Overgate Hospice has employed an Educator to support Advance Care Planning (ACP) across Calderdale Care Homes. The role aims to ensure that every resident has the opportunity to talk about ACP.
Mandy Stamper has been working in this role since October 2022, building relationships and delivering teaching sessions to help staff understand what ACP is and why it is important.
Mandy is supported by the Overgate Education team and works closely with colleague Anne King who also delivers palliative care education in Care Homes.
Outcomes
During 2023 Mandy delivered sessions about ACP at 40 of the 45 local care homes, to over 350 members of staff.
Sessions are evaluated using feedback forms to help ensure the teaching is relevant and effective at increasing staff confidence and competence. Anecdotal evidence shows that the sessions are stimulating a lot of discussion.
Mandy has begun holding reflective sessions, where staff can discuss how ACP is going using case studies. This is helpful to identify what changes need to be made to improve the quality of ACP.
She is also piloting informal coffee sessions for residents, families, and carers, where they can find out more about ACP and ask questions.
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"It has really helped me push for advance care planning at my care home and support service users with this."
"It was brilliant; it was pitched just right, and everything was handled with sensitivity and care. They all said how informative it was and made them feel a lot more confident when planning for later in life.”
Care home staff who attended Mandy's training sessions
Facilitators, challenges and advice
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Key facilitators
Mandy works in collaboration with the Learning Disability Matron and Clinical Nurse Specialist (CNS) for care homes (this is a new post). She has run joint education sessions with these colleagues, who have then returned to the care home to start ACP discussions with appropriate residents.
Challenges
It is difficult for care homes to release staff to attend the training, as they are very busy and understaffed. Training can be cancelled at short notice if staff are not able to attend.
There is a high turnover of staff in the local care homes, which means education sessions need to be run on a regular basis. Arrangements for training are not always passed on to new managers and Mandy has had to rebuild relationships as management staff have changed.
Although the local care homes have limited budgets and staff, it is really heartening to see that there are some good examples of care, and that staff are keen to learn and carry out ACP.
Tips and advice
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Meet the care home Manager first, to discuss the training - get some dates in the diary during that meeting.
Be adaptable to the needs of each care home. Check before each session that the home can release the staff for training. Mandy has taught training sessions in patient lounges, kitchens, and empty bedrooms, depending on where there is space!
Appreciate the challenges care homes face. Make sure you are there as a support, offering education that can help develop staff.
Future development
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Mandy has been working to develop links in the community, to help promote ACP uptake.
Next steps for the programme include:
Gather feedback from managers about ACP and any further training needs.
Develop and deliver new training sessions about recognising dying, which have been requested by care home staff and district nurses.
Build collaborative relationships with new members of the Quest Team of community nurses who work in care homes and are involved in proactive Advance Care planning.
Use participative arts approaches to help people from marginalised communities access and discuss ACP. This will be based on the No Barriers Here approach. Mandy has already attended facilitator training for this.
Mandy is carrying out research into ACP in care homes with Dr Adam Spacey at Salford University. This aims to explore ACP following the COVID-19 pandemic and aims to inform more sustainable methods of delivering education about ACP.
