www.ewin.northwest.nhs.uk/

GOOD PRACTICECASE STUDY

• Wirral Metropolitan College Healthand Social Care team have produced a 2 day course“Introduction to the principles ofEnd of Life Care” with support,help, advice from the Wirral End ofLife Care facilitators and Cheshireand Merseyside Cancer Network

• The course draws on the experienceof Bradford and Airedale End ofLife Care training programme forhealth & social care staff deliveredsince 2004, and the Skills for Careframework of National OccupationalStandards

• The project is supported by WirralDepartment of Adult SocialServices, NHS Wirral End of LifeCare Team and leads in commissioningand Primary Care, the Cheshire &Merseyside Cancer Network, WirralMetropolitan College Health &Social Care department and WirralDomiciliary Care employer group

• To-date 8 (2 day) programmes havebeen delivered by Wirral MetropolitanCollege tutors to a total of 130staff. Feedback has been very positive and encouraging bothfrom the attendees and the managers

• In almost all cases people attendingthe course feel they have increasedconfidence, skills and knowledgeand most feel they will benefitfrom the training and apply it inpractice. Impact on people receivingcare, their families and others providing support is still to be evaluated.

SUMMARY

WIRRAL METROPOLITAN COLLEGE (IN PARTNERSHIP WITH WIRRAL DEPARTMENT OFADULT SOCIAL SERVICES, NHS NW CANCER NETWORK, NHS WIRRAL AND OTHERS)

TRAINING AND EDUCATION FOR

DOMICILIARYCARE STAFFIN END OF LIFE CARE

Logos for Wirral EOLC Domiciliary Case study

Logos for Wirral EOLC Domiciliary Case study

Logos for Wirral EOLC Domiciliary Case study

• 130 Domiciliary Care staff attendedthe training between July andDecember 2010, with only 4 lastminute cancellations. There is acharge of £35 for non-attendanceor late cancellation (one weeksnotice is required). We can generallyfill the places by offering extraplaces to the larger organisations.

• There has been continuous qualityimprovement since the start of the project. Each course contentand delivery is evaluated by theparticipants and feedback hasproved very encouraging. A significant number of responsesindicated that the course contentand delivery reached a very highstandard. Pre and post course comments together with datagraphs representing a sample ofattendees, give some insight tomotivation, benefits of attendanceand the sense of increased knowledge, confidence and skills inthis topic at the end of the two dayprogramme. Please see attachedappendices for performancereports.

• A formal evaluation of the projectwill be presented at the end of theproject delivery – July 2011. Impacton clients, families and supportworkers is ongoing and will formthe submission of various case studiesto reflect the impact of the training.

• Wirral was agreed as the pilot site,with learning from the project tobe disseminated through the PanMerseyside network and acrossLancashire.

• Commitment to End of Life Caretraining for health and social carestaff is an integral part of theWirral End of Life Care strategywhich aims to:

o Improve end of life care for allpatients irrespective of theirdiagnosis.

o Provide greater choice forpatients in their place of careand death.

o Reduce the number of emergency admissions to acutecare for those who haveexpressed a wish to die at home.

o Reduce the number of patientstransferred from home to acutecare in the last week of life.

• Employer representatives on theEOLC Steering group requested atraining programme that would bedelivered rather than distancelearning materials.

• In April 2010 a small team fromWirral attended the Bradford andAiredale End of Life Care training programme for health & social carestaff which they have been deliveringsince 2004.

• Wirral Department of Adult SocialServices (DASS) secured Multi-pro-fessional Education Training (MPET)funding through NHS North WestCancer Network OperationalGroup. The total funding for theWirral End of Life Care project was£70K. This was to provide targetedtraining in EOLC for Wirral domiciliarycare contracted agencies and toimprove communication and workingbetween primary care and socialcare.

• Recognising that, ‘Domiciliary care workers play a vital role inenabling patients to be cared for in their own home.’ (McIlfatrick2007). The Pan Merseyside Network of local authorities andLancashire County Council Adult and Community Services supported a proposal to develop and deliver training for domiciliary care staff.

• DoH (2008) suggests there are significant unmet training needsdespite having a key role in providing care. The project supportedby the Pan Merseyside Network aims to bridge that gap by:

o Offering targeted training linked to the common core competencies and principles for health & social care workersworking with adults at the end of life:

o Ensuring that domiciliary care staff working for Wirral Councilcontracted agencies in Cheshire & Merseyside (primarilyWirral) have the right level of skills, experience and competencies to support people with palliative care, terminalillness and end of life care (EOLC) needs

o Improving communication between domiciliary care agenciesand primary care services in supporting the end of life careprogramme.

BACKGROUND AND CONTEXT

Bauer Il Palazzo

www.ewin.northwest.nhs.uk/

GOOD PRACTICECASE STUDY

KEY OUTCOMES

KEY STAGES OF SET-UP

KEY STAGES OF SET-UP CONTINUED

• Planned project activities include:

o Managers/Senior staff ofDomiciliary Care (80) to receivehalf day training on EOLC

o Domiciliary Care Staff (Target300) to receive a 2 day programme on EOLC

o Purchasing National Council forPalliative Care ‘Care to Learn’training resource / materials(x24) to support the Social WorkLocality Teams

o Awareness raising of End of LifeCare through 4 locality events

o Social Worker and AssessmentSupport Officer (80) to receivehalf day awareness on EOLC

o Shadowing programmebetween Social Care andPrimary Care teams

o Evaluation and sharing of goodpractice

• 18 Domiciliary Care Agencies (holding a delivery contract withthe Local Authority) were contactedto express an interest in the End ofLife Care training project. 14 Employers replied to a scopingexercise of the workforce includingthe Merseyside Chinese CommunityDevelopment Association.

• A scoping exercise of the workforce identified 21 Managers,62 supervisors/coordinators, 567 care assistants/support staff i.e. A potential pool of 650 staffrequiring End of Life Care (EOLC)training.

• In July 2010, a group of managersattended the first draft of the 2 dayprogramme for their staff. Theevent was very well received andfeedback informed changes to thecontent and delivery made beforerolling the 2 day programme out tothe domiciliary care staff.

• End of Life Care training for theMerseyside Chinese CommunityDevelopment Association (MCCDA)was adapted to include Cantonesetranslated materials and interpreters during the delivery ofthe programme. Working closelywith the MCCDA manager and theinterpreter the materials most suitable for translation were identified. The tutor worked withthe interpreter to deliver the content. This has been truly enterprising as this group of staffhave very few training resourcesprepared in their own language. Ithas also been a credit to the tutorswho have demonstrated flexibilityand adaptability.

• Training for Social Workers andassessment support officers willcommence in January 2011 beingfunded through the original allocation of £70K.

• An additional £50k secured for thisstrand of work is insufficient to rollout the programme across theNetwork. Other options to raiseawareness and understandinginclude working with existing education centres to hold awarenesssessions for Social Workers and hospital discharge planning teams.This is work in progress with WirralDepartment of Adult Social Services(DASS) and NHS Wirral EOLC Team.

• Initially the group size was agreedat 20. However taking into accountthe nature of the topic the optimum size is 16. The averagegroup size has been 17.

• The pre course questionnaire hashighlighted apparent confusionabout the definition of End of LifeCare. When asking managers ifstaff currently deliver End of LifeCare, almost all say yes. Yet pre-course questionnaires record thatalthough the majority have provided

EOLC support in the past, it is aminority who are currently providingsuch support. Plans are in hand torevisit the pre course questionnaireat the end of the two days to checkunderstanding of the definition.The significance of this apparentmisunderstanding is that prior totraining attendees understandingof what end of life care is, varies. Anumber of attendees definition ofend of life care is the dying stagenot recognising that end of lifecare can start on diagnosis of a lifethreatening illness. For futurecourses a pre- course questionnairewill be completed prior to attendancewith more detailed instruction andan explanation about the course.

• Feedback from the tutors involvedin the delivery is that it is importantto have a ‘buddy’ available in case asocial care worker becomes upsetor distressed. On all the coursesthere is a member of the collegestaff available should this supportbe required.

• Feedback from the social careworkers is that they feel supportfor them in the workplace is lackingand often do not know where togo for support. As the project is atthe half way stage we feel this is agood opportunity to meet with theemployers to evaluate the programme and raise any concernsthat have been identified.

Bauer Il Palazzo

www.ewin.northwest.nhs.uk/

GOOD PRACTICECASE STUDY

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CONTACT FOR FURTHER INFORMATION

• Tessa Wilson Employer SectorManager (Health & Social Care)Wirral Metropolitan College

Email: Tessa.wilson@wmc.ac.ukTelephone: 0151 551 7416

End of Life Care WirralMetropolitan College CourseTutors

• Denise Jarrett • Janice Roe-Evans

KEY LEARNING