Evaluation of a project providing community palliative care support to nursing homes

This paper reports an evaluation of a 3-year pilot community care project t o extend 'hospice standards' of palliative care to nursing: home residents in Nottingham. The evaluation involved two questionnaire surveys of all mat rons of nursing homes with registered palliative care beds (39 and 43 matro ns, respectively) and 35 interviews with a sample of local stakeholders sel ected to give a range of views regarding the project's impact. The intervie w sample included nursing home matrons (10) and care staff (7); nursing hom e residents and their relatives (4); community nurses (3); members of the H ealth Authority and Social Services (6); and local palliative care experts (5). Other sources of data included referral forms, evaluation of training sessions and a reflective account given by the project coordinator. The ana lysis used descriptive statistics to summarize the quantitative data and an iterative procedure to generate themes from the qualitative data. The over all perception of the project's impact was that it had helped to overcome t he barriers that exist between NHS services and the independent sector. By providing assistance with individual care and access to specialist advice, equipment and training, the project was thought to have decreased the isola tion experienced by staff and residents and improved equity of access to sp ecialist palliative care for nursing home residents. Although it was widely agreed that the nursing home is an appropriate setting for palliative care , concern was expressed about the quality of care that can be given with mo stly unqualified care staff. Ongoing needs for training and liaison between nursing homes and specialist palliative care services were identified.