In an area (pop 235,000) with 112 care homes (3400 beds), the Six Steps to Success Programme supports delivery of high quality End of Life (EoL) Care. 45 homes achieved accreditation and a further 12 in next cohort. As a result, care homes have systems in place to identify residents approaching EoL, provide care and support families. Completing the programme and sustaining the changes made, is demanding yet rewarding.

Aim To support care homes to continue delivering high quality EoLC following completion of 6 programme, reduce unnecessary hospital admissions and enable residents to be cared for and die in preferred place of care.

Method Support initiatives include: delivery of cross boundary EoL education and support from local Specialist Palliative Care Service (SPCS) and TRANSFORM Team; monthly visits and regular telephone calls; collection and collation of data from homes; those approaching end of life are included on cross boundary register; flags on admission to hospital enable TRANSFORM to support admission and facilitate smooth transfer between care settings; quarterly link meetings (hosted by hospice) to share experiences and receive updates; syringe driver loan scheme in place for homes who attend competency based training.

Results Locally agreed criteria for continued accreditation have been agreed, with the majority meeting the requirements (33/35). The TRANSFORM Team has built excellent relationships enabling timely support, prompting best practice, and identifying and meeting the educational needs of staff.

Quantitative data collected helps demonstrate the good work they have done, identify challenges and share good practice, whilst qualitative feedback demonstrates the value, to them, of the support they receive.

Conclusion Through collaborative working with SPCS, acute trust and primary care, Care Home staff feel valued in EoL Care. Ideas and enthusiasm are generated by ongoing support for homes dealing with the challenges such as high staff turnover.