National Institute for Health and Care Excellence FINAL Safeguarding adults in care homes [C] Tools to support recognition and reporting of safeguarding concerns NICE guideline NG189 Evidence reviews February 2021 Final These evidence reviews were developed by the National Guideline Alliance which is part of the Royal College of Obstetricians and Gynaecologists FINAL Error! No text of specified style in document. Disclaimer The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. 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ISBN: 978-1-4731-4000-4 FINAL C ontents Contents Tools to support recognition and reporting of safeguarding concerns .......................... 6 Review question ............................................................................................................. 6 Introduction ........................................................................................................... 6 Summary of the protocol ....................................................................................... 6 Methods and process ............................................................................................ 8 Evidence ............................................................................................................. 10 Summary of studies included in the evidence review ........................................... 11 Quality assessment of studies included in the evidence review ........................... 12 Economic evidence ............................................................................................. 12 Economic model .................................................................................................. 12 Evidence statements ........................................................................................... 12 The committee’s discussion of the evidence ........................................................ 16 References .......................................................................................................... 30 Appendices ........................................................................................................................ 32 Appendix A – Review protocol ...................................................................................... 32 Review protocol for review question C: What tools and ways of working support effective or accurate recognition and reporting of safeguarding concerns in care homes? ......................................................................... 32 Appendix B – Literature search strategies .................................................................... 40 Literature search strategies for review question C: What tools and ways of working support effective or accurate recognition and reporting of safeguarding concerns in care homes? .................................................... 40 Economics Search .............................................................................................. 50 Appendix C – Evidence study selection ........................................................................ 55 Study selection for review question C: What tools and ways of working support effective or accurate recognition and reporting of safeguarding concerns in care homes? ......................................................................... 55 Appendix D – Evidence tables ...................................................................................... 56 Evidence tables for review question C: What tools and ways of working support effective or accurate recognition and reporting of safeguarding concerns in care homes? ......................................................................... 56 Appendix E – Forest plots ............................................................................................ 77 Forest plots for review question C: What tools and ways of working support effective or accurate recognition and reporting of safeguarding concerns in care homes? ......................................................................... 77 Appendix F – Summary tables showing data from existing health and social care guidance with AGREE-II quality ratings ............................................................... 78 Summary of data tables for review question C: What tools and ways of working support effective or accurate recognition and reporting of safeguarding concerns in care homes? .................................................... 78 Appendix G – Economic evidence study selection ........................................................ 88 Economic evidence study selection for review question C: What tools and ways of working support effective or accurate recognition and reporting 4 FINAL C ontents of safeguarding concerns in care homes? ................................................ 88 Appendix H – Economic evidence tables ...................................................................... 89 Economic evidence tables for review question C: What tools and ways of working support effective or accurate recognition and reporting of safeguarding concerns in care homes? .................................................... 89 Appendix I – Economic evidence profiles ..................................................................... 90 Economic evidence profiles for review question C: What tools and ways of working support effective or accurate recognition and reporting of safeguarding concerns in care homes? .................................................... 90 Appendix J – Economic analysis .................................................................................. 91 Economic evidence analysis for review question C: What tools and ways of working support effective or accurate recognition and reporting of safeguarding concerns in care homes? .................................................... 91 Appendix K – Excluded studies .................................................................................... 92 Excluded studies for review question C: What tools and ways of working support effective or accurate recognition and reporting of safeguarding concerns in care homes? ......................................................................... 92 Appendix L – Research recommendations ................................................................... 95 Research recommendations for review question C: What tools and ways of working support effective or accurate recognition and reporting of safeguarding concerns in care homes? .................................................... 95 Appendix M – AGREE II quality assessment ................................................................ 96 AGREE II table for review question C: What tools and ways of working support effective or accurate recognition and reporting of safeguarding concerns in care homes? ............................................... 96 5 FINAL Tools to support recognition and reporting of safeguarding concerns 1 Tools to support recognition and reporting 2 of safeguarding concerns 3 This evidence review supports recommendations 1.1.3, 1.1.4, 1.1.9, 1.4.1, 1.4.8, 1.4.9, 4 1.4.10, 1.4.11, 1.4.12, 1.4.13, 1.4.14, 1.4.15, 1.4.16, 1.4.17, 1.4.18, 1.4.19, 1.4.20, 1.4.21, 5 1.4.22, 1.4.23, 1.4.24, 1.4.25, 1.6.1, 1.6.2, 1.6.3, 1.6.4, 1.6.5, 1.6.6, 1.6.7, 1.6.8, 1.6.9, 6 1.6.10, 1.6.11, 1.6.12, 1.6.13, 1.7.1, 1.7.2, 1.7.4, 1.7.5, 1.7.7, 1.7.8, 1.7.9, 1.7.10, 1.7.11, 7 1.7.12, 1.7.13, 1.12.1, 1.12.2, 1.12.3, 1.12.5, 1.12.6, 1.12.7, 1.12.8, 1.12.10. 8 Review question 9 What tools and ways of working support effective or accurate recognition and reporting of 10 safeguarding concerns in care homes? 11 Introduction 12 Tools to support recognition and reporting of safeguarding concerns are important because 13 this is the means by which safeguarding concerns can be identified and addressed. The 14 Care Quality Commission standards What can you expect from a good care home? include 15 the expectation that staff in care homes have the confidence to report concerns about the 16 care that colleagues, carers and other professionals give. 17 Chapter 14 of the Care Act Statutory