Background Early in the COVID-19 pandemic, care homes felt inadequately valued and considered by policy makers with centrally organised governmental response having counterproductive effects (Marshall, Gordon, Gladman, et al., 2021). Care home staff felt increasingly isolated, with a fifth of social care staff considering leaving the profession (Gordon, Goodman, Achterberg, et al., 2020). A swift response was developed by St Luke’s Hospice to support care homes in Sheffield, not only with palliative care, but also with information dissemination and peer support between care homes.
Provide alternative face-to-face assessment in care homes enabling remote end-of-life.
Support appropriate admission avoidance.
Enable clinical skills development, increased confidence and competence, and psychological support in care homes during the COVID-19 pandemic.
Methods The Care Homes VOICES project supported care homes by providing the following services:
Care home managers’ weekly virtual forum based on ECHO principles for care home managers. Guest speakers included infection control experts, public health, and local commissioners.
Care home education programme – based on ECHO principles included: symptom identification, PPE donning/doffing, managing recovery, and later vaccine advice.
Clinical skills training – multifaceted syringe driver training and competencies.
Specialist palliative care team input – initially virtually and later face-to-face.
Dedicated care home memorials and bereavement care.
Results Number of specialists/experts attending: 105. Average attendance at managers’ forum: 35. Number of CHs attending ECHO sessions: 47. Number of new care homes joined ECHO: 17. Number of individuals syringe driver trained: 39. Approximately 100 individuals attended a hospice-led remembrance. Qualitative responses suggest care homes benefitted from support received:
‘We are dealing with lots of deaths… discussion is needed and the opportunity to reflect and think about my practice.’
‘The COVID-19 programme has been so important for our staff – they have been able to understand and talk about changes to guidance and their own experiences.’
Conclusions The VOICES project has demonstrated how multi-faceted interventions can educate care home staff, disseminate resources, and provide psychological and clinical support amid a pandemic.
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