Aim Domiciliary care workers play an important but often unrecognised role in supporting people to remain at home as they near the end of life, especially those with dementia and frailty. Despite this, few receive specific training in end of life care. Focussed training enables home care workers to improve the quality of care for such people who choose to remain in their homes, and contribute to better coordinated cross boundary care.

Method The fully revised GSF Domiciliary Care training programme focuses on enabling generalist frontline staff in end of life competencies. The Train-the-Trainer cascade programme works with Domiciliary Care Agency Trainers; using action based, interactive learning and reflective practice in six modules, with support from the virtual learning Zone/DVD, and resources. Comparative before and after qualitative and quantitative evaluation is intrinsic and includes frontline care worker confidence self-assessments, supportive care analyses and organisational competency questionnaires.

Results Homecare workers in various areas of the country show improvements in:

• Confidence and competence of home care staff

• Communication, working relationships and collaboration with primary care

• More advance care planning discussions, with service users keen to be involved in these discussions

• Encouragement and empowerment of staff to advocate for their service users leading to improved communications with other professionals

• Increased awareness of the knowledge they already possessed and future training needs.

Conclusion This highlights the important role that domiciliary care workers play, and the importance of empowering care staff that interact with the service users on a daily basis. The GSF Domiciliary Care Training Programme boosts the confidence and competence of care workers, improves collaboration and coordination with others and helps to improve care for more people nearing the end of life at home – which is for most the best place to be.