Developing competencies for end-of-life care in care homes.

The English Department of Health's End of Life Care Strategy suggests that suboptimal end-of-life care in care homes results from inadequate training of staff at all levels. This article reports on one hospice's pilot project that addressed the question, 'Does a competency development package provide a way in which the hospice can support improved end-of-life care in care homes in a sustainable way through education?' The project followed the Medical Research Council framework for the development and evaluation of complex interventions. Competency domains were identified and statements written with participating care homes. A five-day education course was delivered to support the competencies and an assessment workshop explored how the framework could be integrated into existing appraisal systems. At the end of the project, the care homes identified aspects of education and support that would ensure the competencies became fully embedded. From the conclusions drawn, a collaborative model of competency development, education, and assessment is proposed to enable a measurable and sustainable improvement in end-of-life care in the care home setting.