Older people - standards and guidance
You can use this page to familiarise yourself with regulatory standards for each of the UK countries. Key guidance is also listed.
Some documents are in PDF format - see how to access PDF files.
Regulatory standards
England
Care Quality Commission (CQC) The essential standards
The essential standards of quality and safety are central to the work of the CQC in regulating health and adult social care. Each of the standards has an associated outcome that they expect all people who use services to experience as a result of the care they receive. The standards relate to the 28 regulations contained in the legislation governing their work. The essential standards include standards for hospitals, care homes, care in the home and dentists.
The CQC has also produced a guide which provides a summary of the guidance that they have produced to help providers of health and adult social care to comply with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and the Care Quality Commission (Registration) Regulations 2009. See: Guidance about compliance. Summary of regulations, outcomes and judgement framework (PDF 566KB).
Care Quality Commission (2012) Government standards
These guides help the public to understand what standards of care they have a right to expect in care homes, hospitals, care at home and dentists and what they should do if they experience poor-quality care.
Northern Ireland
Department of Health, Social Services and Public Safety (DHSSPS): Safety, Quality and Standards – Care standards
Residential care and nursing homes are overseen by the Regulation and Quality Improvement Authority (RQIA), which is responsible for monitoring the standards of private, voluntary and Trust homes. The RQIA inspects all registered homes to make sure they meet Minimum Standards, which are set by the Department of Health, Social Services and Public Safety (DHSSPS). The standards focus on the safety, dignity, wellbeing and quality of life of service users. They are designed to address unacceptable variations in the standards of treatment, care and services and to raise the quality of services. See also: Regulation and Quality Improvement Authority (RQIA) Minimum standards.
Scotland
Scotland’s National Care Standards
The National Care Standards were developed by the Scottish Government to ensure that everyone receives the same high quality of care no matter where they live in Scotland. The Standards set out what you can expect from the care service you use. They are written from the point of view of the person using the service in an easy to understand style. The standards are based on six main principles: dignity, privacy, choice, safety, realising potential, equality and, diversity. They include standards for care homes for older people. See: Care Homes for older people.
Clinical Standards Board for Scotland (CSBS) (2002) Older people in acute care national standards
This document introduces the Older People in Acute Care clinical standards as adopted by the Clinical Standards Board for Scotland (CSBS). These standards are used by CSBS to assess the quality of clinical services provided in acute settings throughout Scotland for older people. The national overview report sets out the findings of a review of performance against the CSBS standards for older people. View: National Overview - Older People in Acute Care (2004).
Wales
Doing well, doing better: Standards for Health Services in Wales
The Healthcare Inspectorate Wales (HIW) is the independent inspectorate and regulator of all health care in Wales. The updated framework of standards set out the requirements of what is expected of all health services in all settings. They provide a consistent framework that enables health services to look across the range of their services in an integrated way to ensure that all that they do is of the highest quality and that they are "doing the right thing, at the right time, for the right patient in the right place and with the right staff".
Care and Social Services Inspectorate Wales: Care for adults
This section of the Care and Social Services Inspectorate Wales (CSSIW) website introduces the regulatory and legislative framework and links to the national minimum standards for social care.
Guidance
Guidance is listed alphabetically by organisation.
Age UK publications
These are in the form of guides, leaflets and factsheets aimed at older people and their carers. The information and advice includes leaflets on Health and wellbeing and Home and care.
British Geriatrics Society: Clinical guidelines
This section of the website has clinical guidelines developed by the BGS (usually in conjunction with other bodies).
British Geriatrics Society: Good practice guides
These guides cover issues of governance in older people's care.
Centre for Workforce Intelligence (2011) Integrated care for older people: Examining workforce and implementation challenges
This report is the first in a series investigating the workforce implications of moving towards an integrated health and social care system. This report considers eight different ‘point’ models of care, describing the service provided and assessing economic, quality of care and workforce implications.
Joint Improvement Team Action Areas: Reshaping care for older people
The Joint Improvement Team (JIT) works closely with partnerships and other lead agencies in key action areas that support service developments and improvements. The action areas aim to support good practice initiatives and help identify innovative solutions that could inform wider strategic development.
Joseph Rowntree Foundation (JRF) (2011) A Better Life – what older people with high support needs value
Part of the JRF's A Better Life programme, this paper explores the views of older people and the factors that help or hinder them; and proposes a model which demonstrates how their needs could be met.
Through the five year programme, JRF is commissioning a range of work to increase their understanding of what can help older people with high support needs now and in the future, whatever setting they live in. The programme will then produce recommendations for policy and practice. The Better Life website has been inspired by the JRF's programme A Better Life, investigating how older people with high support needs can have a better quality of life. Visit: A Better Life.
King's Fund (2012) Continuity of care for older hospital patients: a call for action
This paper explores how continuity of care for those aged 70 and older with multiple health problems, affects them and the people closest to them. It considers what good practice would look like and makes recommendations on practical models and methods for improving continuity. As well as reviewing published evidence the paper also includes case studies from individual carers, and examples of interventions designed to strengthen relationships between patients, carers and professionals.
NHS Institute for Innovation and Improvement: Focus on: Frail older people
This document aims to help local health communities and organisations improve the quality and value of care for frail older people, using urinary tract infections (UTIs) as a tracker condition. It is one of a series of documents produced by the high volume Healthcare Resource Groups (HRG) programme. “The primary aim of the team’s work has been to discover how the top performing healthcare organisations in the NHS and elsewhere deliver the highest quality care with the best resource utilisation”[please note that you will need to register and have an nhs.net email address in order to access this document].
NICE Patient experience in adult NHS services quality standard
This quality standard from NICE (National Institute for Health and Clinical Excellence) includes ensuring that patients are given the opportunity to discuss their health beliefs, concerns and preferences in order to individualise their care. It also states that patients have their physical needs, psychological concerns assessed. In addition the standard states that patients are made aware that they have the right to choose, accept or decline treatment and these decisions are respected and supported.
NICE Clinical guideline (CG138) Patient experience in adult NHS services
This guidance promotes person-centred care that takes into account a patient's needs, concerns and preferences. It acknowledges the value patients place on healthcare professionals acknowledging their individuality and the unique way in which each person experiences a condition and its impact on their life. The guidance therefore makes a number of recommendations on knowing the patient as an individual, essential requirements of care, and enabling the patient to actively participate in their care.
NICE public health guidance (PH16) Mental wellbeing and older people
This guidance is for all those involved in promoting older people's mental wellbeing. It focuses on practical support for everyday activities, based on occupational therapy principles and methods. This includes working with older people and their carers to agree what kind of support they need.
National Voices (2011) Principles for integrated care
National Voices has developed this set of principles to support joined-up care and continuity of care between services and care settings. The principles fall into two groups - those which describe the nature of integrated care and those which address its organisation. They are intended to inform all approaches to integrated care which should be person-centred and fully inclusive, but it is recognised that different models and systems will be required. There is also a range of statements that describe what success might look like from a user perspective in terms of better integrated care.
Nursing and Midwifery Council (NMC) (2009) Guidance for the care of older people
The purpose of this guidance is to establish principles for best practice in the care of older people in all settings where nursing care is provided, in both hospitals and the community. The focus is on respect, dignity and communication and it is intended that the guidance be read in conjunction with ‘The Code: Standards of conduct, performance and ethics for nurses and midwives’. The NMC also has information for older people on what they should expect from nurses, and what to do if they have any concerns. See: Older people and their carers.
Patient and Client Council (2012) Someone to stand up for me - a toolkit to promote advocacy for older people in the independent care home sector (PDF 1.56MB)
This toolkit is aimed at those working in the care home sector. It provides ten tools to help people think through, plan and undertake advocacy work. These encompass a draft policy, key messages, issues for discussion and checklists.
Royal College of Physicians (2012) Acute care toolkit 3: acute medical care for frail older people
The third in a series of toolkits and produced in collaboration with the British Geriatrics Society, this aims to improve the care of the frail older patient. Assessing these patients can be particularly difficult as they can often arrive at hospital with multiple symptoms or conditions. The toolkit recommends procedures for both initial assessment on admission and later Comprehensive Geriatric Assessment.
Social Care Institute for Excellence (SCIE) Older people
This section of the SCIE website brings together all of the resources produced by SCIE which are relevant to care of older people. This includes: hospital care; home care; housing and care; medication; mental health; end of life care; participation. Resources include relevant videos from Social Care TV. View: Social Care TV.
SCIE: Social Care Online
This is an online database of the UK's most complete range of information and research on all aspects of social care and social work.
Scottish Government: Older people
This section of the website provides links to Scotland's long-term strategy for older people and other related topics including community care and improving your health.
Scottish Intercollegiate Guidelines Network (SIGN) (2009) Management of hip fracture in older people
The aim of this guideline is to ensure that older people with a hip fracture receive optimal management. This guideline covers pre-hospital care, management in the emergency department, pre- and postoperative care, discharge planning and rehabilitation. Prevention of hip fracture and the management of osteoporosis are covered elsewhere.
The Knowledge Network Scotland: Care for Older People Portal
NHS Education for Scotland, in partnership with the Scottish Social Services Council, have developed a website to provide a ‘one stop shop’ for finding and sharing knowledge. This portal provides information, resources and education for health and social care staff who support older people in Scotland. It includes evidence, learning resources, legislation, standards and guidelines, and publications on topics such as nutrition, stroke, dementia and medicines management.
For standards and guidance on: dementia; dignity; nutrition and hydration; patient safety; safeguarding see Specific areas of care.