In response to National guidelines and local need to offer an alternative place for end of life care when patients no longer wish to die at home, we built three independent living units from a government grant. The authors now offer our population of approx 500 000 the opportunity for nurse-led respite and end of life care, in a homely environment. We deliver 24 h care from a dedicated team of healthcare support workers and specially trained volunteers, supported from our community specialist palliative care nurse team who are independent prescribers. The aim was to provide high quality, low cost care for patients and their family. Utilising our team of volunteers, we selected 26 volunteers to undertake extended education and training who were able to demonstrate competency in caring for palliative patients and their family. The training includes end of life care and palliative care, basic communication skills, role of multi disciplinary team, manual handling and infection control. In fact 14 have enrolled to undertake their NVQ at diploma level and we are currently exploring specialised bereavement training with memory boxes. The authors acknowledge that we may experience a rapid turnover of voluntary staff that could move into permanent employment; however this framework of offering training and utilising their skills is cost effective, highly skilled and up-to date. This training has been possible by linking with a local college and using the expert skills of one of our HCSW who is a NVQ assessor. Through the dedication of the voluntary staff and trainers we have been able to provide excellent cost effective patient care during end of life and respite support for families. The feedback from patients and families has been very positive.
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