Background Care homes have been particularly badly affected by the events of 2020. We acquired short-term resource from two streams to improve system resilience during winter.
Aims To assess the impact of enhanced specialist palliative care to care homes regarding responsiveness, professional support and education, referrals, advance care planning (ACP), hospital admissions and deaths in preferred place of death (PPD).
Methods A free education programme was offered to all care homes in Preston, Chorley and South Ribble commencing in November 2020. This was complemented by input from a Clinical Nurse Specialist over a total of six months.
Results Between 1 January and 31 May 2021, 56 patients were referred. 69% from the hospital palliative care team. 46% of patients had cancer. Four patients died before they were assessed. 68% of patients were seen within seven days of referral. 29 patients died during the project timescale and 93% of deaths were in a care home. The only hospital admission was precipitated by an acute event. We found evidence that documentation of ACP and escalation of treatment plans improved by our intervention. Potential hospital admissions were avoided in 14 cases due to ACPs. There were challenges for carers in attending education, with 172 attendees over 34 sessions. With regard to visiting during a time of societal restrictions, 28% of review appointments took place face-to-face.
Conclusions Education was well-received but further work is required to improve accessibility and to assess longevity of benefit. We responded clinically in a more timely manner, as compared to ‘normal care’. We identified a theme of inadequate and inconsistent documentation of future care planning.
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