Using NICE guidance in social work

Examples of how to use our guidance

These example scenarios feature fictional situations and people. They show how NICE guidance could be used in social work practice.

Use our guidelines and quality standards to find specific recommendations to support your professional judgement in your everyday work.

View examples for principal social workers

Featured scenario: developing relationships with parents

A social worker makes a home visit to a family following concerns of neglect highlighted by the school. Katie, the mother, becomes angry with the social worker. She feels that they are interfering and have no right to be there asking such personal questions when she's no worse than other mums she knows.

Action

The social worker remembers a group supervision session which covered content from the child abuse and neglect guideline, including ways to build relationships with parents. She explains more clearly to Katie the legal context for her visit. This helps to depersonalise the situation and makes Katie feel more informed.

More information

The guidance includes advice to be open and honest when working with parents, including sharing the legal context in which they are involved.

Chloe, 14, has a history of self-harm. She has recently been admitted to an inpatient mental health unit following an overdose. Chloe lives with her dad, Jakob. Jakob works night shifts and relies on public transport. He complains to Chloe’s social worker that he has not been involved in any care planning discussions since Chloe has been admitted.

Action

Chloe’s social worker uses guidance on transition between inpatient mental health settings and community or care home settings to show staff on the ward the importance of supporting and involving families. The social worker is able to persuade the psychiatric team to arrange meetings at different times to fit with Jakob’s working pattern and reliance on public transport.

More information

The guidance includes advice on building relationships with and supporting families, parents and carers throughout admission.

Farzana, 13, is blind, has a moderate learning disability and is experiencing depression following the loss of her father. Farzana’s mum, Shazia, has said how worried she is about Farzana. She also says that she feels overwhelmed as she is a carer for her own mother, who has dementia and lives with them in the family home.

Action

Farzana’s social worker uses guidance on depression in children and young people to feel assured that Farzana is being offered appropriate support for her depression. They also use guidance on assessment, management and support for people living with dementia and their carers to help prepare for a sensitive discussion with Shazia about her needs. Following the discussion Shazia agrees to a carer’s assessment and information about how her mother could be supported by adult services.

More information

The guidance includes advice about the recognition and management of depression in children and highlights that people who live with a person with dementia could be at an increased risk of depression.

Featured scenario: managing violence and aggression

Alice, 14, has mental health issues. She lives with her dad and has regular breaks in a residential children’s home. The home informs Alice’s dad of any incidents where Alice has hit staff or young people. Alice tells her dad that when this happens, she is not allowed to phone him afterwards and this upsets her.

Action

Alice’s social worker uses guidance on the short-term management of violence and aggression in mental health, health and community settings to plan a review meeting with Alice, her dad and the care home manager. The plan includes good practice in terms of not using restrictions on contacting family as a punishment.

More information

The guidance includes recommendations on de-escalation and appropriate restrictive interventions for children and young people.

A team leader of an integrated mental health team has identified that young men referred to their service with both mental health and substance use issues are twice as likely to stop attending appointments.

Action

The team leader uses guidance on coexisting severe mental illness and substance use: community health and social care services to develop a proposal for local research to find out why this group of people stop attending the service. They make the case that the research could be used to change the service, making it more effective in meeting the needs of men with mental health and substance use issues.

More information

The guidance includes advice on service design for managers and organisations and specific guidance on maintaining contact with individual people accessing support.

Joanne has a moderate learning disability and has experienced 2 psychotic episodes. The second time she was admitted to a psychiatric inpatient unit. Joanne was recently discharged, but she and her family are worried that this might happen again and they don’t know what to do.

Action

Joanne’s social worker refers to guidance on mental health problems in people with learning disabilities and transition between inpatient mental health settings and community in a request to colleagues in learning disability and psychiatric teams to meet with Joanne and her family. The purpose of the meeting would be to create a crisis plan, which would include advance decisions about treatment and support and potential triggers or indicators of crisis.

More information

The guidance includes advice on developing a mental health care plan for people with a learning disability, crisis planning, and involving and supporting family and carers.

Featured scenario: supporting parents

Raphael, 10, has a severe learning disability and autism. He has no sense of danger, frequently hits his head on the wall and needs one-to-one support from his parents during waking hours. His parents are exhausted and feel isolated. They don’t know what they should do when he becomes distressed and hurts himself.

Action

Raphael’s social worker contacts colleagues in the local autism team to make a case for additional support for the family. The social worker refers to guidance on learning disabilities and behaviour that challenges and autism spectrum disorder in under 19s in the email, highlighting the value that the additional support would offer the family.

More information

The guidance includes advice on the provision of short breaks and access to advice and ongoing support for families and carers.

William, 53, lives with his mother Elsie, 82. William has Down’s syndrome and a mild learning disability. Elsie is worried about how William will cope when she dies. William wants to continue living in the family home. He would also like to learn how to fish and to visit Blackpool on holiday.

Action

William’s social worker refers to guidance on the care and support of people growing older with learning disabilities and the quick guide on person-centred future planning in a review meeting with William and Elsie. They use the quick guide as a basis for starting to discuss and create a future plan with William.

More information

The guidance includes information about person-centred planning for the future, involving family and carers if appropriate, and considering needs such as housing and future wishes.

Rainey has a moderate learning disability and was recently diagnosed with terminal bowel cancer. Rainey is frightened of dying and wants to leave hospital as soon as possible. Rainey’s consultant advises that she may only have up to 2 weeks to live.

Action

Rainey’s social worker uses guidance on the care and support of people growing older with learning disabilities and care of dying adults in the last days of life to help plan an agenda for an urgent multi-disciplinary care planning meeting. They use the guidance to ensure that Rainey’s wishes and concerns are given priority and to ensure that the care and support provided is seamless.

More information

The guidance includes recommendations on person-centred end of life care planning and communication needs, including the opportunity to discuss fears and anxieties.

Featured scenario: discharging people from hospital

During supervision, a hospital social worker discusses the pressure they are feeling to discharge people to care homes when those people may not have the capacity to make a decision about where they live. The social worker feels this potentially conflicts with the Mental Capacity Act 2005, particularly the principle of seeking the least restrictive option.

Action

The supervisor advises the social worker to use specific recommendations from guidance on transition between inpatient hospital settings and home and decision-making and mental capacity to strengthen their professional power when discussing discharge planning with health colleagues, including informing best interest meetings.

More information

The guidance recommends that decisions about long-term care are not made whilst in crisis and that decisions are made in the person's best interests.

Adio enjoys meeting his friends at a local Jamaican café, where he eats his main meal of the day. However since having a stroke Adio lacks the confidence to leave the house. Adio’s daughter has noticed that he has lost weight and that he seems depressed.

Action

The social worker meets with Adio, who confirms that he misses his friends and Jamaican food. Adio’s social worker uses guidance on people’s experience of adult social care and stroke rehabilitation in adults to plan a discussion with the occupational therapist in the stroke rehabilitation team. Following the discussion there is agreement that visiting the café will be included as a goal in the plan.

More information

The guidance recommends that each person’s self-defined preferences and needs should be used as the basis for care and that stroke rehabilitation plans should include goals that are meaningful for the person.

A practice educator asks a first year social work student to write a critical reflection on how they review care and support for older people in care homes. The student knows that wellbeing is key to the Care Act 2014, but is struggling to understand what this means in practice.

Action

The student uses the quality standard on mental wellbeing of older people in care homes and the quick guide on promoting positive mental wellbeing for older people to help understand what contributes to positive mental wellbeing in care homes. They conclude that they will use each quality statement to check care records in future reviews that they undertake in care homes.

More information

The guidance includes statements describing support that improves mental wellbeing in care home settings, such as participation in meaningful activity and maintaining and developing personal identity.

We've produced these example scenarios to help social workers understand how to use our guidelines and quality standards.

Our guidelines focus on a particular topic or setting and provide a comprehensive set of recommendations for action.

Our quality standards focus on areas of variation in practice and can be used to measure improvement or demonstrate good quality.