Quality standard
Quality statement 3: Recognition of mental health conditions
Quality statement 3: Recognition of mental health conditions
Quality statement
Older people in care homes have the symptoms and signs of mental health conditions recognised and recorded as part of their care plan.
Rationale
Mental health conditions are highly prevalent among older people in care homes, but are often not recognised, diagnosed or treated. Ageing with good mental health can make a key difference in ensuring that life is enjoyable and fulfilling. The recognition and recording of symptoms and signs of mental health conditions by staff who are aware of the role of the GP in the route to referral can help to ensure early assessment and access to appropriate healthcare services.
Quality measures
Structure
Evidence of protocols to ensure that staff are trained to recognise the symptoms and signs of mental health conditions in older people, and record them in their care plan.
Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by provider organisations, for example from staff training records.
What the quality statement means for different audiences
Organisations providing care ensure that staff are trained to be alert to the symptoms and signs of mental health conditions in older people in care homes and to record them in a care plan.
Social care, health and public health practitioners look for symptoms and signs of mental health conditions and record them in the older person's care plan.
Local authorities and other commissioning services commission services from providers that can produce evidence of protocols for training staff to be alert to the symptoms and signs of mental health conditions in older people in care homes and to record them in a care plan.
Older people in care homes are cared for by staff who recognise the symptoms and signs of mental health conditions (such as depression and anxiety) and record them in their care plan.
Source guidance
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Dementia: assessment, management and support for people living with dementia and their carers. NICE guideline NG97 (2018), recommendations 1.2.1 and 1.2.5
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GP services for older people: a guide for care home managers. Social Care Institute for Excellence (SCIE) guide 52 (2013), Managers' responsibilities and the NHS reforms: actions as a result of listening to residents and relatives, accurate, up-to-date recording; Workforce development, standards and regulation: developing trained, confident care workers
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Common mental health problems: identification and pathways to care. NICE guideline CG123 (2011), recommendations 1.3.1.1, 1.3.1.2 and 1.3.2.1
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Delirium: prevention, diagnosis and management. NICE guideline CG103 (2010, updated 2023), recommendations 1.3.1 and 1.5.1
Definitions of terms used in this quality statement
Care homes
This refers to all care home settings, including residential and nursing accommodation, and includes people accessing day care and respite care. [Expert opinion]
Mental health conditions
These include common mental health conditions such as depression, generalised anxiety disorder and social anxiety disorder, and may also include dementia and delirium. People may have more than one mental health condition at a given time. (See the NICE guidelines on dementia, depression in adults, depression in adults with a chronic physical health problem, delirium, common mental health problems and social anxiety disorder for more information.)
Recognised
Recognised in this context relates to staff observing and recognising the symptoms and signs of mental health conditions, and sharing information and concerns with healthcare professionals, including GPs. Staff should be continually alert to new or worsening symptoms and signs. Observation of behaviour should happen on an ongoing basis and in response to the presentation of relevant symptoms. [Expert opinion]
Trained staff
This refers to staff who have been trained to recognise and record the symptoms and signs of mental health conditions when caring for older people. Staff should be alert to the presentation of new symptoms and signs and aware of existing conditions. Staff should also be competent in recognising when older people need a referral for assessment and management of the mental health condition. [Expert opinion]
Equality and diversity considerations
When looking for symptoms and signs of mental health conditions, be aware of any learning disabilities, acquired cognitive impairments, communication and language barriers, sensory impairment and cultural differences. Staff should ensure that they are aware of the needs and preferences of older people who are approaching the end of their life.
It is important that staff are aware that older people in care homes have the same right to access healthcare as people living independently in the community. This is stated in the NHS Constitution for England.