National Institute for Health and Clinical Excellence (NICE)
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Older people in care homes – a new NICE briefing to help local authorities

The National Institute for Health and Care Excellence has published a new briefing to help local authorities and partner organisations put older people’s needs at the heart of the care given by residential and nursing homes (Wednesday 18 February).

There are more than 450,000 people living in the 12,800 registered residential care homes and 4600 registered nursing care homes in England[1].  Although local authorities run fewer than 1000 residential care homes, they have a duty of care for all residents. They oversee safeguarding issues and promote residents’ wellbeing.

The NICE briefing pulls together key recommendations from relevant NICE guidance and quality standards to help local authorities commission high quality services, which make best use of resources and provide good value.  For example, without proper care and attention, older people in care homes can become malnourished and end up in hospital. The briefing emphasises the steps that care homes should take to provide residents with a balanced, healthy diet and to be aware of the signs of malnutrition.

Commenting on the new briefing, Professor Gillian Leng, Deputy Chief Executive at NICE, said: “Older people often move to a care home as a result of a crisis, with no preparation and little or no planning.  This briefing underlines the importance of focusing care on the needs of the resident. It aims to help local authorities make well-informed, evidence-based decisions on issues affecting the care provided for older people.  

“NICE recommendations advise that people living in care homes should be helped to retain their independence and identity, for example through supporting them to take part in activities they enjoy, and allowing them to go at their own pace.  It’s also important to respect a person’s right to make their own decisions if they still have the capacity to do so. This includes having as much choice as possible about personal routines such as when someone eats or sleeps, or spends time alone. The person’s needs should come before what is most convenient for the home.”

Professor Leng added: “Older people’s physical needs are equally important to their mental wellbeing. The briefing also highlights recommendations on preventing falls, supporting people with dementia, procedures for reporting safeguarding and handling medicines errors, and quality statements on screening for malnutrition. Following the steps set out in the briefing will help local authorities and their partner organisations to deliver good standards of care for older people in care homes. The briefing may also help families and people moving into homes to ask questions about the care being provided.”

The recommendations and quality statements signposted in the briefing include:

  • ensure older people in care homes retain their independence and identity  
  • set clear policies and plans for older people in care homes
  • provide equal access to services
  • ensure residents are safe
  • prevent infections among residents.

The briefing ‘Older people in care homes’ is available at

For more information call Dr Tonya Gillis at the NICE press office on 0300 323 0142 or out of hours on 07775 583 813.

[1] In 2013, 12,848 residential care (as opposed to nursing) homes for adults and older people in England were registered with the Care Quality Commission. The number of residential care home beds (declared at the point of registration) was 244,232.The number of registered nursing homes was 4664. The number of nursing home beds was 218,678 (Annual report and accounts 2013/14, Care Quality Commission).

Notes to Editors

About the new Local Government Briefing

  1. The new briefing ‘Older people in care homes’ is published on 18 February 2015, and is available at:
  2. NICE’s local government briefings aim to help councillors and local authority staff find out which public health actions are most effective in improving the health of people in their area, while also providing the best value for money. Based on recommendations from existing NICE public health, clinical guidance and quality standards, the briefings have been developed with input from the independent Local Government Reference Group. The group comprises councillors, local government officers, and others with an interest in community health and wellbeing. The briefings are in addition to NICE’s ongoing programme producing public health guidance. Topics covered include tobacco, physical activity and workplace health, alcohol, health inequalities and behaviour change.

About NICE

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for driving improvement and excellence in the health and social care system. We develop guidance, standards and information on high-quality health and social care. We also advise on ways to promote healthy living and prevent ill health.

Our aim is to help practitioners deliver the best possible care and give people the most effective treatments, which are based on the most up-to-date evidence and provide value for money, in order to reduce inequalities and variation.

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