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Developing competencies for end of life care in care homes
  1. John Lansdell and
  2. Mary Mahoney
  1. St Catherine's Hospice, Crawley, England


Introduction End of life care is provided by generalists, often in the care home sector. Inadequate training and support can lead to suboptimal end of life care in care homes. The development of measureable competencies supported by education is essential to improve care delivery. This relies on working together as hospice competencies are not directly transferrable to the care home environment.

Aim To improve end of life care in care homes in a sustainable way through the development of core competencies supported by education.

Method This pilot project involved hospice staff working collaboratively with four local care homes. Year one developed a competency framework within each individual home informed by focus groups. Year two analysed competencies and identified key issues for inclusion in a 5-day training programme, tailored to address these issues in the broader context of palliative care. 15 care home staff attended the course, feeding back learning in their respective homes. The impact of the course on end of life care delivery was considered. Year three incorporated the competencies into existing staff appraisal systems. Senior care home staff were trained to assess competence, promoting sustainability of the competency work.

Results Engaging care home staff in the development of competencies and identification of educational need is essential to ensure a tailored, relevant programme. Effective measurement of competence is achieved through appropriate assessment linked to staff appraisal. Opportunities for sharing learning throughout the process should be identified at an early stage.

Discussion and conclusions Developing a competency framework demonstrates an ongoing commitment to the development of staff and ultimately care home services, when supported by a tailored package of education. Working together is fundamental to success.

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