The examples below provide insight into how other Good or Outstanding rated services are succeeding in this area of inspection.
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Supporting people to become qualified
The service supported people to access qualifications which supported them to be more independent with their lives. One person had completed a qualification in independence which staff said had improved their confidence and self-esteem.
Read more about this service here.
Care provider: Orbis Support Offices
Date published: March 2023
Driving forward End of life care improvements
There were members of staff with the specific skills to understand and meet the needs of people and their families in relation to emotional support and the practical assistance they needed at the end of the person's life.
The end of life champion was highly motivated, driven, clinically and professionally skilled. They led the team, providing them with support, guidance and training and identified areas for improvement.
This was done through team, relatives and external professionals' feedback and aimed at ensuring each person experienced a compassionate, dignified and individualised end-of-life journey. They cascaded information to the team and led on the development of advanced end-of-life care plans. They delivered bespoke advanced care planning training to senior staff, monitored and audited the developed care plan. This allowed them to identify areas for further development and celebrated successes along the way.
Read more about this service here.
Care provider: The Royal Star & Garter Home - High Wycombe
Date published: January 2023
A practical and workload friendly approach to person-centred end of life care
Within Cavendish Professionals Homecare, with an ever-increasing need for dementia, palliative and end of life services, we actively engaged with the new Lantern Model of nursing care. This model supports palliative and end of life services, especially within a home or care home setting.
What sets this contemporary model apart from others is how it easily includes all staff, despite being nurse-led, and its outcomes all reflect best practice as totally person-centred. This model is exciting and workable in any setting.
The model was very well received by staff and doesn’t increase workload. Rather, it builds on the very good practice already being evidenced, and complements this.
Outstanding care must be totally inclusive of a client’s needs and wishes – this is what the Lantern Model promotes. Our staff had access to the four available webinars of discussion about the Lantern Model – with guest expert speakers who encourage staff with implementing this new method of providing outstanding palliative and end of life provision.
The model also supports families, as it fitted well with our involvement with the dementia-friendly John’s Campaign ethos we’re already working with. Enabling open and transparent family communications is key in all successful dementia and end of life care discussions.
As ever in health and social care, it’s not what we think about the delivery of our services, but the client, family and CQC feedback that actually measures our accomplishments – and we’ve only got one chance to get this right at end of life care.
Read more about this service here.
Care provider: Cavendish Professionals Homecare
Date published: October 2021
End of life care in a Shared Lives service
People's care was not time-limited, and changes in people's needs and circumstances were innovatively, sensitively and wholeheartedly responded to. When one person became very poorly and required end of life care, the staff adapted the placement to meet their needs.
The Shared Lives host (carer) was passionate about supporting the person and refused to consider terminating the placement as end of life Care was not an expectation placed on Shared Lives hosts (carers). The host, along with staff and professional support, went beyond the extra mile to support the person to have a peaceful end.
The person had been at the placement for some time and had a strong bond with the host. Through discussions with staff and the person's family, it became clear the person wanted to remain at their home for their remaining life.
A palliative nurse working with the staff and host told us the host had a unique relationship with the person and that: "Never once did we consider that the person would’ve had better care in a hospice". The host worked relentlessly and passionately to support and achieve the person's final wishes. The service reviewed the experience and used reflective practice, and had further developed processes should they need to support a host again.
Read more about this service here.
Care provider: Shared Lives Scheme - Coventry City Council
Date published: April 2020
Support for relatives during a loved one's final days
Where relatives wanted to stay with their family member towards the end of their life, they were provided with a ‘care basket’ that contained toiletries, snacks, reading material or crossword books, a brush or comb etc. They were also provided with accommodation.
Read more about this service here.
Care provider: Davers Court - Care UK Community Partnerships Ltd
Date published: March 2020
Respecting people after they have passed
People continued to be treated with respect after their death. When a person passed away, a white butterfly was attached to the door handle of their bedroom. This ensured the person's death was discreetly communicated to others.
With the person's prior consent, a ceremony adapted to their preferences regardless of their faith, culture or ethnicity was held in the reception area of the service, accompanied by a piece of music chosen by the person or those closest to them. This meant others could pay their final respects as the person left the service for the final time. People's coffins were also draped with a wreath of poppies and their national flag.
Read more about this service here.
Care provider: The Royal Star & Garter Homes - Solihull
Date published: March 2020
Soul midwife training
Staff had accredited soul midwife training and described it as a holistic journey rather than a medical pathway. The process involves collecting stories that are important to people to recreate happy memories to support end of life care. For example, the staff can talk people through a trip to the seaside, by playing recordings of waves and seagulls, heating the room and recreating the smell of the seaside. They also use elements to help families understand the journey they and their loved ones go on.
Read more about this service here.
Care provider: Landermeads Care Home
Date published: March 2020
Ensuring final wishes are met
The service was particularly skilled at helping people and their families or carers to explore and record their wishes about care at the end of their life, and to plan how they’ll be met so that they feel consulted, empowered, listened to and valued.
One person, with the support of their family, ensured their specific wishes were recorded. Staff worked with palliative care professionals and developed an advance care plan for the person's changing needs. Staff also worked with advocacy services to fulfil one of the person's final wishes of marrying their girlfriend. The person's end of life wishes were complete when they were laid to rest at Doncaster Rovers memorial garden.
A letter from family members said: "We’re so grateful that we were able to work in partnership with your team along the way and we’ll never forget the outstanding care and compassion shown, not just to [person] but to us in his final days."
Read more about the service here.
Care provider: Creative Support - Doncaster Personalised Services
Date published: February 2020
Are we ready to talk about death, dying and bereavement?
Are your staff ready to talk about death with the people they support, to support people at their end of life, as well as supporting family and friends to deal with the loss of a loved one? As care workers, we use conversations to find out about the people we support – what’s important to them, how they’d like us to support them and what their wishes are, including around their end of life.
Think about your own wishes for the future. If you can think about your own death, it can help you to feel more comfortable talking to others about theirs. Sharing similar stories or wishes, if you feel comfortable to do so, can help you to have open and honest conversations.
Let me start this off by sharing my own wishes for the future. I’m a very practical person, so for me one of the most important things is sorting out the practicalities – I’ve written a will, I have life insurance, I’ve started thinking about my funeral and I’ve considered who my last power of attorney could be. We’ll never truly be ‘ready’ to die but having an open dialogue can really help, and I urge everyone who works in social care to ask themselves how they can ensure they’re ‘ready’ to do this.
Click here to read the rest of this blog
Care provider: Claire Henry, Independent Consultant and former CEO of the National Council for Palliative Care
Date published: May 2019
Ensuring access to support from health services
The homecare agency liaised with district nurses for another person to arrange appropriate pain relief and equipment, and ensured that the communication between the multi-disciplinary team was working well as it helped the service to provide good and effective end of life care.
Care provider: Anonymous
Date published: April 2018
Supporting family members through end of life care
The home care provider was available on the on-call phone throughout the night to offer support to the family. During the person’s final days, care workers put flowers in their room and pretty pillows around to make the person feel as comfortable and at ease as possible. It also gave comfort and re-assurance to the family that the person was cared for, and also listened and understood the family's feelings.
Care provider: Anonymous
Date published: April 2018
Accommodating people’s wishes as part of end of life care
An elderly person who was dying of lung cancer explained to the service that one of their only pleasures was smoking. However, the fact that they were reliant on oxygen meant this presented a major risk, and so far this pleasure had been denied.
The service listened to the views of the individual and discussed with their GP this possibility. They formed an agreement between all parties that the individual would be permitted a short period of time to smoke, safely away from her oxygen tank.
Read more about the service here.
Care provider: The Good Care Group
Date published: April 2018
Providing emotional support
The homecare agency supported people to remain at home through illness and at the end of their lives. One person whose health had deteriorated quickly following the death of a family member was provided with emotional and spiritual support during their grieving process. The person was unable to attend the funeral, so the service arranged for one of their regular care workers to sit with them for the day to provide emotional support for them during this difficult time.
Care provider: Anonymous
Date published: April 2018
Respecting end-of-life wishes
The service was caring for a person at the end of their life. The person requested to be buried within 24 hours of dying due to their religion. The service liaised with the local Mosque and developed a step-by-step guide for staff to honour the request and kept in regular contact with the person’s family and GP to ensure all went to plan.
Care provider: Eden Mansion Nursing Home (Cedar Care)
Date published: April 2018
Supporting people through grief
When the mother of a person who needed care and support passed away, the registered manager and staff worked tirelessly to support the individual through their grief and helped to arrange the funeral. The service also ensured that the person didn’t withdraw from community engagement - something they were at risk of as a result of the trauma.
Care provider: Anonymous
Date published: April 2018
Documenting and following religious beliefs
Where appropriate, the service ensures the care plan clearly documents religious beliefs and related actions needed associated with their end of life. For a person who wasn’t able to talk, this was documented in picture form to ensure they could review and approve their end of life care.
Care provider: Anonymous
Date published: April 2018
Championing end of life care
The service has established end of life care champions to support the development of others. Champions ensure that everyone in the organisation is involved and committed to delivering great end of life care.
Care provider: Anonymous
Date published: April 2018
Adults with autism supported employment project
The objective of this project was to enable adults with autism to live independent, fulfilling and rewarding lives through active participation in employment.
As part of this project, we ran 12 weekly sessions offering advice, support and specialist training for nine people with autism, delivered a specialist ‘supporting an employee with autism’ training course for 207 managers, supervisors and employees. As part of this course, we hosted an open event and forum where employers were invited to attend to meet people with autism and receive specialist advice regarding employing people with a diagnosis.
Due to the stresses on people with autism entering a new environment and meeting and interacting with new people, we operated a ‘flexible’ time system for the support sessions so that people could still access the service without being overwhelmed.
Click here to read the rest of this case study.
Care provider: ProACT and Autism Inclusive
Date published: December 2017
Using assisted technology to implement an end of life programme
This project used assistive technology to support learning and development that was mapped to the St Luke's Hospice ‘saying it without words’ programme.
The project helped to highlight a need for effective communication skills in supporting end of life care, including those with dementia, learning disabilities and other specific communication needs.
Click here to watch the video exploring how this project was carried out and what it achieved.
Care provider: St Luke’s Hospice
Date published: January 2014