Overview of National Minimum Information Standards
Introduction
Standardisation of the content of the various stages of assessment and care management is a pre-requisite for the effective recording and appropriate sharing of information for the benefit of people receiving community care services and support.
This compendium sets out the national minimum information standards for all adults, covering Assessment, Shared Care and Support Plans and Review. It also includes national minimum information standards for the identification of needs and support for Carers ('Carers Assessment').
These standards have evolved from the original SSA Guidance and complement the guidance on care management issued by the Scottish Executive in 2004 ( Circular CCD8/2004) and, subsequently, the Care Management Framework published in 2006 (Circular CCD2/2006). Development of the standards, including those for carers, has been informed by the national work in early 2007 to develop Outcomes for Community Care and the standards will support both the objectives and the measurement of the Outcomes.
The compendium builds on and supersedes the National Minimum Information Standards for Single Shared Assessment for All Adults issued in August 2006 ( CCD3/ 2006).
The standards are the 'national minimum' and should be adopted in all partnerships (as defined locally). They apply to all community care groups.
Points to Note about the Standards
- There are two distinct types of standards used throughout this document:
Information Standards which describe the subject matter that must be included without specifying exactly how it should be done or recorded. This leaves flexibility at local level into how information standards are incorporated into local tools and guidance in an appropriate manner to enable assessors to gain good insights of, and to accurately document, the needs of the people assessed. There is no intention that the question wording in the national standard has to be mirrored exactly in local tools for the tools to be compliant. Indeed compliance may be achieved through the provision of explicit guidance that ensures that the relevant practitioner considers the item. Thus in some cases there may be no requirement to include unique fields on a system to match every information standard.
Data Standards which specify the content at a more prescriptive level and include details on the format and codes to be used for each of these standards. Data standards are particularly useful where there is a strong consensus on the exact content and where the data gathered are intended to be transferred across different systems. Compliance with the standards does require that local tools conform to the format and codes specified.
Both forms of standards - Information Standards and Data Standards - are used in this document and are labelled accordingly.
- It is recognised that the standards do not contain all the information required to address a person's individualised care needs. They set out the minimum information which all professional groups within health, social care and housing would expect to record, a 'core' of information to which specialist modules can be added. One underlying principle is that once this core information has been gathered it can be shared between the relevant professionals whenever appropriate, avoiding the need to gather the same information repeatedly with all the inconvenience and attendant risks.
- To meet the standards local assessment and care management tools, electronic systems or processes should have the capability to record every data item in the standards, but there is no presumption that every item will be recorded for every person. For example, it is possible that fewer items will be recorded for individuals with relatively simple needs, and items will not be recorded where they are clearly not applicable [ e.g. Landlord Details are not applicable to a home owner].
- The order in which the standards are presented in this document is not intended to be prescriptive.
Information sharing occurs in a variety of formats. The purpose of the National Minimum Information Standards is to support good practice in the recording of information that is gathered during and for the purposes of assessment and care management. Data required to share information electronically using the eCare Framework is contained within separate eCare specific documentation and can be accessed from the website: www.scotland.gov.uk/dss. The purpose of the National Minimum Information Standards is to support standardisation of the practice of assessment and related activities and not to define the technical specification for data sharing. The latter is contained within specific eCare documentation.
- Where a standard requires that further details should be recorded this should be done in accordance with good practice for assessment and care management.
- The SSA- IoRN is currently designed for use with people aged 65 and over. The SSA- IoRN questions and supporting guidance are listed at the end of the Assessment section. The questions are fixed and should be answered based on information drawn from the assessment process.
General Principles underpinning the Minimum Standards
In drawing up these standards, the Assessment Review Co-ordinating Group ( ARCG) was guided by the following principles:
- The minimum standards need to "make sense" to practitioners and should reflect good professional practice
- The standards should support the development of local assessment and care management processes
- The standards should be a foundation for the development of supporting information systems
- Where possible, any mandatory information requirements should be supported by the standards.
- The National Minimum Information Standards issued by ARCG should complement not duplicate, other work on data standards for health and social care. Where relevant standards have already been the subject of a separate consultation these will be adopted by ARCG and viewed as part of the National Minimum. For example the Personal Details in Section 2 are a sub-set of the Generic Core Dataset produced by The Social Care Data Standards Programme.
- A positive approach at local level towards the benefits of compliance is crucial to the process of building standardisation of information.
The National Minimum Information Standards cannot be considered in isolation from practice. For this reason this document should be read in conjunction with relevant national policies on assessment (including SSA), care management and carers' assessment.
Background to the ARCG and the development of minimum standards
The ARCG
The Assessment Review Co-ordinating Group ( ARCG) was formed to meet the demands of local partnerships in Scotland for national minimum information standards that would standardise the recording of information about people receiving community care services and facilitate data sharing. It was formed following a national Integration Seminar hosted by the (then) Scottish Executive in March 2004.
ARCG membership includes a representative cross-section of local partnerships, supported by staff from the Joint Future Unit, the central eCare Programme, Standards Branch, the Information and Statistics Division of NHS Scotland, and the SE's Community Care Statistics Branch. Membership of the Group as at 2007 is listed in Appendix One.
Context for the Minimum Standards
The Scottish Executive issued general guidance for Single Shared Assessment in November 2001 in a circular entitled Guidance for Single Shared Assessment of Community Care Needs (circular CCD 8/2001).
The SSA Guidance provided the initial reference point for the ARCG's work (see below). The work of the ARCG has also been informed by subsequent initiatives, including:
- Extensive work by local partnerships both on developing their own local assessment tools and procedures and on converting existing paper tools into an electronic form
- National work by the Standards Branch on the agreement of core data standards for eCare, and harmonisation with generic standards for health produced by the National Clinical Dataset Development Programme ( NCDDP)
- The development and incremental roll-out of the SSA-Indicator of Relative Need ( SSA- IoRN). This is a standardised tool (currently validated only for use with older people) which groups individuals according to their level of relative need, and is applied following a comprehensive Single Shared Assessment
- Early work to devise an agreed common core national dataset that will summarise the characteristics of older people (including the SSA- IoRN result) receiving community care services; this has a 'working title' the Care Assessment Data Summary ( CADS)
- Establishment of Performance Indicators for Single Shared Assessment within the Joint Performance Information and Assessment Framework (commonly referred to as the JPIAF 6 PIs) and, in 2007, the National Outcome Measures For Community Care.
- The Scottish Executive Circular CCD/2003 emphasised the importance of assessment of carers and noted, 'the fundamental principle underlying the new legislative provisions is at Local Authorities, the NHS and other support agencies should recognise and treat carers as key partners in providing care.'
Reflecting early priorities the ARCG initially devised, consulted on and issued, in December 2004, ( SE Circular CCD 15/2004) a set of minimum standards for the assessment of older people. This was superseded by National Minimum Information Standards on Assessment covering All Adults issued in August 2006 (CCD3/ 2006).
The diagram below indicates the key elements surrounding the process of assessment of need and care management. In health this is commonly referred to as the nursing process: within social care it is often referred to as the assessment and care management process.
Scope of the National Minimum Information Standards
Broadly speaking, the shaded areas in the diagram below are the areas covered by this document.
Links/references
The paper refers to a number of specific documents produced by various related work streams. These can be found at the following locations:
Care Management: http://www.scotland.gov.uk/Resource/Doc/1095/0014712.pdf
Original SSA Guidance 2001 http://www.scotland.gov.uk/Resource/Doc/1095/0014719.pdf
Data Standards Manual (Core and Supplementary Person Information Datasets) http://www.scotland.gov.uk/Topics/Government/DataStandardsAndeCare/Manual
SSAIoRN (relating to Older People) http://www.scotland.gov.uk/library5/health/rumhb.pdf
JPIAFhttp://www.scotland.gov.uk/about/HD/CCD2/00017673/JPIAF.aspx
National Training Framework for Care Management: http://www.scotland.gov.uk/Resource/Doc/1095/0014712.pdf
Coordinated, Integrated and Fit for Purpose. A delivery framework for adult rehabilitation in Scotland. http://www.rehabilitationframework.scot.nhs.uk/Documents/reports/CoordIntandFitforPupose.pdf
CHP Toolkit:
Management of Long Term Conditions
Carers: The Community Care and Health (Scotland) Act (2002) http://www.hmso.gov.uk/legislation/Scotland/acts2002/20020005.htm
The Elements of Nursing 4th edition. (Roper, Logan and Tierney) Churchill Livingstone, Edinburgh
The Review of Nursing
Voices from the Frontline