Quality statement 3: Reviewing needs and preferences

Quality statement

People with dementia participate, with the involvement of their carers, in a review of their needs and preferences when their circumstances change.

Rationale

The needs of people with dementia will change as their circumstances change. It is important their care and support adapts quickly to changes in circumstances, and a review should be triggered when changes happen. This can help ensure that appropriate care is provided at the right time to enable people to continue to live well with dementia.

Quality measure

Structure:

a) Evidence of local arrangements to ensure that people with dementia participate, with the involvement of their carers, in a review of their needs and preferences when their circumstances change.

b) Evidence that decisions made under the Mental Capacity Act 2005 about needs and preferences of people with dementia are made in line with the code of practice that accompanies the Act.

Outcome:

a) Feedback from people with dementia that they participate in a review of their needs and preferences when their circumstances change.

b) Feedback from the carers of people with dementia that the person they support has their needs and preferences reviewed when their circumstances change.

What the quality statement means for each audience

People with dementia take part in a review of their needs and preferences when their circumstances change.

Carers of people with dementia are involved in helping the person they support participate in a review of their needs and preferences when circumstances change.

Local authorities and others commissioning services work with providers to ensure the services they commission enable people with dementia to participate, with the involvement of their carers, in a review of their needs and preferences when circumstances change.

Organisations providing care and support ensure people with dementia participate in a review of their needs and preferences, with the involvement of their carers, when circumstances change.

Social care and healthcare staff ensure people with dementia participate, with the involvement of their carers, in a review of their needs and preferences when circumstances change.

Source guidance

NICE clinical guideline 42 recommendation 1.1.7.2.

Data source

Structure: a) and b) Local data collection.

Outcome: a) and b) Local data collection.

Definitions

Carers

The Department of Health defines a carer as someone who provides unpaid support to family or friends who couldn't manage without this help, whether they're caring for a relative, partner or friend who is ill, frail, disabled or has mental health or substance misuse problems.

Review of needs and preferences

This refers to the actions taken to re-examine the support needs and preferences of a person with dementia and assess whether existing support is still appropriate or needs altering to address unmet needs or changes in preference. It can also apply to re-examining needs and preferences of people not currently receiving support but for whom circumstances have changed.

When circumstances change

This refers equally to changes experienced by people with dementia and changes experienced by their carers. This includes, but is not limited to, changes in:

  • care and support needs

  • behaviour

  • mental health and wellbeing

  • preferences

  • personal circumstances.

When people with dementia lack capacity, review decisions made on their behalf under the Mental Capacity Act 2005 should be made in line with the accompanying code of practice.

Equality and diversity considerations

NICE clinical guideline 42 recommendation 1.1.1.7 lists alternative and additional support that may be needed if language or acquired language impairment is a barrier to accessing or understanding support.

Social care and healthcare staff should identify the specific needs of people with dementia and their carers arising from diversity, including gender, sexuality, ethnicity, age and religion. These needs should be recorded in care plans and addressed (NICE clinical guideline 42 recommendations 1.1.1.3 and 1.1.1.5).