Presentation on theme: "GOLD STANDARDS FRAMEWORK"— Presentation transcript:
1 GOLD STANDARDS FRAMEWORK POSITIVE OUTCOMES FOR A CARE HOME
2 WHAT IS THE GOLD STANDARDS FRAMEWORK ? TO HELP TO DELIVER A “ GOLD STANDARD OF CARE” FOR ALL PEOPLE AS THEY NEAR THE END OF THEIR LIVESIt involves working together as a team with other professionals, to help to provide the highest standard of care possible for residents and their families as they face the last stages of their lives.
3 WHAT IS THE GOLD STANDARD FRAMEWORK ? Delivers both QUALITY IMPROVEMENT plus QUALITY ASSURANCE the programme has 3 aimsTo improve the quality of care provided for all residents from admission to the home.To improve the collaboration with GP’s primary care teams and specialists.To reduce the number of hospital admissions in the final stages of life, enabling more people to die with dignity in the home, if that is their wish.
4 HOW CAN IT IMPROVE CARE?Setting up a register with regular planning meetings to discuss and focus on care.Planning for the needs of residents at varying times, using coding and a needs/support planAdvance care planning – discussing the choices, preferences and options to best meet the needs of the resident and their families.Reducing the need for crisis admission to hospital.
5 HOW WILL IT IMPROVE CARE? Working closely with the family to best meet the needs of their loved one and to be aware of the choices that are available.Even better working with GP’s, District Nurses, Palliative Care Specialists, hospitals and othersInformation and communication with other services e.g. Out of Hours medical services, ambulance services.
6 HOW WILL IT IMPROVE CARE? Use of an agreed plan for the final days of life, to enable a good death.Ongoing reflection and education of staff according to their needs. Staff who aspire to the best, and we wish to affirm and encourage them, building confidence and ability to provide excellent care.
7 THE SEVEN C’s COMMUNICATION COORDINATION CONTROL OF SYMPTOMS CONTINUITYCONTINUED LEARNINGCARER SUPPORTCARE OF THE DYING
8 COMMUNICATIONIdentify residents in need of palliative care – code using for example ABCD codingsRegular team meetingsLabel / colour code notes and code for handovers and GPUse advance care plan ( preferences, DNAR, preferred place of care)Residents, families, GP’s and Specialist practitioners are aware that the Care Home are involved in GSF
9 COORDINATION Allocated Coordinator for each home Agreement with owner to support programmeKey worker for each residentEnsure communication with GP, Primary Health Care Team and familyEnsure communication with specialist palliative care team e.g. local Macmillan nurses, hospital
10 CONTROL OF SYMPTOMS Use of assessment tools when relevant Agreed management plan recorded and communicated related to protocolAdvanced care plan completed for all residentsBasic equipment available as standard and PRN medication available in advance
11 CONTINUITYOut of hours handover form completed for all residents and kept in local out of hours officeAdvanced Care Plan/ Patient held record or medication card shared with others
12 CONTINUED LEARNING Regular review, Weekly meeting Monthly review meetings- audit of last deaths using traffic lights Significant Analysis with other professionals if possibleProgramme of on going education/ training of staff, including induction of all new staffLibrary resource of books, articles and web sites
13 CARER SUPPORTStaff – staff issues and learning points and feedback after death for all staff e.g. carers, cleaners, maintenance staffFamily – written information for family and note families concerns and issues
14 CARE OF DYING Minimum protocol for the last days of life used Liverpool Care Pathway for the Dying or Integrated Care PathwayAgreed practice for notification of relatives, verification of death procedure and after death careSupport for the bereaved families after deathSupport for all staff and other residents as needed
15 SO WHAT HAS CHANGED AT MERRYFIELD? Everyone aware that we are participating in GSFCoding of residents available for all staff including catering and all ancillary staffRegular focus meetings with staff from all departmentsAdvanced Care Plans, preferred place of care DNAR any individual wishes
16 SO WHAT HAS CHANGED AT MERRYFIELD? Attend GSF meetings at the GP surgery with GP’s, District Nurses and Macmillan Nurse to discuss all residents on the register. Regular speakers from local palliative care organisationsAdditional assessment tools used e.g. depression scale, PACA and PEPSICOLA Distress ThermometerWe have purchased a Syringe Driver and the surgery can provide a Drug Box when needed for the Home and the District Nurses containing end stage drugs
17 SO WHAT HAS CHANGED AT MERRYFIELD? Out of Hours handover forms are kept in the Office at Witney hospital used by Out of Hours Doctors so they have in depth knowledge of all residents when contacted by the Home.Advanced Care plans shared on admission to Hospital and Out Patient appointmentsDignity Policies and Audit tools
18 SO WHAT HAS CHANGED AT MERRYFIELD? Audit of deaths using Significant AnalysisRegular ReviewsOn going trainingLibrary resourcesDrama therapist to work with residents who are dying and for residents who are grievingLeaflets written by the home with information of services available in house and in the local community both relevant to before and after the death
19 SO WHAT HAS CHANGED AT MERRYFIELD? Minimum Protocol used for the last days of lifeRegistered with the Liverpool Care PathwayPolicies for Notification of Relatives, Verification of Death and after death careSupport for bereaved relatives, staff and other residents available from a Personal Bereavement Service in Witney for both religious and non religious clients providing spiritual support