Individual research recommendation details

Recommendation ID

NG150/3

Question

What training, support or interventions help to reduce caring-related accidents or incidents?

Any explanatory notes
(if applicable)

Why the committee made the recommendations
Qualitative evidence suggested that carers often lacked confidence or felt overwhelmed in their caring role. There was also a wide range of evidence suggesting that training containing a variety of components can improve carers' skills and confidence in caring, and their understanding of the health condition, disability or needs of the person they care for, so the committee recommended carer-specific training programmes.
The committee used the evidence to pinpoint the common features of effective, cost-effective and acceptable carer training programmes. Tailoring programmes means their exact content would depend on the training needs of different carers but, based on the evidence, the committee recommended some core components to include. Those elements related to psychological and emotional wellbeing are included in the psychological and emotional support section of this guideline.
By consensus, the committee also agreed to add some additional components in recommendation 1.6.6 that they felt were valuable, based on their knowledge and experience, but which did not have specific support from the evidence.
Qualitative evidence suggested that some carers have insufficient information about medication management and the use and maintenance of equipment to administer medication. Therefore, the committee recommended that training programmes could include managing medicines. For guidance on managing medicines in the community, see NICE's guideline on managing medicines for adults receiving social care in the community.
The committee agreed by consensus that training could be delivered in a number of ways, in groups or one-to-one, and that it was important to acknowledge the range of skills and specific expertise needed by trainers. The committee also agreed that trainers should seek input directly from people who have been carers when designing and delivering carer training so that training programmes are based on real and recent lived experiences of caring.
From the evidence it was clear that many carers value the chance during training to meet other carers with similar experiences or circumstances, as well as the opportunity to have a break from caring. Moderate quality evidence suggested that training programmes reduced carers' sense of isolation, helped them interact with each other, discuss and resolve issues they are facing, and provide informal emotional support. Based on this evidence and their own expertise, the committee agreed that training programmes should provide a balance between learning and social and emotional support, and opportunities to explore different ways of continuing to offer support and advice to each other (peer support).
Evidence showed positive feedback from minority groups (in this case lesbian, gay, bisexual and transgender carers) that training groups which are inclusive or specific to them were valued and allowed them to meet others from that community. Therefore, the committee agreed to make a recommendation to ensure that training programmes are designed with a particular focus on being inclusive and supporting diverse groups.
There was no evidence on the impact of training for carers on caring-related accidents or incidents (involving either the carer or the person they care for), including failure to take prescribed medicine and falls. The committee therefore made a research recommendation to identify what training, support or other interventions aimed at carers help to reduce caring-related accidents or incidents (see research recommendation 3). The committee noted that it would be helpful if any new research were able to identify the association between increased accidents and specific factors such as the carer's age and their physical and mental health.

How the recommendations might affect practice
The recommendations reinforce best practice. The way services deliver carer training programmes varies across the UK, so the recommendations will help to improve consistency.
Providing multicomponent training programmes may involve initial additional costs. First, there may be an increase in the number of requests for training. Training may also be needed for practitioners to deliver the training. However, the components in recommendation 1.6.5 were based on the elements of the START (Strategies for Relatives) training programme. The economic evidence suggested that START was cost effective for carers of people with dementia and the committee agreed that it was reasonable to extrapolate this to all carers. Therefore, any additional costs of providing the programmes would be worth the benefits in carers' wellbeing and quality of life.
Full details of the evidence and the committee's discussion are in evidence review E: providing training for carers to provide practical support.

Source guidance details

Comes from guidance

Supporting adult carers

Number

NG150

Date issued

January 2020

Other details