SIX STEPS TO SUCCESS
IN
CARE HOMES
by
Rachel Moorhouse
End Of Life Care Facilitator for Care Homes
0161 208 1868
Salford’s
Six Steps
Homes
Cohort two
Cohort one
Kenyon Lodge
Beechfield Lodge
Moorfield house
Hope manor
Alderwood
Amadeus
Heath Cottage
Walkden Manor
• Step 1 - Discussions as the end of life approaches
• Step 2 - Assessment, care planning and review
• Step 3 - Co-ordination of care
• Step 4 - Delivery of high quality care in care homes
• Step 5 - Care in the last days of life
• Step 6 - Care after death
Adapted from The North West End of Life Care
Model
Six Steps to Success programme
Advance Care Planning
• Preferred Priorities for Care (PPC)
• Advance Decision to Refuse Treatment
(ADRT)
• Lasting Power of Attorney (LPA)
1
Advancing
disease
1 year
2
Increasing
decline
6 months
‘Rapid
Discharge
Pathway’
(RDP)
End of
Life Care
Tools
‘Liverpool Care Pathway for the
Dying’ (LCP)
3
4
Last Days of
Life
First Days
after Death
Death
The North West End of Life Care Model
5
Bereavement
1 year
ACP
&
Communication Day
Interactive session on communication
skills including practical
demonstrations
Discussing DNA/CPR
Advance Care Planning
Best Interest Discussions
ADRT
LCP Study Day
Appropriate hospital admissions and Significant event analysis
Diagnosing dying
Multi- disciplinary team discussions,
DNACPR
Nutrition/ hydration
Communication to relatives/ carers
GP review
Commencement of the Liverpool Care of the Dying Pathway
Facilitating conversations with relatives & carers
Religious, spiritual and cultural care
Symptom
Care after death
What do we expect?
•
•
•
•
•
Residents placed on end of life register
Shared Communication
Advance Care Planning
End of life care policy
Review holistic assessment to include end of
life care/ wishes
• Involve residents/ families/ all staff
• Every resident to have an eolc key worker
•
•
•
•
•
All staff to know key contacts
Review training needs of staff
Dignity Champion
Review the environment
Understand the LCP- last hours /days
of life
• Review bereavement policy
• Audit
• Completed portfolio
The Future
• 8 nursing homes to start the programme
January 2013
• Residential cohort summer 2013
• McKinley training offered to all nursing
homes who have completed six steps/GSF
• Verification of death in nursing homes
• Broader education and support
• Integration with hospital and community end
of life care events
Thank you
Any questions?