivering personal care and practical support to older people living in their own homes guideline and Home care for older people quality standard to inform the pack's content. They chose our guidance as it's a recognised independent source of evidence-based guidance.
The pack includes hyperlinks to sources of useful information for users of the service and can be shared electronically. There are links to our social care resources designed for the public. Service users have given the welcome pack positive feedback. It will continue to be updated and shared with people new to the service.
Mansfield District Council's Advocacy, Sustainment, Supporting Independence and Safeguarding Team (ASSIST) set up a hospital discharge scheme. They used our Transition between inpatient hospital settings and community or care home settings for adults with social care needs guideline in the development, implementation and delivery of the scheme.
A multi-disciplinary team assesses the individual needs of people before they are ready to be discharged. ASSIST address barriers to safe hospital discharge by a variety of methods including fast-tracking repairs to properties, sourcing alternatives to residential care and installing telecare.
Nottingham Trent University evaluated the hospital discharge scheme. They found evidence of:
- a reduction in unnecessary bed days
- cost effective use of resources
- improved outcomes for those with social as well as medical needs, following discharge.
A key learning point was the relevance of our guidance to the development of the hospital discharge service.
Plymouth City Council’s Quality Assurance and Improvement Team (QAIT) noticed that some local care home providers weren't aware of our Managing medicines in care homes guideline.
QAIT worked with the Northern, Eastern and Western (NEW) Devon CCG's Community Pharmacist Care Home Lead to develop a series of targeted educational events for local care homes. They considered recommendations from our guidance in relation to local practice. This included comparison between their own medicines management policy and our recommendations.
Around 85% of local care home providers attended these events and attendees evaluted them positively. Subsequent QAIT care home reviews showed local medicines policies had been changed. There was a 10% increase in the number of policies meeting our recommendations for content. QAIT and NEW Devon CCG are planning annual refresher sessions to continue the positive steps towards embedding guidance.
The i-QAF dashboard was created to monitor, benchmark and improve the quality of care experienced by older adults within local care homes. The dashboard includes relevant NICE guidelines and quality standards along with other guidance and best practice.
Newham Borough Council worked with a group of stakeholders, including both adult social care and health commissioners, provider organisations and other key groups and roles, to develop i-QAF.
Using the quality dashboard as part of a continuous cycle of improvement has contributed to:
- a 31% reduction in falls
- improved care home CQC ratings
- a 20% reduction in ambulance call outs
- a 13% reduction in A&E admissions.
Effective joint working continues through the local Quality Assurance Group. i-QAF content is regularly reviewed and updated with latest guidance.
Solihull MBC use our guidance regularly in a variety of ways. NICE guidance is a trusted source of standards and guidance to drive improvement in local quality of care.
They use our guidance to support integrated commissioning across health and children’s services. The topic based content enables an integrated approach as it spans different sectors and areas of responsibility.
Solihull MBC have also used our standards within service contracts and as markers of quality. When individual providers have highlighted a specific need, they've used NICE guidelines, quality standards and quick guides to support focused improvement. Defining outcomes and measures of quality is a priority within Solihull's adult care & support commissioning team, and our guidance supports this approach.
Warrington Borough Council recognise our quality standards as a valuable resource as they provide a shared space for discussions between commissioners and providers. We use robust and independent processes to develop quality standards based on the best available evidence. This results in clear, specific, measurable statements of quality.
Warrington BC have included quality statements within service specifications for domiciliary and residential care. Examples of this include statements from:
They've also devised a framework for monitoring quality in local domiciliary and care home services. This includes our quality statements. Warrington BC developed the framework with a small group of providers. The partnership approach ensured that the framework was relevant and helped providers to improve the quality of their services.
The Royal Star and Garter Homes have 2 care homes providing nursing and therapeutic care to the ex-service community. As part of a proactive approach to promoting quality, each care home showcases a ‘policy of the month’. This is picked according to the needs of individual residents in the home, new staff or publication of new national guidance or legislation. The Royal Star and Garter Homes check regularly for newly published guideline and quality standards. They then update policies to reflect our evidence based standards or recommendations.
They promote the policy of the month on the staff intranet and it's discussed at staff meetings. Discussion of relevant aspects are also encouraged at staff handovers. They see our guidance as a reliable source of information on what works well in adult social care and in relation to specific health conditions. It's also a way to evidence good and outstanding care.
Short, visual guides for social care audiences.
Statements covering priority areas for quality improvement (including ways to measure quality).
More detailed recommendations, based on the best available evidence.
If you've got comments, suggestions or feedback on the commissioning resource.
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- how our guidance is being used in adult and children's social care.