Nursing home quality improvement programme marks two years in operation

A transformative free learning programme, supporting the delivery of compassionate and person-centred care in Ireland’s nursing homes, is marking two years since it officially launched.

The Caru programme was set up on foot of recommendations from the Covid-19 Nursing Homes Expert Panel Review Report, which showed that 79 per cent of notified deaths during the pandemic occurred in the over-75 age group and that deaths in nursing homes represented 56 per cent of the national total. The Nursing Home Expert Panel was convened in 2020 by the Minister for Health to provide learnings and recommendations from the Covid-19 experience.

The Caru programme is the result of recommendations from this panel relating to palliative care, with the report specifically citing the development of an Irish Hospice Foundation (IHF) led programme. Caru was set up by IHF in partnership with the All-Ireland Institute of Palliative Care (AIIHPC) and the Health Service Executive (HSE) and was officially launched at the end of 2022.

Caru is a quality improvement programme focused on improving palliative, end of life and bereavement care to residents of nursing homes and their families and loved ones. This is a multi-strand programme aimed at supporting all staff in delivering good quality end of life care.

It is grounded in evidence-based practice and aims to expand the confidence of nursing home staff in planning and engaging in end-of-life care. Most importantly, the programme recognises that this preparation is required for all team members within nursing homes, and not just those with medical or healthcare roles. As a result, Caru has helped to train catering, administrative and support staff alongside healthcare and nursing colleagues, this inclusive approach ensures that all team members are empowered to engage compassionately with residents, their families and colleagues, even in challenging situations.

The free Caru programme has been delivered in almost half of Ireland’s private, public and voluntary nursing homes since it launched in 2022. Programmes are delivered through a series of networking events, including project echo learning networks, quality improvement workshops and webinars. A team of Caru regional leads engage with nursing home teams around the country, using a series of workshops to train and empower them through evidence-based practice methods, and learning initiatives.

Irish Hospice Foundation also delivered a unique Arts & Health programme within nursing homes has also generated successes in engaging nursing home residents and staff members in discussion on grief and their own end-of-life wishes using art, music and dance as a way to open important conversations.

Caru Seeds has seen a range of successful projects, many of which have delivered ongoing change within nursing homes. At Milford Care Centre in Limerick the team has formed Milford Voices Choir, which is a choir of nursing home residents.  This initiative was set up by the activities co-ordinator, Michelle Clifford and choir co-ordinator Aisling Rafferty.  Music is a fantastic way of promoting conversation and conjuring memories, and this choir had many interesting conversation as residents discussed and chose the music they would like to perform. Milford Voices Choir will be holding a special Christmas Carols concert in Milford Nursing Home this December.

CEO of the Irish Hospice Foundation, Paula O’Reilly, said: “Irish Hospice Foundation is incredibly proud of the achievements of the Caru programme since its launch, and the impact that it has had in just two short years.  I look forward to continuing to work with our partners at AIIHPC and with the HSE to continue to extend the impact of this work with nursing homes teams, residents and their families.”

The programme was a finalist in the Age Friendly Ireland Awards 2024 and the judging panel commended the impactful nature of the programme on the residents, staff and families in nursing homes engaged with Caru.

Additionally, a Caru group from Killure Bridge Nursing Home in Waterford won a coveted award at the recent Nursing Homes Ireland awards ceremony.