A new home for end-of-life care

Nicola Johnstone, registered support manager, Belong Atherton

Care providers are innovating to enhance standards of palliative care, give people more control over how they spend their final years and enrich experiences at end-of-life. Contributing to this is adoption of national frameworks for end-of-life care, partnership-working with local healthcare and community organisations and a creative approach to facilitating meaningful occupation. As ever, barriers to change include the sector-wide problem of recruiting nursing staff.

Belong’s approach to end-of-life care, for which several villages have been awarded Gold Standards Framework ‘Platinum’ status, includes starting early conversations about care options, future planning, supporting stages of decline, maximising quality of life and creating a robust support network for residents and families.

Belong’s approach to end-of-life care, for which several villages have been awarded Gold Standards Framework ‘Platinum’ status

Most people moving into a care setting have life-limiting illnesses, so we start the process of advanced care planning from the outset and have those delicate conversations surrounding planning for the future without being afraid of using the words ‘death’ and ‘dying’.

This enables us to be fully prepared to support the resident to live life to the fullest in spite of any medical conditions. Ranging from facilitating the achievement of lifelong aspirations to supporting residents to engage in multi-sensory activity, including innovative arts, music or exercise programmes, Belong has invested both in partnerships and appropriate technologies to promote fulfilment and wellbeing for people on end-of-life pathways.

Belong’s village model, in particular, offers the advantage of continuity of care as people’s needs change and a vibrant community setting, where friends and family members are always welcome and where they can continue to enjoy shared experiences with their relatives. A person with minimal care requirements can begin their journey with Belong living independently in one of the village’s apartments. If their support needs increase, there is the capacity to support them in a household with a specialist nursing team.

Standards of end-of-life care in residential and extra care facilities have been enhanced in recent years as a result of partnerships with local healthcare professionals and institutions. At Belong Atherton, this has included taking part in a pilot scheme with a local hospice providing resources and training for employees. Consequently, nurses and support workers feel empowered to make a greater difference in people’s lives, working collaboratively with GPs, district nurses and other health professionals to put the resident at the heart of the care provision. The result has been an improvement in standards of palliative care across the region.

Outstanding end-of-life care cannot be achieved without dedicated, highly skilled staff. This is not always easy to achieve, given the perennial problem of recruiting nurses to the care sector.

Contributing to this is the persistent perception that social care doesn’t afford the same opportunities for nurses as a career in the NHS. This simply isn’t true. Nurses in a social care setting are well rewarded and required to draw upon the full breadth of their knowledge and training every day, making significant impact in people’s lives and developing close relationships with people they are supporting.

At Belong, they perform a similar role to district nurses, providing care to residents across different households, as well as overseeing teams working with customers in the community. There is also wide scope for nurses to specialise in particular disciplines and progress to managerial roles.

Countering these perceptions in order to advance standards of end-of-life care in the sector necessitates creative ways of making nurses aware of the opportunities offered by progressive care providers.

It’s a positive step that nursing education now includes health and social care, and Belong has offered placements for student nurses for a number of years. As a result, many students have had their eyes opened to the opportunities that social care offers and returned to undertake further placements. If more operators take on student nurses, then it’s a great opportunity to dispel those myths early and change the face of end-of-life care in the sector.

Nicola Johnstone is registered support manager at Belong Atherton. She was formerly clinical lead nurse at the care village. In 2016, she received the End-of-Life Care Award at the Great North West Care Awards and received an invitation to meet HRH The Prince of Wales at Buckingham Palace in recognition of her contribution to frontline nursing.




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