Facilitator: Step 4 Welcome group, housekeeping, register Ice breaker of choice. Ground rules to flip chart for weekly display.

Review / Recap Step 3 workshop review Review of ‘To Do’ List Reflection discussions Step 3 revisit/summary – ask participants to identify one thing they learned from the step 3 workshop Discuss homework completions – ‘To Do’ list and reflection piece Facilitator to emphasise that evidence may be used for QCF end of life unit, award, certificate – if undertaking now or in the future.

Objectives Step 4 objectives: Recognise the complex combination of services across a number of settings Recognise the importance of Significant Event Analysis Recognise the need for training on end of life care Identify aspects surrounding dignity, environment and family/carers at the end of life Progress through ppt as prompt screens

Delivery of high quality care in domiciliary care Step 4 Delivery of high quality care in domiciliary care “Individuals may be receiving a complex combination of care services. They are entitled to receive high quality care regardless of their care setting and who is providing the services.” The Route to Success in end of life care – achieving quality in domiciliary care Review RTS workbook pages 17-18

Complex combination of services What challenges exist in domiciliary care in end of life care? How does this impact in ‘out of hours’ care? How can distress be minimised? Group discussions – end of life care scenario’s from experience Flip chart – Challenges raised = possible solutions Facilitator may source local information – local advice/support phone lines, availability of out of hours pharmacies, etc

Education & Training What education, training and skills are needed in end of life care, within the domiciliary care setting? Posed question – list responses on flipchart / white board Discuss

Education & Training Formal courses Online learning In-house training Reflection on practice Supervision and feedback Independent learning Discuss

Syringe Driver Awareness Care Planning & Assessment Development in EOLC End of Life Care Communication Skills Symptom Awareness Syringe Driver Awareness Equality & Diversity Care Planning & Assessment Condition Awareness Advance Care Planning Mental Capacity Act Record keeping Dignity End of Life Care Plan Facilitator to identify that education, training and skills are broad and may be led or responsive to individuals within their care remit, or may be more generalised foundations of care

Significant Event Analysis Group activity: In groups discuss a recent end of life care event. Make notes on the Significant Event Analysis template. Be ready to feedback to the group Engineered groups of 3-4 (depending on size of overall group) Significant event template on A3 if possible for each group. After feedback display the charts for participants to review at break

Dignity “Dignity is concerned with how people feel, think and behave in relation to the worth or value of themselves and others. To treat someone with dignity is to treat them as being of worth, in a way that is respectful of them as valued individuals.” Royal College of Nursing Watch selected EOLC/dignity film and discuss

Become a ‘Dignity Champion’ Stand up and challenge disrespectful behaviour Act as a good role model by treating other people with respect, particularly those who are less able to stand up for themselves Speak up about Dignity to improve the way that services are organised and delivered Influence and inform colleagues Listen to and understand the views and experiences of citizens www.dignityincare.org.uk Social Care Institute for Excellence Handouts – promote becoming a Dignity Champion via website link

Environment Fit for purpose... Comfort Dignity Privacy Safety Adequate temperature, lighting, ventilation Adequate space (for care delivery) INDIVIDUAL CHOICE Discuss the challenges with environments in a person’s own home and how the care worker is able to balance this with individual preference and choice

Family/carers & significant others Roles Participation/involvement Limitations Awareness and understanding Preparation for end of life changes Feedback Include individual’s choice – do they want family/carers/significant others involved?

Objectives Step 4 objectives: Recognise the complex combination of services across a number of settings Recognise the importance of Significant Event Analysis Recognise the need for training on end of life care Identify aspects surrounding dignity, environment and family/carers at the end of life Revisit to ensure objectives have been met

Onwards... ‘To Do’ List Reflective practice Evaluation of session Next session: Step 5: Care in the last days of life