Tuesday 14 February 2017

It’s good to talk - Bringing confidence when talking about End of Life Care in Residential/Care homes

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Photo Orchard House web main

In June 2016 the Garden House Hospice Care successfully secured funding from the East and North Hertfordshire Clinical Commissioning Group’s Better Care for Hertfordshire Care Home Residents Vanguard Programme for two, one-year education posts to provide End of Life Care education in nursing homes in East & North Hertfordshire.

Both roles were successfully filled by Caroline Smith, previously Practice Development Nurse and Jane Landon, previously Hospice at Home Sister at Garden House Hospice Care.

Jane Landon, End of Life Care Educator says

“Following the Abc programme staff feedback has shown that knowledge and confidence in end of life care issues had improved vastly.  Consequently, staff feel more confident to instigate difficult end of life conversations with residents and their families using the communication skills learned on the course.   Care home staff are truly committed to giving their residents good care at end of life and the Abc programme aims to supports them in their daily practice”. 

All residential & care homes in East & North Hertfordshire are eligible for the free training programme so far over 20 homes have engaged in the programme so far. One successful residential home Orchard House, based in Letchworth has seen how staff and residents has benefited from the End Of Life Care training.

Orchard House Case Study
Orchard House based in Letchworth is a residential care home providing accommodation and personal care for up to 35 people with learning disabilities.

The need for end of life training was identified by Jeanette Morrow, Team Leader.  Traditionally people with learning disabilities, living with a life limiting diagnosis would be admitted to hospital for end of life care.  Jeanette recognised that Orchard House staff would benefit hugely from end of life education as a current resident is living with a life limiting illness.  
Orchard House want to support their residents with their end of life wishes and preferences. They feel it is important that residents could be offered the choice to be cared for in a familiar environment, with staff that know them well and have cared for them, in some cases for many years.

The Course:
In August 2016, twelve Orchard House staff successfully completed the two-day end of life care training programme, delivered by Jane Landon, End of Life Care Educator.  Initially staff were apprehensive at what the course might involve, and how topics may affect them personally and professionally.  Throughout the day staff had the opportunity to discuss end of life issues, and emotions were raised when discussing residents whom close relationships had been made over the years.  On day two of the programme the group were joined by two Learning Disability Clinical Nurse Specialist nurses, which provided another opportunity to answer any further questions about end of life care.

Feedback:
Jeanette, Team Leader says
“We are really pleased to have had the opportunity to complete this training. The course has given us all a valuable insight to end of life care. We all feel much more confident to instigate difficult end of life conversations with residents and their families.  Staff are more confident in their assessment skills, like identifying non-verbal signs of pain and distress. 
I really recommend this course, as it benefits both the residents and staff. 
It is important to Orchard House that our residents avoid unnecessary trips to the hospital, as it is a distressing time for residents and families.  Jane was an excellent trainer, and was really supportive to our training needs”

Outcome:
Orchard House have been able to use their learning to support residents in planning their own end of life care. As a direct result, each resident now has an end of life care section in their notes which includes their wishes, preferences and funeral plan.
In January 2017 a further 12 Orchard House staff completed the programme and future dates are also booked for more staff. They aim to have all Orchard House staff  complete the Abc 2 day end of life care programme.

For more information or to book a 2 Day On-site End of Life Workshops for Care Home and Residential Care Staff email education@stfrancis.org.uk