Stage 1: referral points

Patient experience in adult NHS services

1.5.14 Explore the patient's preferences about the level and type of information they want. Based on this, give the patient (and their family members and/or carers if appropriate) clear, consistent, evidence-based, tailored information throughout all stages of their care. This should include, but not be limited to, information on their condition (or conditions) and any treatment options, where they will be seen, who will undertake their care, expected waiting times for consultations, investigations and treatments.

1.1.1 Ensure that intermediate care practitioners: develop goals in a collaborative way that optimises independence and wellbeing adopt a person-centred approach, taking into account cultural differences and preferences.
1.1.2 At all stages of assessment and delivery, ensure good communication between intermediate care practitioners and: other agencies people using the service and their families and carers.
1.1.3 Intermediate care practitioners should: work in partnership with the person to find out what they want to achieve and understand what motivates them to focus on the person's own strengths and help them realise their potential to regain independence build the person's knowledge, skills, resilience and confidence learn to observe and guide and not automatically intervene, even when the person is struggling to perform an activity, such as dressing themselves or preparing a snack support positive risk-taking.
1.4 Referral into intermediate care. People have the right to be involved in discussions and make informed decisions about their care, as described in NICE's information on making decisions about your care.

1.1.5 Provide nurse-led support in the community for people at increased risk of hospital admission or readmission. The nursing team should work with the team providing specialist care.
1.1.6 Provide multidisciplinary intermediate care as an alternative to hospital care to prevent admission and promote early discharge. Ensure the benefits and risks of various types of intermediate care are discussed with the person and their family or carer.

1.1 Ensuring care is person centred.
1.1.1 Ensure services support the aspirations, goals and priorities of each person, rather than providing 'one size fits all' services.
1.1.2 Ensure support focuses on what people can or would like to do to maintain their independence, not only on what they cannot do. Recognise: that people have preferences, aspirations and potential throughout their lives and that people with cognitive impairment and those living alone might be at higher risk of having unmet social care‑related quality of life needs or worse psychological outcomes.
1.1.3 Ensure people using home care services and their carers are treated with empathy, courtesy, respect and in a dignified way by: involving people and their carers in discussions and decisions about their care and support. Agreeing mutual expectations. Always respecting confidentiality and privacy. Providing a reliable service that people and their carers can trust. Regularly seeking feedback (both positive and negative) about the quality and suitability of care from people using the service, including those who do not have a carer or advocate.
1.1.6 Ensure the person using the service, and their carers (if the person has involved them in their care), can direct the way home care is delivered. This is so that the person's safety, comfort, independence and sense of security are always promoted.