Background Most people express a wish to die in their usual place of residence thus care home staff are supporting more people at the end of life. These staff are often inadequately trained and lack experience in end of life care. Care homes can feel marginalised from accessing hospice services.

Aim The hospice to support care homes caring for those residents who wish to die in their usual place of residence and avoid an unwanted hospital admissions at the end of life.

• Implementing the ‘wheel of support’ to improve hospice services to care homes:

• On site delivery of end of life care training, to enable care staff to support their residents’ wishes

• Enhanced relationships between hospice and care homes – hospice staff working alongside care staff to provide clinical support and guidance.

• Monthly Community Palliative Care Network (CPCN) meetings providing training, support and reflective practice.

• Enable staff to work closely with G. P.s and out of hours providers to avoid unwanted admissions to hospital at the end of life.

Method The Wheel of Support offers care home staff and residents a range of hospice health and social care services including:

• 24 hr advice line

• Monthly hospice key worker visits

• GSF facilitation

• Individual resident referrals

• Social support from hospice neighbours

• Hospice staff working alongside care home staff

• Education and training

• Access to resources

Results Carers report increased confidence caring for their residents at end of life, liaising with G. P.s and out of hours providers. CPCN meetings have facilitated sharing experiences with other staff in similar care situations.

Conclusion The development of enhanced hospice services to care homes has led to a more knowledgeable and confident workforce enabling more residents to avoid unwanted hospital admissions at the end of life.