Participating in the national Adopt and Spread Programme, the originating Bevan Exemplar has supported spread and adoption in new areas across a variety of care settings in Wales. Each adoption site focused on different care settings and services to deliver the standardised Six Steps to Success programme which tests the potential of wider adoption of the Six Steps to Success programme throughout Wales.
“Professionals caring for people with palliative and end of life care needs are equipped in all health care settings to support patients and their families” (Palliative & End of Life Care Delivery plan, WG 2017)
“Theme 7 Education Delivery: Professionals caring for people with palliative and end of life care needs are equipped in all health and care settings to support patients and their families to make informed choices over their care and supported to cope with uncertainty.” (Palliative & End of Life Care Delivery Plan, WG 2017)
The key targets measured as part of participating in the programme are:
- Unscheduled admissions into secondary care from care homes and home based care reduced.
- The individual has a choice in their care plan/advance care planning offered.
- All individuals have a key worker.
- Out of hours unscheduled admissions reduced.
- Bereavement support to other residents, families and carers.
- Knowledge skills and confidence of staff improved.
The adoption sites overcame challenges to reach their goals.
- Care homes – Wi-Fi and hardware
- Trainers – Wi-Fi, hardware and ICT skills
- Care Homes – staffing shortages, lockdowns, bereavements
- Trainers – redeployment of our trainers, staff shortages.
Results in Wrexham
The Six Steps to Success Palliative and End of Life Care Education Programme for Domiciliary Care Services in Wrexham. (Wrexham County Borough Council, WCBC, facilitator with support from BCUHB)
Wrexham are supporting the development of champions to cascade learning to their colleagues within a domiciliary care setting to provide high quality care to individuals in their own home.
7 Domiciliary Champions have completed the Six Steps Programme, the portfolios are in the final stages of being marked.
Due to Covid-19 they faced many challenges including restricted access to face to face training and visits to the Domiciliary Service as well as the increased requirement to develop ICT skills.
Audit results from knowledge, skills and confidence (KSC) complete pre and post programme.
Results in Powys
Graph showing the cohort of care home representatives’ self-assessment of knowledge, skills and confidence as an overall average of the sixteen topics before and after the Six Steps to Success programme.
Future considerations for Wales
- Develop a skilled workforce, with knowledge, skills and confidence to deliver ‘what matters to me’ quality palliative and end of life care
- Ensure provision of a strong partnership link between health & social care services
- Sustainability of equitable, consistent and evidence-based practice
- All Wales funding as a priority to provide cost effective and efficient method of disseminating best practice in end of life care for a variety of care settings
- Offer Six Steps to Success programme to different care settings, including prisons and adapted supported living
- Maintain effective partnership working with national Six Steps to Success Team in NHS England
Participating in the national A&S programme along with Bevan Exemplar has enabled a variety of care providers to access evidence-based practice via the structured Six Steps to Success programme. The course content facilitates and supports the ethos and themes of the Palliative and End of Life Delivery Plan (2017), Social Services and Well Being (Wales) Act (2014) and Care Inspectorate Wales.