Seventy per cent of care home residents die in a care home (Public Health England, 2017) therefore a large part of what care homes provide is end-of-life care (Social Care Institute for Excellence, 2017). Since April 2020 there were 173,974 deaths of care home residents which was an increase of 19.5%, meaning care homes were dealing with more resident deaths than ever before (Office for National Statistics, 2021). The care home project was introduced to sixteen care homes across a geographical area in April 2020 in response to the COVID-19 pandemic.

The aim of this project was to enable care homes to identify residents who were in the last year of life. This was achieved through weekly support either by phone or video conferencing platforms using an empowerment approach. Once residents were identified the facilitators prompted care home staff to consider the following; Do Not Attempt Cardiopulmonary Resuscitation orders, emergency care plans, anticipatory medications and any communications which may be needed with the GP, resident or resident’s family.

To support learning, a root cause analysis was completed following a resident’s admission to hospital to determine if the admission was avoidable or unavoidable. A reflective debrief was also conducted following each death. All of these were subjected to thematic analysis. The analysis identified several findings including having rescue packs of antibiotics and clear, concise completed ReSPECT forms could make hospital admissions avoidable. The care home staff were also able to clearly reflect on the impact of the COVID-19 pandemic on the end-of-life care residents received, with the visiting restrictions causing a great deal of distress to both loved ones and care home staff.

Overall, the care home project supported a number of care homes and their staff to provide good quality end-of-life care during unprecedented times using learning from across the project to inform all homes.