Shortcomings in end of life care in Scottish care homes
Friday, April 17th, 2009
on behalf of Care Inspectorate
More than 40% of care homes in Scotland need to improve the support they offer people with life-limiting illnesses and those who require palliative and end of life care, according to a new report from Scotland’s care watchdog.
The report, Better care every step of the way, reflects the findings of 1036 inspections and three investigations carried out by the Care Commission at care homes for older people between April 2007 and March 2008.
During the inspections, the Care Commission evaluated whether staff in care homes had an understanding of what constituted palliative and end of life care – and how well they were delivering it to people who live in care homes and their families.
The report reveals that 449 care homes (43%) did not realise they should be delivering palliative and end of life care to residents with life-limiting illnesses.
The Care Commission also found that 9% of homes did not have a copy of the document “Making good care better”, which sets out guidance on the correct standard of care that homes should provide. A further 35% said the statements did not apply to their service.
Inspectors also found 54% of services had not fully trained their staff or given them enough educational support to deal with sensitive issues surrounding death and dying. The report concluded because of this lack of support many staff members found it hard to talk to residents and their relatives and carers about how living with a life limiting illness affected them.
The Care Commission recommends that care home staff need increased knowledge, skills and educational support to ensure that the standard of palliative care is improved across Scotland. During the inspection period the Care Commission made 546 recommendations for improvement in specific care homes.
Susan Brimelow, the Care Commission’s Director of Healthcare Regulation, said: “The increase in demand from an ageing population means that more people are living longer with life-limiting, long-term conditions and an increased need for palliative and end of life care.
“We found that a lot of good quality palliative care is provided in care homes across Scotland. There are many examples of the excellent care and our report also features many letters of appreciation from relatives about the care their loved ones have had.
“However, it’s disappointing that the palliative care needs of residents in 43% of care homes in Scotland are not always recognised or well supported by staff.
“Care home providers and managers must recognise the need for increased knowledge, skills and educational support to ensure residents, families and carers receive high quality palliative and end of life care. Improved access to this specialist care for everyone who needs it is vital.”
*The report Better Care Every Step of the Way is available from www.carecommission.com
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