Case study:

11 November 2008

Providing co-ordinated care through Supportive and Palliative Care Standards for Care Homes (Nursing) in NHS South of Tyne and Wear

Key points

NHS South of Tyne and Wear has produced a set of standards for supportive and palliative care aimed at ensuring that people living in a nursing home with any condition (including illnesses other than cancer and those who are frail and elderly) receive the best quality care, including at the end of life.

The Supportive and Palliative Care Home Standards, which are currently being piloted in the area, were developed as a mechanism to encourage high quality equitable care for all residents living in nursing care homes, by supporting homes to undergo a structured process of quality improvements.

The initiative arose from a lack of local standards for this area of care and the need to find a tool that was not too expensive for the users. Local surveys showed big variations in standards of care in local care homes as well as levels of knowledge and skills among staff.

The assessment book contains six standards which each care home should aim to achieve. They relate to service provision, training and education, communication, symptom management, end of life care and bereavement care.

The framework encourages a self-assessment process where clinical and managerial improvements can be identified. The key outcomes include: enhanced communication and continuity of care as well as improved symptom management, anticipatory care, end of life care and care after death.

Homes will need to produce evidence to show they are meeting the standards. If a particular standard is not being met the home will be expected to agree an action plan on how this is going to be achieved.

Once all standards have been met, there will be a verification process and homes will be presented with a certificate to recognise their achievement. This will be an annual process to help monitor development.

The standards, which were developed by Gail White (Palliative Care Specialist Nurse for Care Homes in Sunderland) with Jackie Richardson and Louise Watson (Palliative Care Modernisation Facilitators for South of Tyne and Wear), were piloted in Gateshead, Sunderland, South Tyneside and Newcastle between June and October 2008.

Although they are still incomplete, feedback from homes in Sunderland suggests that care managers believe the standards are workable and will make a difference.

If this is mirrored elsewhere, the standards could be rolled out next year (2009) across the whole of the North of England Cancer Network.

The project has faced a number of challenges, including gaining the support of regional managers and persuading managers at the care home level to work with the standards. It has also become clear that homes will need to be supported throughout the process.