NA38-End of Life and Palliative Care Policy
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{{org_field_name}}
Registration Number: {{org_field_registration_no}}
End of Life and Palliative Care Policy
1. Purpose
The purpose of this policy is to establish clear, comprehensive, and legally compliant guidance for all staff working for {{org_field_name}} in delivering or supporting palliative and end-of-life care. {{org_field_name}} recognises that the provision of compassionate, dignified, and person-centred end-of-life care is a vital aspect of healthcare, particularly for those working in care homes and other social care settings. Temporary workers, including registered nurses and healthcare assistants supplied by {{org_field_name}}, may frequently encounter service users who are approaching the end of their life or are receiving palliative care. It is essential that staff understand their roles, responsibilities, and the principles of high-quality end-of-life care, respecting the rights, wishes, dignity, and choices of service users and their families. This policy aligns with current legislation, national guidelines, and best practice, including the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, the Human Rights Act 1998, the Equality Act 2010, the Mental Capacity Act 2005, and the National Institute for Health and Care Excellence (NICE) Guidelines on Care of Dying Adults.
2. Scope
This policy applies to: All temporary workers supplied by {{org_field_name}}, including registered nurses, healthcare assistants, and other care staff. All directors, consultants, and agency representatives who are responsible for overseeing or supporting the delivery of care. All situations where agency staff are involved in or contribute to the care of individuals who are receiving palliative or end-of-life care. This policy is applicable to all client settings, including care homes, nursing homes, and specialist palliative care units where {{org_field_name}} staff are deployed.
3. Related Policies
- Safeguarding Adults Policy – Confidentiality and Data Protection Policy – Infection Prevention and Control Policy – Equality, Diversity, and Inclusion Policy – Mental Capacity and Deprivation of Liberty Safeguards (DoLS) Policy – Incident Reporting Policy – Whistleblowing Policy
4. Definition of Palliative and End of Life Care
Palliative care refers to the holistic support provided to people with life-limiting illnesses, focusing on improving quality of life, symptom management, and emotional, psychological, and spiritual support, regardless of the stage of illness. End-of-life care is a specialised aspect of palliative care provided when a person is approaching the last weeks, days, or hours of life. The emphasis is on providing comfort, relieving distress, and ensuring dignity until death.
5. Principles of End of Life and Palliative Care
All staff representing {{org_field_name}} must ensure that care is: Person-centred: Respecting the preferences, needs, beliefs, and values of the service user. Holistic: Addressing physical, emotional, psychological, cultural, and spiritual needs. Compassionate: Delivered with kindness, empathy, and sensitivity. Respectful: Protecting privacy, dignity, and autonomy at all times. Inclusive: Involving family members, friends, and advocates in care planning and delivery where appropriate.
6. Responsibilities
Directors As {{org_field_name}} does not have a registered manager, the directors will assume full accountability for: Ensuring that this policy is embedded within the organisation’s practices. Providing appropriate training and support to all staff in relation to palliative and end-of-life care. Reviewing and updating this policy annually or sooner if there are significant legislative or best practice changes. Ensuring that staff working in palliative care environments are suitably skilled, trained, and supported. Collaborating with clients to ensure that agency staff are aware of and comply with client-specific end-of-life care protocols.
Temporary and Agency Staff All registered nurses, healthcare assistants, and temporary workers must: Deliver care in line with this policy, their professional codes of conduct, and the client’s policies and procedures. Recognise the signs of deterioration and report these promptly. Engage with service users and their families with empathy and sensitivity. Promote dignity and comfort at all times. Comply with documentation, handover, and reporting requirements. Liaise effectively with other members of the multidisciplinary team, including care home staff, GPs, specialist palliative care nurses, and spiritual support where appropriate. Undertake mandatory and refresher training relevant to end-of-life care.
7. Advance Care Planning
Staff must respect the right of individuals to be involved in decisions about their care, treatment, and preferences, particularly as they approach the end of life. Where appropriate, agency staff should: Be aware of advance care plans, Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) orders, or other legally valid directives. Respect and follow documented decisions and communicate any concerns to the client’s manager or senior clinician immediately. Support the involvement of family members, friends, advocates, or Independent Mental Capacity Advocates (IMCAs) where appropriate, in line with the Mental Capacity Act 2005.
8. Communication
Effective communication is vital when delivering palliative and end-of-life care. Staff must: Communicate in an open, honest, and sensitive manner. Use clear, jargon-free language, adapting communication styles to meet individual needs, including those of people with dementia, sensory impairments, or learning disabilities. Respect cultural, spiritual, and religious beliefs and practices of the service user and their family. Maintain clear and accurate records of all communication relating to care planning, symptom management, and family involvement.
9. Symptom Management and Comfort
Agency workers must work collaboratively with client staff and healthcare professionals to provide effective symptom management. This includes: Supporting clients to administer prescribed medications in line with placement protocols and their own professional competency. Monitoring and reporting symptoms such as pain, breathlessness, agitation, and distress promptly. Assisting with repositioning, personal care, mouth care, hydration, and other measures to enhance comfort. Ensuring that any interventions provided are documented accurately and reported during handover.
10. Dignity and Respect
All staff must preserve the dignity and rights of individuals receiving end-of-life care by: Maintaining privacy at all times during personal care, treatment, and interactions. Supporting individual cultural, spiritual, or religious needs and preferences. Ensuring the service user is involved in care decisions wherever possible. Using kind, compassionate, and respectful language and non-verbal communication.
11. Supporting Families and Significant Others
Agency staff have a role in supporting family members and significant others by: Treating families with compassion, patience, and respect. Providing honest, appropriate information within the limits of their role. Directing families to appropriate client representatives for discussions relating to care decisions or emotional support. Being mindful of the emotional impact of bereavement on families and working sensitively within these situations.
12. After Death Care
Staff must follow the client’s procedures and their own professional responsibilities when a death occurs. This includes: Respectfully caring for the body of the deceased in line with the client’s policies, cultural considerations, and professional guidance. Reporting the death immediately to the appropriate placement manager or senior clinician. Documenting the event accurately and sensitively. Offering appropriate support to family members present.
13. Safeguarding and End of Life Care
Staff must remain vigilant to safeguarding concerns even when a person is receiving end-of-life care. Abuse, neglect, or exploitation is never acceptable. Any concerns must be reported immediately following the Safeguarding Adults Policy and local safeguarding procedures.
14. Emotional Wellbeing of Staff
Providing end-of-life care can be emotionally challenging. {{org_field_name}} is committed to supporting staff by: Offering access to debriefing and emotional support through the agency. Encouraging staff to reflect on their experiences and seek additional support if required. Ensuring that directors are available to listen and support staff who experience distress, emotional fatigue, or bereavement following a placement.
15. Equality, Diversity, and Non-Discrimination
{{org_field_name}} will ensure that palliative and end-of-life care is delivered in line with the Equality Act 2010 by: Recognising and valuing diversity in culture, beliefs, and values. Adapting care to meet the needs of individuals from all backgrounds. Ensuring that no one is discriminated against on the basis of age, disability, race, religion or belief, gender reassignment, sex, sexual orientation, or marital status.
16. Training
All agency staff will receive appropriate training in: Palliative and end-of-life care principles. Communication skills specific to end-of-life care. Recognising and reporting changes in condition. Supporting families and loved ones. Advance care planning and DNACPR awareness. Emotional wellbeing and self-care. Mandatory updates will be provided as required and monitored by the directors.
17. Monitoring and Compliance
The directors of {{org_field_name}} are responsible for: Reviewing client feedback and incident reports relating to end-of-life care. Addressing concerns or complaints about the standard of end-of-life care delivered by agency workers. Conducting audits of documentation and practice relating to palliative and end-of-life care where appropriate. Ensuring that lessons learnt from incidents, complaints, or feedback are shared across the organisation to improve practice.
18. Policy Review
This policy will be reviewed at least annually or sooner if: There are changes in legislation, national guidelines, or best practice. Significant incidents or feedback indicate a need for revision. Updates to the NICE guidelines or CQC standards occur. The directors of {{org_field_name}} will be responsible for the review, implementation, and communication of this policy.
Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
Copyright © {{current_year}} – {{org_field_name}}. All rights reserved.