St Christophers Hospice and their work with Croydon

St Christopher’s Hospice and their work with Croydon care homes Lilette Denton and Barbara Kenyon

Learning Disability and mental Health Care Homes • Practice facilitators continue going into these homes to embed an end of life care programme • End of life programme is called the Six steps to success • Funding for this ends in March 2019

The six steps to Success • • • Assessment, Care planning and Review Future Care planning Good co-ordination of care Delivery of high quality care Care in the last weeks/days of life Care after death

Learning Disability Homes 2016: Phase 1 of the LD programme: 20 homes completed the STEPS and received certificates 2017: Phase 2 of the LD programme: 11 homes completed the STEPS and received certificates 2018: Phase 3 of the LD programme: 17 homes plus 5 from Phase 2 to complete

Mental health homes • Practice development facilitators going into 17 mental health care homes • Different way of working: Some residents doing their own Advance care plans with the help of the managers • Educating managers to try and prevent hospital admissions ie encourage exercise, healthy eating and meaningful hobbies

St Christopher's is now offering a new model of working with care homes

Clinical care Home Champions • Each nursing home to have a clinical champion • The clinical champion’s role is to support nursing homes with implementing the steps to success while supporting them clinically • Clinical support to residential homes will continue • St Christopher’s is in the process of recruiting clinical champions

How care Homes can access education at St Christopher’s Hospice • Affiliation • Service level agreement • Payment dependent on the size of your care home

Educational offer for care homes (1) Introduction to palliative care study days (every 2 months): Topics include: how to recognise that a resident is coming to the end of life; advance care planning; preventing inappropriate hospital admissions; communication skills; dignity; overview of dementia; assessing and managing common symptoms at the end of life; and managing loss and looking after ourselves. Monthly half-day workshops: Topics include: difficult conversations with residents and families/loved ones; advance care planning; practical demonstrations of mental capacity assessments and best-interest meetings; palliative care emergencies; care of residents with Parkinson’s disease; prognostic indicators; depression and suicidal ideation. Dementia topics: delirium and depression; basic rights and risk taking; sexual expression; total pain in people with advanced dementia. End of Life Programme: Support workshop/study day to help care homes complete the evidence folders for their end-of-life care programmes. Certificates for Steps to Success will be provided when the folder has been assessed by St Christopher’s staff as satisfactory.

Educational offer for care homes (2) • The ECHO Project: Support to set up and implement ECHO, a community of learning linking several care homes in each borough. Using a hub-and-spoke model, care home staff are facilitated to present real cases for discussion and learning. The curricula for each educational session is decided by care homes. • Access to information and advice on apprenticeships and workforce development initiatives in vocational qualifications via our online Information Hub (www. informationhub. org. uk). There is normally a subscription fee for this service but it is free to care homes affiliated with St Christopher’s. • Discounted offers on courses that are appropriate for care homes. These include, among many others: Nurse Verification of Expected Death; Advance Care Planning; Award in Awareness of End of Life Care - City & Guilds Level 2 and 3; Award in Awareness of Dementia (With Added Learning on Long-Term Conditions and Frailty) City & Guilds Level 3; the Namaste Care programme. • Registered Managers’ Network meetings: We will continue to run these half-day meetings for home managers in conjunction with Skills for Care.

Collecting Audit data Death audit data Hospital admissions The demographics of each individual home The standards –Pre steps to success programme and Post steps to success programme • Final report on the work undertaken by St Christopher’s in March 2019 • Future funding • •