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

2. 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.

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
Progress through ppt as prompt screens

4. 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

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?
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

6. 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

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

8. 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

9. 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

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
Watch selected EOLC/dignity film and discuss

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
Social Care Institute for Excellence
Handouts – promote becoming a Dignity Champion via website link

12. 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

13. 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?

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
Revisit to ensure objectives have been met

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