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P-49 End of life care @ home: care assistant certificate
  1. Clare Lawrance1,
  2. Carole Cousins2,
  3. Sian Williams3,
  4. Sara Stevenson-Baker4 and
  5. Jane Berg2
  1. 1Woking and Sam Beare Hospices, Woking, UK
  2. 2Princess Alice Hospice, Esher, UK
  3. 3Phyllis Tuckwell Hospice, Farnham, UK
  4. 4St Catherine’s Hospice, Crawley, UK


A collaborative educational initiative in Surrey aimed at care workers delivering end of life care at home.

National End of Life Care strategy strongly emphasises the need to provide excellent end of life care in all settings (Department of Health, 2008; National Palliative and End of Life Care Partnership, 2015; Hospice UK, 2017). However, current statistics indicate that while 80% of people would prefer to die at home, only 23.5% achieve this (Hospice UK, 2017; ONS, 2018).

A suggested contributory factor is the lack of appropriate expertise in end of life care within the domiciliary care setting. To address this need, the four Surrey hospices (Woking & Sam Beare, Phyllis Tuckwell, Princess Alice and St Catherine’s) developed a partnership with agency staff to co-design and introduce an end of life training course specifically aimed at care assistants providing care at home.


  1. Improve the knowledge, understanding, attitudes, behaviours and clinical skills of care assistants providing end of life care at home by sharing Surrey hospices’ expertise;

  2. Enhance local partnership working and hospice education collaborations.

Method The hospices developed a three-day course comprising two taught days, a half day carers coaching session followed by group reflection. The course content is based on the five Priorities of Care with strong focus on the communication and practical skills required for end of life care.

Results A pilot programme was delivered in March 2018. Evaluation results were extremely positive with strong evidence that knowledge and skills gained were transferred into practice. Attendees indicated the course improved their knowledge and communication while the teaching style, coaching and reflection enhanced their understanding and performance.

Unfortunately, subsequent courses attracted low numbers with agencies reporting being unable to afford course costs (agreed at £330/3 days) and backfill. The hospices are seeking further Clinical Commissioning Group support and/or grant funding to continue offering the course and in addition, it will now be offered beyond domiciliary care to residential and care home staff as well.

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