Planning ahead - care home residents' experiences of advance care planning

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Summary of report content

Surrey Health and Wellbeing Board has identified 'helping people die well' as a strategic focus.  Our research showed that providers were taking a variety of approaches to end of life care planning so we spoke to care home residents across Surrey about their experiences and attitudes.

In Summer 2019 we visited 15 care homes, speaking to staff and to 21 residents or their families about advance care plans.  

We found

- people who had made plans were happy to have done so, but many had not made plans and did not wish to

- the main barriers to planning were lack of urgency and not knowing what they should be thinking about, as much as an unwillingness to think about dying.  

- most plans are initiated/enabled by professionals (HCPs, care workers) rather than individuals, often in response to a health event

- plans may be recorded in different places and we found evidence of inconsistent plans for individuals

We recommended

- support for providers (training, systems) to enable care staff and HCPs to initiate conversations and help people make plans

- encouraged providers to check an individual's plans are consistent across all paperwork

As a result of our work we are now part of the Surrey Heartlands End of Life Strategy Development Task and Finish team.



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General details

Report title 
Planning ahead - care home residents' experiences of advance care planning
Local Healthwatch 
Healthwatch Surrey
Date of publication 
Friday, 1 November, 2019
Date evidence capture began 
Saturday, 1 June, 2019
Date evidence capture finished 
Sunday, 1 September, 2019
Type of report 
Key themes 
Consent to care and treatment
Information providing
Other information of note about this report 

Methodology and approach

Was the work undertaken at the request of another organisation? 
Primary research method used 
Unstructured Interview
User stories
How was the information collected? 
Visit to provider

Details of health and care services included in the report

Secondary care services 
Care of the elderly
Social care services 
Adult social care
Nursing care home
Residential care home

Details of people who shared their views

Number of people who shared their views 
Age group 
All people 18 and over
Not known
Sexual orientation 
Not known
Does the information include public's views? 
Does the information include carer's, friend's or relative's views? 
Does the information include staff's views? 
Types of health and care professionals engaged 
All care professionals
Does the information include other people's views? 
What was the main sentiment of the people who shared their views? 

Outcomes and impact

Were recommendations made by local Healthwatch in the report? 
Does the information contain a response from a provider? 
Is there evidence of impact in the report? 
What type of impact was determined? 
Network related impact

Network Impact
Relationships that exist locally, regionally, nationally have benefited from the work undertaken in the report
Implied Impact
Where it is implied that change may occur in the future as a result of Healthwatch work. This can be implied in a provider  response, press release or other source. Implied impact can become tangible impact once change has occurred.
Tangible Impact
There is evidence of change that can be directly attributed to Healthwatch work undertaken in the report.