Introduction Care home residents are conveyed to acute settings in more frequent episodes in the absence of a completed ReSPECT process or clear escalation plan. Resuscitation is required to commence in the absence of a clear do not attempt resuscitation decision. There is a large percentage of decisions to convey a resident in the absence of a ReSPECT document and/or an advance care plan to support wishes to remain in their usual place of residence.
The scope of this service is to ensure that all ReSPECT and Advance Care plan documentation was up to date and fully completed with residents/families and other professionals, working in partnership with primary care and the care home sector across Wolverhampton.
Methods The service initially commenced within 3-6 care homes with a population of 50-75 residents, identified by conveyance figures, GP and PCN leads. The aim to complete, per home, 75% of all identified residents ReSPECT document prior to engagement with other homes.
Compton Care Clinical Nurse Specialist engaging with care homes to proactively embed the ReSPECT process, support and role model advance care planning conversations increasing the confidence and skills of care home staff in identifying their residents’ needs.
Results From the onset of the service February to April 2022 increased activity over timeline. Increased numbers of both care homes and residents engaging in the process of ReSPECT in support of dying within usual place of residence. Further results to follow on poster.
Discussion The implementation of this service will ensure that residents are able to have meaningful conversations in relation to their wishes and preferences for palliative and end of life care. From onset the feedback received from care home staff, PCN leads and GP who have been supportive toward the service, PCN ANPs and both residents and families has remained positive. The team have led on meaningful ACP discussions and facilitated ReSPECT process to support residents’ choices. The increased demand and activity across Wolverhampton has enabled further expansion of the team by Compton Care; increasing the number of both CNS and paramedic practitioners within the service, each now aligned with individual PCNs.
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