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Table 2 Example of the portfolio content assessed for step 1 sections in the case studies

From: Improving end of life care in care homes; an evaluation of the six steps to success programme

Step 1 - Discussions as the end of life approaches
Not all care home residents are in the last year of life. The first step on the route to success is about identifying residents who are thought to be in their last year of life so that discussions around end of life care and advance care planning can be initiated.
1.1.There is a policy or action plan developed within the care home for end of life care QM 5.1 Care Home Policy - End of Life Care
Should include all components of the Six Steps Programme.
Copy of care homes Philosophy of Care
• Use of service users/families in the development
• Any feedback from service users
Case study factors noted;
• Is it a working document? – i.e. when reviewed/discussed
1.2.There is a system in place for identifying residents in the last year of life QM 5.3 End of Life Care Register
Photocopy of the populated register used in practice with patient details anonymised
Evidence of a team approach to the register – could include minutes of meeting (including MDT)
Documentation in residents notes
Use of the North West Tool
Operating procedures/policies for identifying
-Patients in last year of life
-ACP, LCP, GSF, Syringe drivers
-Spiritual assessment. Verification of death
Case study factors noted;
Good practice : date of policy, who is to review it,
How do we know staff have see them (Register of staff)
End of life registers – evidence of review for ACP
Patient records & communication with family