Case study:

11 May 2010

Introduction of end of life care tools to improve care at Risedale Estates

Key points

Residents at Risedale Estates care homes in the north west of England say they feel more comfortable and in control of their care following the introduction of the Gold Standards Framework (GSF).

The five homes, which care for 243 residents with a variety of care needs including residential, Elderly Mental Illness and continuing care, joined the pilot scheme for the GSF (phase 2) in 2005.

A GSF link team – consisting of a facilitator, a Macmillan nurse and five link nurses – then helped introduce the scheme.

They began by implementing a new advanced care plan for all residents, which included issues around end of life and their preferred place of care.

A new resuscitation policy was also introduced and all nurses received training in basic life support and how to verify death.

Finally each care home identified a group of residents who would benefit from being on the GSF register and these were then reviewed at two-week intervals.

The homes have also introduced the Liverpool Care Pathway and the Preferred Place of Care document, which help residents to discuss their wishes before any crisis or emergency.

The new care pathway allows nurses to discontinue irrelevant procedures in the last 48 hours of life and concentrate on ensuring the last hours are comfortable and peaceful for residents and families.

Staff say they feel more confident and knowledgeable because of the training they have received and better able to communicate effectively with the multidisciplinary team.

The GSF link team won the 2006 Allcora Excellence in Care award, together with a £6,000 prize.