End of life care needs in Scotland not being met

Many care homes in Scotland are failing to meet the end-of-life needs of terminally ill residents, according to the Care Commission.

A report by the Scottish regulator found many care homes “had fallen short of best practice” and failed to grasp the importance of providing palliative care.

Poor take-up of training

More than half of workers had received no training in communicating sensitive issues around death or dying, while 43% of care homes did not realise they should be delivering palliative care to residents with life-limiting illnesses.

The National Care Standards for older people in Scotland state that staff should be aware how to access specialist services. However, 56% of care homes admitted they did not have a policy for referring residents to specialist palliative care services.

In addition, one in 10 homes did not have a copy of national guidelines for palliative care in care homes.

Difficulty in initiating conversations

However, the report – Better Care Every Step of the Way, based on the findings of more than 1,000 inspections and three investigations between April 2007 and March 2008 – also found examples of good practice by many providers.

The Care Commission found shortcomings in training explained the difficulties reported by staff in discussing end of life issues with residents and their families.

Regulator promises action

Susan Brimelow, director of healthcare regulation, called for improvemed access to specialist care, and additional training for care home staff to ensure residents and families receive high-quality palliative and end-of-life care.

She added that officials would follow up the care homes where recommendations were made to ensure they were being implemented.

Guidelines under review

A Scottish government spokesperson said implementation of the national action plan, Living and Dying Well, would take the findings of the report into account.

She added: “Later this year, we will be looking at how to update Scotland’s National Care Standards to inform people using care services and their families, both now and in the future, how their palliative and end of life care needs should be met.”

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