1. Facilitator: Step 4 1

2. Review / Recap Step 3 workshop review Review of ‘To Do’ List Reflection discussions 2

3. 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 3

4. 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 4

5. 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? 5

6. 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 6

7. Education & Training What education, training and skills are needed in end of life care, within the domiciliary care setting? 7

8. Education & Training Formal courses Online learning In-house training Reflection on practice Supervision and feedback Independent learning 8

9. 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 9

10. 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 10

11. 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 11

12. Environment Fit for purpose...  Comfort  Dignity  Privacy  Safety  Adequate temperature, lighting, ventilation  Adequate space (for care delivery) INDIVIDUAL CHOICE 12

13. Family/carers & significant others Roles Participation/involvement Limitations Awareness and understanding Preparation for end of life changes Feedback 13

14. 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 14

15. Onwards... ‘To Do’ List Reflective practice Evaluation of session Next session: Step 5: Care in the last days of life 15