Winner: St Anne’s Community Service, Oxfield Court Nursing Home and Nicky Lyall (training department)
Category: Practice and Service Development
Jean Willson, winner of the 2014 Linda McEnhill Award, hands over the trophy to the team form St Anne’s Community Services
Oxfield Court Nursing Home is part of St Anne’s Community Services and supports 24 people with LD living in 4 bungalows.
Following some bad and sad experiences of poorly managed deaths, the Home Manager (Marnie Walker) teamed up with the hospice next-door for support and training. This was the beginning of a collaboration between LD and PC services, leading to a wide range of important initiatives:
- Mutual teaching sessions, so the hospice could learn about communication and the home could learn about symptom management or recognising the end of life
- Development of a non-verbal pain tool
- The nursing homes went through the national Gold Standard Framework training and gained accreditation (NB another of St Anne’s Community Services Homes, Heatherstones, won the Linda McEnhill award for this in 2010)
They were then given some funding by the Clinical Commissioning Group (CCG) to develop their work further, and a project team was created with support from Nicky Lyall from their local training department.
- A training package was produced, including a DVD. Families, carers and people with LD were involved in this.
- Locally, all LD services contracted through Kirklees CCG now have mandatory end of life care training; they have to work through the training package as part of their contract
One of the innovations has been to adapt the GSF tools to fit the needs of people with LD. The GSF coding system does not take account of the life-long conditions of some people with LD, erroneously marking them as being close to death. Instead, the team developed “POLE” (Probability Of Life Expectancy”) which encourages staff to assess health care needs well before the need for end of life care planning. POLE guides staff to be clear about what being “in optimum health” means for each individual, and think about possible health conditions people may develop, so they can be vigilant for changes and take advice quickly if concerns are raised.
The effect of all this work has been:
- Six people with LD have died since these developments, and the team has noted real improvements to their end of life care.
- Staff feel more confident, and have more open and honest conversations with people with LD and their families
- They have held sessions for families on end of life care.
- Death and dying has moved from being a taboo subject to one that is openly talked about and planned for.
JUDGES VERDICT: This is an extraordinary, outstanding and inspirational list of achievements and innovations. The judges were impressed with the collaborative nature of the work of St Anne’s Community Services, partnering not only with palliative care professionals, but crucially, also involving families and carers. This has led to clear improvements in end of life care for people with LD within the Kirklees area. This work should be widely disseminated. The PCPLD Network would like to uphold it as a national example of best practice.
The effectiveness of this work is highlighted by the care provided to two people with LD who died within the care of St Anne’s Community Services, Heatherstones Nursing Home and 8 Oxfield Court, who both won a Highly Commended Award this year.
Highly Commended Awards 2015: Heatherstones Nursing Home & 8 Oxfield Court
Category: Outstanding end of life support of an individual
Pat Charlesworth, representing the judges, presents the Highly Commended award to Gerard Wainwright and Sara Lockwood from Heatherstones Nursing Home
Peter Allum, representing the judges, presents the Highly Commended award to Marnie Walker from 8 Oxfield Court
These two homes, which are part of St Anne’s Community Services, described the end of life care of two people with LD in their respective homes. Both received outstanding care. It was provided with warmth and dedication, but it was also well planned and well supported, both by other agencies and by the home managers. The judges were particularly impressed with how they involved the families and supported them with great sensitivity.