Introduction This project uses an innovative approach to creating a new Hospice at Home team. The team aims to deliver a service that can respond quickly with a flexible and adaptable approach to meeting the needs of people who are in the last week of their lives and who wish to remain at, or return, home. It also incorporates the needs of families and carers. The service does not offer aspects of care which require a Registered Nurse and therefore works very closely with Primary Healthcare teams.

The team comprises of a Registered Nurse Team Co-ordinator, Staff Nurse and 14 whole time equivalent Healthcare Assistants.

Aims To keep decision making as close to the patient's situation as possible in order to deliver a fast, flexible and appropriate response to rapidly changing needs and situations.

To create a service that delivers not just personal care but which uses a creative approach to supporting people who wish to remain at home at the end of their lives.

Method Developing the assessment and decision making skills of the Healthcare Assistants who deliver the care. This empowers them to assess, plan, deliver and evaluate patient's care needs directly.

Flexible approach to needs assessment looking at all aspects of patient's, and their families', requirements. Not just focusing on personal care of the patient but what the whole family situation requires in order for the person to remain at home. For example, house work, shopping, meal preparation, etc.

Utilising the Hospice volunteer base to meet needs that cannot be delivered by the Heath Care Assistants. For example, garden maintenance and simple household maintenance.

Evaluation Project will be evaluated through the use of families and carer's satisfaction surveys and audit of the number of patient's who achieve their preferred place of death.