End of Life Care Facilitator Competency Framework

Name

Date (from)

Date (to)

This competency framework was developed by Chris Banks, End of Life Care Co-ordinator at Sussex Community NHS Trust, with support from the National End of Life Care Programme.

Acknowledgement

2

Introduction to the framework 3

Using the framework 4

Section 1

Competences 6

l Communication 7

l Facilitation 9

l Audit 13

l Learning and development 16

Section 2

Learning and development plan 23

Section 3

Reflection tool: How are you doing? 30

Contents

3

Introduction

Welcome to the End of Life Care Facilitator Competency Framework.

This framework has been developed to support quality of facilitation practice by encouraging and assisting End of Life Care Facilitators to continually review their learning and practice. The framework is not meant to be totally comprehensive, or to be the definitive guide. Your job description and person specification give details of what is expected of you as an End of Life Care Facilitator; use this framework as an aid to developing your individual role.

This framework provides a basis to support and improve the quality of practice by encouraging and assisting learning, and enhancing knowledge and skills. The framework will help guide development as well as capture evidence that will:

l Support the development of KSF profiles demonstrate the readiness for career progression

l Support ongoing registration with the Professional Bodies

l Support development into the role of End of Life Care Facilitator.

Competence can be defined as: “The state of having the knowledge, judgment, skills, energy, experience and motivation required to respond adequately to the demands of one’s professional responsibilities”(Roach,1992). Competences describe the minimum requirements for a post.

The competency framework for End of Life Care Facilitators is based on nationally recognised frameworks, best practice guidelines and local frameworks:

l National Occupational Standards (NOS)

l National Workforce Competences (NWS)

l Knowledge and Skills Framework (KSF)

l National Profiles for Nursing Services

l Common Core Competences and Principles (DH 2008)

l RCN integrated career and competence framework for Registered Nurses (2009)

l Evaluation Toolkit: Assessing outcomes of end of life care learning events (2010) University of Brighton & NHS East Midlands

l St Catherine’s Hospice (Crawley) Community Services Competences.

The framework is designed to support the development of the Facilitator by identifying the extent of knowledge and skill required for that level of practitioner. The framework recognises that to be effective, practitioners must be competent to fulfil the functions of their role. In addition, it is essential that Facilitators expand their area of competence by developing the breadth and depth of their knowledge, and their skill and expertise.

The competences are designed to support development and enable recognition for knowledge, skills and competence in daily roles. They reflect all the domains in which Facilitators may be required to practise.

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5

Using this framework

Section 1 of the framework sets out key components of core competency areas for a competent End of Life Care Facilitator: 1. Communication

2. Facilitation

3. Audit

4. Learning and development

l Develop and deliver learning programmes

l Ensure currency of own practise.

Each competency sheet consists of indicators (skills and behaviors to demonstrate competence) for the competency key component. There is also an assessment tool that includes both self and assessor measurement of competence made by considering a series of questions.

It is important for you and your practice that you can demonstrate you have the right skills, knowledge and experience to be an End of Life Care Facilitator according to the identified components. Competency assessment will tell you where you are doing well and where you need to fill gaps through learning and experience.

There are 3 stages to having your competence assessed:

1. Identifying the competences that apply to you role

2. Assessing your performance against these competences

There are a number of ways your mentor/supervisor can assess your performance against the competences. These include:

Self assessment, direct observation, question and answer sessions, reflective discussions, testimony from other staff and learning log evidence.

3. Identifying gaps and taking action to fill the gaps

Having undertaken a self assessment and a mentor/supervisor assessment, you should now be able to identify:

l Things you are currently doing well

l Areas where you need to develop further

l Any new skills or knowledge you need to gain.

These aspects of your performance could feed into your annual appraisal. It is important to remember that competence has been shown to decrease over time in some tasks, especially when they are practiced infrequently. To help you maintain your competence, ask for feedback regularly from colleagues, your mentor and through evaluation of learning and development sessions you deliver. It is recommended that competences are reviewed on an annual basis, or earlier should any concerns arise.

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Section 2 invites you to negotiate a learning and development plan in terms of your strengths and areas for development, and what steps you will take to support your development.

You and your assessor will agree how you can gain competence; this could be through a range of methods:

l Education and training

l Shadowing

l E-learning

l Reflection

l Networking.

You will agree a review date and document the review and indicate whether competence has been achieved or whether further development is needed.

Section 3 can be used to undertake reflective practice based on the competency framework. Reflection can be undertaken for both positive and negative experiences to enable you to reflect on your areas of strength as well as those areas needing development.

We anticipate that at first you may have to refer to Section 1 as a prompt, but with time you may feel that you can simply use Section 3.

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Section 1: Core Competences

Completing the competency sheets

In response to each competency statement you and your mentor/supervisor must decide whether your performance or knowledge and skills meet the stated criteria.

You and your assessor can choose to make the judgment together, discussing each of the competences and agreeing how well you perform against them. Alternatively, you could make the judgments separately and bring them together to use as a basis for discussion. The outcome will be the identification of competences that you agree you are performing to the specified standard, as well as areas where there is a gap in your knowledge or skill.

Your assessor should make their assessment/judgment based upon their observations of you performing within your role. They may also use feedback from both colleagues, other professionals you work with or service users. Where there is uncertainty about whether or not you meet the standard – perhaps because you are new in post, you will need to action plan to ensure you are able to be assessed against the standard.

It is important to document your competency assessment and the evidence you gathered to demonstrate your competency.

If there is a discrepancy in the rating of the competency between you and your assessor then a period of time should be agreed for further evidence to be gathered and reviewed together.

Score Competency Knowledge and skills

1 Does not have the skills to be competent Does not have the knowledge and skills required

2 Developing competence Developing the knowledge and skills

3 Competent but not using skills regularly, needs updating

Has the knowledge and skills, but uses them infrequently

4 Fully competent and undertaking regularly Has the knowledge and skills, and uses them regularly

A score of 3 or 4 is required to be deemed competent

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Self assessment

Mentor’s assessment

Comments and supporting evidence

1. Able to develop mutually supportive relationships to support end of life care across the health and social care sector

2. Uses communication skills to promote understanding and facilitate working relationships

3. Communicates with a range of different stakeholder groups and teams as appropriate for role

• Clinicalstaff

• TrustManagers

• Commissioners

• SHAendoflifeleads

• Learning&developmentleads

• GPpractices&staff

• SocialCare

• Familiesandcarers

4. Able to challenge effectively in a range of different situations and levels of authority

Communication

9

Self assessment

Mentor’s assessment

Comments and supporting evidence

5. The ability to work with people from a wide range of backgrounds

6. Able to bring together a range of stakeholders to plan and develop end of life care services, policies and procedures

7. Able to identify the appropriate communication method for different situations

8. Understand your own communication style (A HandyGuidetoFacilitation,NHS Institute for Innovation an Improvement (2009) page 51-59)

Communication(continued)

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Self assessment

Mentor’s assessment

Comments and supporting evidence

1. Provide effective guidance, coaching and support to enable others to develop the knowledge and skills required to deliver high quality end of life care

2. Understand the differences between:a. Facilitationb. Teachingc. Co-ordination

3. Awareness of own style when facilitating groups

4. Able to adapt own style to meet the needs of the group

Facilitation

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Self assessment

Mentor’s assessment

Comments and supporting evidence

5. Able to understand the group to be facilitated to ensure effective facilitation (size, role of participants, current knowledge etc)

6. Through facilitation able to use group experiences to support learning for the group

7. Ensures that those practitioners being facilitated to develop are competent to practise

8. Facilitates the development of others at the appropriate level by assessing and ensuring their fitness to practise

Facilitation(continued)

12

Self assessment

Mentor’s assessment

Comments and supporting evidence

9. Able to set boundaries for self

10. Able to set clear boundaries for groups and other individuals

11. Able to be flexible when working with groups to meet their needs

12. Effectively handle discussion within groups

Facilitation(continued)

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Self assessment

Mentor’s assessment

Comments and supporting evidence

13. Understanding how facilitation style may need to be changed dependent on situation•Supportive•Persuasive•Directive

(Bentley 2001)

14. Offering de-briefing and/or Significant Events Analysis

15. Able to challenge in group situation

16. Able to provide effective feedback to enable others to improve their practice

Facilitation(continued)

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Self assesment

Mentors assesment

Comments and supporting evidence

1. Support audit of End of Life Care Pathway, ACP/PPC and ADA and competency

2. Analyse and use evidence to inform improvement and deliver change

3. Seeks and implements ways of improving care for end of life patients

4. Works collaboratively with internal and external colleagues to monitor effectiveness of end of life learning and development

Audit

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Self assessment

Mentor’s assessment

Comments and supporting evidence

5. Actively seek feedback from partners

6. Actively seek feedback from service users

7. Linking national audit to local needs

8. Participates in policy and service development discussions aimed at improving patient care/services by:• demonstratinga

willingness to engage in service/practice development and embrace change

• contributingtothedevelopment and scope of nursing practice as an individual and in the team

Audit (continued)

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Self assesment

Mentors assesment

Comments and supporting evidence

9. Understanding of audit processes – national and local

10. Understands the different ways audit can be undertaken

11. Able to undertake audit at a local level

12. Able to interpret results and present in an appropriate manner to stakeholders

Audit (continued)

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Self assessment

Mentor’s assessment

Comments and supporting evidence

1. Understand the characteristics of an effective group

2. Understand the impact of effective group work

3. Design learning programme and learning and development sessions to meet learners requirements

4. Flexibility to deliver training to different levels of staff as required

Learning and Development

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Self assessment

Mentor’s assessment

Comments and supporting evidence

5. Able to develop clear aims and outcomes for learning and development sessions

6. Understand the Core competences and principles for end of life care (DoH 2010)

7. Able to match learning outcomes to Core competences and principles for end of life care (DoH 2010)

8. Deliver learning and development programmes to increase knowledge and skills of generalist care staff

Learning and Development (continued)

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Self assessment

Mentor’s assessment

Comments and supporting evidence

9. Identifies individual and team learning needs

10. Able to deal with disruptive individuals in groups

11. Prepare and develop resources to support learning

12. Ensures the teaching session follows clear and logical steps to meet specified aims and objectives

Learning and Development (continued)

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Self assessment

Mentor’s assessment

Comments and supporting evidence

13. Able to gain feedback from group participants during teaching session

14. Ensure feedback on completion of teaching session from participants either verbally or formally• Wereexpectationsmet• Wereobjectivesmet• Whatcouldbechanged• Whatworkedwell• Whatdidn’tworksowell• Whathasbeenlearnt• Howwillthisbetaken

back to practice• Howdidthefacilitator

support your learning• Whatcouldthefacilitator

have done to increase your learning

• Anyotherquestions

15.Makesuseofappropriatetechniques to support learning

Learning and Development (continued)

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Self assessment

Mentor’s assessment

Comments and supporting evidence

16. Enabling sustainability in clinical practice through:• Supportforclinicalstaff• Adviseandsupportfor

clinical staff• Supportinthe

implementation of end of life care tools

• Educationinpracticeas required to support sustainability

• LinkstoCorecompetences and principles

17. Ensures currency of own practice by: • Keepingup-to-date

with evidence-based practice, research and development within field of practice

• Developingnewknowledge and understanding

• Maintainingacurrentaction plan with supervision from senior member of team

• Competencyassessment• KSF/Personal

Development review

18. Understands and is able to teach other about national and local end of life care standards

Learning and Development (continued)

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Self assessment

Mentor’s assessment

Comments and supporting evidence

19. Able to describe and apply methods to identify learning needs

20. Able to integrate different learning opportunities and create a coherent learning programme

21. Aware of current national and local debates in relation to end of life care

22. Aware of and able to apply methods for evaluating own performance

Learning and Development (continued)

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Self assessment

Mentor’s assessment

Comments and supporting evidence

23. Aware of and able to apply methods to evaluate effectiveness of learning for individuals and their practice

24. Able to use e-learning to support end of life care learning and development

25. Able to support learners using e-learning materials

Learning and Development (continued)

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Section 2: Learning and Development Plan

Competence to be achieved

Agreed actions to achieve competence

Review and evidence

Review Date

Competent sign and date

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Section 2: Learning and Development Plan

Competence to be achieved

Agreed actions to achieve competence

Review and evidence

Review Date

Competent sign and date

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Section 2: Learning and Development Plan

Competence to be achieved

Agreed actions to achieve competence

Review and evidence

Review Date

Competent sign and date

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Section 2: Learning and Development Plan

Competence to be achieved

Agreed actions to achieve competence

Review and evidence

Review Date

Competent sign and date

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Section 2: Learning and Development Plan

Competence to be achieved

Agreed actions to achieve competence

Review and evidence

Review Date

Competent sign and date

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Section 2: Learning and Development Plan

Competence to be achieved

Agreed actions to achieve competence

Review and evidence

Review Date

Competent sign and date

30

Section 2: Learning and Development Plan

Competence to be achieved

Agreed actions to achieve competence

Review and evidence

Review Date

Competent sign and date

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Section 3: Reflection

What did I do, or what do I do well?

What didn’t go so well, or what could I improve?

What steps can I take to make these improvements?

How are you doing?

After each event or process you run or help with, you may find it useful alone or with others to answer the three questions below, referring simply to the competency headings as a general prompt.

Perhaps annually, go through the competency framework in Section 1 and consider more carefully your performance progress on each.

www.endoflifecareforadults.nhs.uk

Published by the National End of Life Care Programme

Programme Ref: PB0046 A 11 12Publication date: November 2012Review date: November 2014

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