Concept To develop a low cost, consistent end of life care programme, available to all care homes. It will support the development of nominated staff in residential and nursing homes to become End of Life Care Home Representatives (champions) implementing organisational change utilising the Route to Success for care homes.

Why? Fits with the End of Life Care Strategy, identifying the need for a cultural shift in attitude and behaviour across the health and social care workforce Provide stronger partnerships between the NHS and the independent care sector Address the key components of End of Life Care education to support care homes in providing end of life care i.e. Advance Care Planning, communication skills and 5 Priorities for Care of the Dying Person Improving equity of quality end of life care for all residents in a care home

End of Life Care Strategy “Good PCTs working with local authorities will wish to commission services from care homes which: Residents approaching the end of life are on an end of life care register Each resident is offered a care plan, which clearly identifies their needs and preferences for care Staff receive the training and support they need to provide end of life care There is a appropriate access to GP, District nursing and specialist palliative care advice” DOH, 2008, End of Life Care Strategy p95

Quality Improve the resident and family experience of end of life care in a care home setting Enhance care delivery within the care home at end of life A skilled workforce Innovation A low cost Network EOL programme providing a consistent approach across localities with a wide access to all care homes Can support care homes who currently have high recorded admissions to the acute sector for end of life care Develop a care home representative to take responsibility for the future development of end of life care provision in their care home Productivity Enhanced end of life care Enhanced MDT working Deliver choice at end of life Wider awareness and implementation of End of life care Development of locality End of Life Care home Forums Address equity Prevention Reduction in hospital admissions at end of life from Care homes Reduction of isolated working QIPP

CQC

End of Life Care Quality Markers For Care Homes Action Plan for End of Life (EoL) Mechanisms to discuss and record wishes (Advance Care Planning) Resident’s needs assessed and reviewed Nominate a key worker for each resident at EoL Residents who are dying have an individual plan of care. Families and carers are involved in decisions at EoL to the extent they wish Other Residents are supported following a death Quality of EoL care is audited and reviewed Process to identify training needs of all workers, common requirements – communication skills, assessment and care planning, ACP and symptom management Training needs addressed for those staff initiating Advance Care Planning Aware and encourage attendance to EoL care training Review all transfers in and out of the care home at EoL

All care homes to access End of Life Care training Gold Standards Framework Macmillan Foundations in Palliative Care Pack /TRIBAL Six Steps to Success Other Education Programmes End of Life Care Training Matrix

Overview of the Six Steps to Success Programme Induction workshop Six Steps to Success workshops Supporting education: communication skills, Advance Care Planning and 5 Priorities for Care of the Dying Person Conclusion workshop Continuation of care home forum

Recruitment Local awareness raising session Participation agreement to be signed Registration

Expectations of an End of Life Care Home Representative Regularly meet with other End of Life Care Home Representatives Develop other learners in end of life care Build resource files within the care home Produce a portfolio to evidence the implementation of the programme that could be shared with regulatory bodies (CQC), commissioners and social services To be a link with the local End of Life Care Facilitator Initiate change management within the home Register with NHSIQ Facilitator/Champions Network

Attendance from care home representative and manager/matron Portfolio of evidence Completion of knowledge, skills and confidence audit Pre programme audit on end of life care activity National, regional and local driving forces Introduction to the Six Steps to Success programme Audit cycle/change management Roles and responsibilities of care home representative Commence an end of life care policy/action plan Induction Workshop

Six Steps Step 1 - Discussions as the end of life approaches Step 2 - Assessment, care planning and review Step 3 - Co-ordination of care Step 4 - Delivery of high quality care in care homes Step 5 - Care in the last days of life Step 6 - Care after death

Conclusion Workshop Review of the programme Individual feedback on progress Portfolio review Issues and challenges Post programme audit Completion of End of Life Care Policy

Celebration On Completion of the six step programme the End of Life Care Representative will become the Care Home End of Life Care ‘Champion’ The Care Home Representative will receive a certificate of attendance Care home will receive a dated certificate on completion of portfolio

Sustainability Care home forum continues regularly External speakers Staff agendas Continuing access to education and support End of Life Care Home Forum will be a valuable resource group to drive and trial new initiatives in End of Life Care for the care home sector i.e. e –learning

Evaluation Ongoing evaluation throughout the course Pre and post-course audits Audit of ACP National roll out of the Six Steps to Success Programme Recruitment Presentation V2 Nov 2014