Case study:

21 March 2011

Training and education for domiciliary care staff in end of life care

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Key points

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Over the past year the Wirral Metropolitan College Health and Social Care team has been working to meet the training needs of domiciliary workers by running two-day introductory courses on the principles of end of life care.

Working in partnership with Wirral Department of Adult Social Services, NHS Wirral and Merseyside & Cheshire Cancer Network, the team has so far delivered eight courses to a total of 130 staff. Feedback has been very positive from both participants and their managers.

In almost all cases people attending the course feel they have increased confidence, skills and knowledge and most feel they will benefit from the training and apply it in practice. The impact on people receiving care, their families and others providing support has still to be evaluated.

Despite their key role in providing care domiciliary care workers have significant unmet training needs, according to the Department of Health. This project aims to bridge that gap by:

• Offering targeted training linked to the common core competences and principles for health and social care workers working with adults at the end of life
• Ensuring that domiciliary care staff working for Wirral Council contracted agencies in Cheshire and Merseyside (primarily Wirral) have the right level of skills, experience and competencies to support people with palliative care, terminal illness and end of life care needs.

It also aims to improve communication between domiciliary care agencies and primary care services.

Planning for the project began early in 2010 thanks to a grant from the NHS North West Cancer Network Operational Group. A scoping exercise showed a potential pool of 650 staff requiring end of life care training.

The network approached 18 domiciliary care agencies with local authority contracts to see if they would be interested in the training. Fourteen replied, including the Merseyside Chinese Community Development Association (MCCDA).

The project began in July 2010 with a trial run of the programme for a group of managers whose feedback informed changes to content and delivery before it was rolled out to the staff themselves. The training for the MCCDA was also specially adapted to include Cantonese translated materials and interpreters during the course.

Between July and December last year 130 domiciliary care staff attended the training. Participants evaluate the content and delivery of each course and feedback has proved very encouraging.

The programme has also thrown up some important lessons for the future. For instance, although the initial group size was agreed as 20 experience suggests the optimum size would be 16.

The course has also highlighted apparent confusion about the definition of end of life care. It would seem that before training a number of participants define end of life care as the dying stage, not recognising that end of life care can start on diagnosis of a life-threatening illness. In future the pre-course questionnaire will have more detailed explanation of what end of life care means as well as a description of the course.

Course tutors’ feedback also suggests it is important to have a ‘buddy’ available in case a social care worker becomes upset or distressed. A member of college staff is available on all the courses if required.

Training for social workers and assessment support officers began in January 2011. A formal evaluation of the whole project – including the impact on clients, families and support workers – will be presented in July 2011.

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