Table 2 The 7Cs

C1

Communication

Identify patients in need of palliative care, regular meeting to discuss with team and/or primary health care trust, label notes, use advanced care plan

C2

Co-ordination

Allocated co-ordinator for whole, key carer/link person/link worker for each patient

C3

Control symptoms

Use of assessment tool, agreed note keeping and action points, equipment standard and PRN (taken only as needed) medication

C4

Continuity

Form sent to out of hours provider, patient held record or medication card

C5

Continued learning

Regular review/audit of last deaths using significant event analysis, programme of ongoing training, library resource

C6

Carer support

Staff issues and learning points + feedback after death, all staff supported

C7

Care in the dying phase

Modified Liverpool Care Pathway implemented in last days of life, agreed practice for notification of relatives, death certification and after death care, support for the bereaved families, support for staff and other residents as needed