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Contacts

Contact:

John McCarthy

Director of Care

Organisation:

Grantham House

Westmead Close Westacre Droitwich Worcestershire WR9 9LG United Kingdom

Tel:

01905 796561

Email:

Case study:

11 May 2010

Improving end of life care in Worcestershire


Key points

  • A pilot study identified ways in which staff could improve their care of dying residents
  • It is hoped this will allow more residents to end their life in familiar surroundings with families and friends
  • The need for spiritual guidelines and assessment forms was highlighted and these are now in place

Nine care homes (personal care) run by Heart of England Housing and Care Ltd in Worcestershire have been examining ways of developing services to allow more residents to spend their last few months in familiar surroundings with families and friends.

Director of care John McCarthy explains that their homes already looked after residents who were dying, with the help of primary care services.

But they were finding that as they worsened residents would often be moved to hospital or a care home (nursing) where they died.

As a result the group decided to conduct a pilot study in two homes. This involved staff working with local district nurses to examine how the care of those approaching the end of their lives could be improved.

The team looked specifically at the next two people in each home who were approaching death.

Following this exercise the district nurses identified good practice in supporting residents with personal and physical care.

This involved considering, for example:

Appearance and comfort

Skin and pressure area care

Oral hygiene

Nutrition and hydration

Management of continence

Moving and handling and positioning to aid comfort

Managing pain relief

Maintaining good relationships with residents, their families and medical professionals

Involving families and friends in the resident’s life

Respecting residents’ and families’ wishes leading up to and at death

District nurses also identified areas for improvement, some of which were relatively simple to implement.

For instance, the homes were struggling to address people’s spiritual needs fully.

But at a National Council for Palliative Care event Mr McCarthy and his assistant director met a hospice chaplain who was able to provide them with spiritual needs guidelines and assessment forms as well as an action plan.

The learning from the pilots is now being spread to the nine other homes within the group.

It is also hoping to find funding to appoint a trainer/champion who can develop a training strategy to be used by all the care homes in the county.


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