Background Audits and Care Quality Commission intelligence revealed a knowledge and skills gap for domiciliary carers giving end-of-life care. This resulted in end-of-life patients in Essex not always dying in the place of their choice, with frequent inappropriate 999 calls and transfer to hospital.
Aim This project was devised to offer unified end-of-life care teaching to domiciliary care providers across Essex, to upskill carers and create supportive links with council and local hospices. This ultimately would improve the care given to those at end-of-life, reduce unnecessary hospital admissions and support the confidence and comfort of carers.
Methods A three-day course was created by the three main hospices in the area working collaboratively with the local council. Funding was sourced by the council, so that participants could attend free-of-charge. The course was delivered in all three areas, covering the same end-of-life care material and addressing all six Ambitions for end of life care (National Palliative and End of Life Care Partnership, 2015; National Palliative and End of Life Care Partnership, 2021). The course also addressed the Care Quality Commission’s inspection Key Lines of Enquiry and fulfilled requirements of latest national guidance (Thomas, 2021).
Results The teaching has reached approximately 650 carers over the last two years, through a cascade method of teaching. Pre- and post-learning questionnaires demonstrated increased knowledge and confidence for all participants. Furthermore, 80% of attendees reported cascading the knowledge acquired to colleagues, with 60% reporting a marked improvement in attitude of staff toward giving end-of-life care. Telephone calls to local hospice helplines increased, with a parallel reduction in 999 calls, meaning that those patients received more appropriate care at home. Links to local hospices have been strengthened, and participating care agencies have received recognition for their improved work, with one agency gaining ‘Outstanding’ in their inspection, and a care sector award for their end-of-life care.
Conclusion This joint teaching project has improved end-of-life care given to people across a whole county, and also offers a model for others to replicate.
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