Exam Pass Notes

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A Simple 6-Step Memory Aid

• Prepare
• Create privacy
• Explain clearly
• Acknowledge emotion
• Support next steps
• Record and hand over

Key Principles

• Bad news in residential care covers serious incidents, clinical deterioration, hospital transfer, loss of function, end of life concerns, safeguarding issues, and death.
• Frontline care staff are often present and involved even when a clinician, nurse, or manager delivers the main explanation.
• Prepare by checking the facts, understanding the limits of your role, and considering privacy and the person’s communication needs.
• Use plain language and avoid jargon or vague phrases that confuse people.

Uncertainty and End of Life

• State what is known and what is uncertain.
• Do not guess timings or offer false reassurance.
• The most appropriate professional should lead on prognosis when possible.
• Respect the resident's wishes and capacity, and involve others only as the resident or their decisions indicate.

Follow-Up

• People often need time, repetition, and another chance to ask questions.
• Duty of candour and openness arrangements vary across the UK, but timely apology where appropriate, clear explanation, and suitable follow-up are expected.
• An apology can be part of openness without admitting liability.
• Escalate safeguarding concerns through local procedures and manage confidentiality and information sharing carefully.
• Record what was explained, who was told, outstanding questions, and the agreed next steps.
• Debrief and support staff after difficult conversations or serious events.