SIX STEPS TO SUCCESSIN

CARE HOMESby

Rachel Moorhouse End Of Life Care Facilitator for Care Homes

0161 208 1868

Salford’s Six Steps

Homes

Cohort oneKenyon Lodge

Beechfield LodgeMoorfield house

Cohort twoHope manorAlderwoodAmadeus

Heath CottageWalkden 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

‘Liverpool Care Pathway for the Dying’ (LCP)

Last Days of Life

First Days after Death

1 year1 year

Advancing disease

Bereavement

6 months

1 2 3 5

The North West End of Life Care Model

4

Death

Increasing decline

‘Rapid Discharge Pathway’

(RDP)

Six Steps to Success programme

End of Life CareTools

Adapted from The North West End of Life CareAdapted from The North West End of Life CareModelModel

Advance Care Planning • Preferred Priorities for Care (PPC)• Advance Decision to Refuse Treatment (ADRT)• Lasting Power of Attorney (LPA)

ACP

&

Communication DayInteractive session on communication

skills including practical demonstrations

Discussing DNA/CPRAdvance Care PlanningBest Interest DiscussionsADRT

LCP Study Day

Appropriate hospital admissions and Significant event analysis

Diagnosing dyingMulti- disciplinary team discussions, DNACPRNutrition/ hydrationCommunication to relatives/ carersGP reviewCommencement of the Liverpool Care of the Dying Pathway Facilitating conversations with relatives & carers Religious, spiritual and cultural careSymptom 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?