Survey says care homes are challenged in end of life care
A survey of organisations providing specialist palliative care services to care homes has highlighted the good work they do and identified the key challenges they face.
Commissioned by Public Health England and undertaken by the Marie Curie Research Centre at Cardiff University, with input from the National Council for Palliative Care and Hospice UK, the survey examined the role of specialist palliative care in providing support to care homes in England.
One hundred and eight specialist palliative care services based in hospices, the community or hospitals were surveyed between November 2016 and January 2017. 90% of those surveyed had been providing services to care homes for 10 years or more. Just over half provided services within one Clinical Commissioning Group (CCG) area, while 5% covered 5 CCGs. 72% were specifically commissioned to provide palliative care support in care homes, while the other 28% were providing ‘at home’ specialist palliative care which included people living in care homes as a usual place of residence.
Currently 22% of deaths in England take place in a care home (including nursing homes). Although 84% of those surveyed said they provided education or training to care homes, the report found a need to reinforce learning across the sector. High turnover of staff was a big obstacle to improving end of life care in care homes, affecting continuity of care and uptake of training. The report also found that specialist palliative care performance measures were more focussed on processes than outcomes and that there could be more emphasis on capturing patient and carer experiences.
Alisha Newman, author of the report and research associate at the Marie Curie Research Centre at Cardiff University, said the survey report made several recommendations, including better data collection, a focus on patient related outcomes rather than numbers, and ways to improve staff training including raising awareness and attainment of key competencies in palliative care.
“The report provides a set of recommendations that can be acted on straight away,” said Ms Newman.
“However, more needs to be done to provide consistent and sustained support to care home staff. The views and experiences of patients and families also need to be considered if we are to develop and deliver high quality, evidence-based and person-centred palliative care services in care homes in the future.” – The full survey report can be downloaded from: www.endoflifecareambitions.org.uk