Abstract

In November 2015, Wigan and Leigh Hospice launched their ‘Hospice in your care home service’ which aims to educate and support nursing home staff to enhance the care of their residents and those important to them. The team of four registered nurses and one health care assistant provide formal education, clinical skills training and facilitate resident coding meetings in a bid to increase confidence and competence in the nursing home workforce, whilst advocating a more proactive approach to planning for the end-of-life.

Adapted from the model utilised at St Christopher’s Hospice, the service differs in that, the team will respond to urgent referrals from the home or other healthcare professionals, when it has been agreed that the resident is dying and further support and advice may be required. The team will work alongside the staff in the nursing home to embed the five priorities of care, utilising this as a learning opportunity for the care staff via role modelling of sensitive conversations with residents and families/those important to the resident and skilling up staff to promote a good death for the individuals they care for.

The rationale for the team has been the high numbers of hospital admissions from nursing homes within our locality and a reduction in the numbers of care home staff accessing education at the hospice. Analysis of the contributing factors indicates that theoretical and clinical skills education is something the care home staff desire, however this needs to be easily accessible for them, on site and be delivered in a variety of ways which are meaningful for them in practice.

A three-month evaluation has already highlighted a 20% increase in the number of residents with advance care plans, and homes now managing their own syringe driver set up, rather than using community nursing services.