Background Domiciliary care is the ‘front line’ of social care delivery, (Wittenberg & Hu. Projections of demand for and costs of social care for older people and young adults in England, 2015 to 2035. PSSRU discussion paper No 2900; 2015) carers are ideally placed to identify people living with frailty and signpost them to appropriate services. Frailty is everyone’s business, all health and social care staff should have access to frailty education appropriate to their role (British Geriatrics Society. Joining the dots: A blueprint for preventing and managing frailty in older people. BGS; 2023).

Aim By providing carers with knowledge and skills to identify and manage people living with frailty, we aim to demonstrate an increase in referrals from carers to hospice services and reduce incidents of unscheduled emergency care.

Method Four agencies were recruited as partners to receive training in frailty, palliative and end of life care. The agencies represented a range of providers in terms of CQC ratings, nature of care packages provided and location. Following consultations with partner agencies, a training programme was designed and is being delivered in line with the ‘Frailty Framework of Core Capabilities’ (Skills for Health & NHS England; 2018). Support meetings with care managers aim to identify people with frailty and provide support with complex cases, encouraging referral to hospice services and use of our 24hour advice line.

Results Around 100 care workers are scheduled to complete the training before September 2024, and 65 hospice staff attended training. Feedback from attendees so far shows a marked increase in confidence having attended training and all reported an intention to change practice. All partnership agencies have engaged with support meetings, they report challenges as they act as advocates for people and their families in navigating health care systems particularly at end of life and, by necessity, deliver increasingly complex healthcare tasks.

Conclusion The importance of care workers to the functioning of the healthcare system should not be underestimated. The project is ongoing, we expect to evidence referral pathways originating from care providers and subsequent engagement in advance care planning leading to reduced unscheduled episodes of emergency care.