A brief guide for young people and their families in Cheshire.

WHAT IS CHILDREN AND YOUNG PEOPLE'S CONTINUING CARE.

A continuing care package will be required when a child or young person,

0-18yrs has needs arising from a disability, accident or illness that cannot be met by existing services or specialist services alone.

The service gives children, young people and their parents the choice to live at home as recommended by DOH policies. The service is provided within the home predominantly by health care assistants who have direct access to support from a designated case manager.

The Integrated Care Board, which is responsible for arranging health services locally, has a responsibility for assessing children and young people to see if they need a package of continuing care.

AIMS

The aim of the service is to support children and young adults with long term conditions at home, school and respite centres by providing care to optimise the highest quality of life and independence. The service also aims to care for children and young people in the community for as long as possible to avoid hospital admissions.

Complex Care is a bespoke package of care beyond what is available through core and universal health services. It is provided to children with high levels of complexity or intensity of nursing care needs. Each child/young person undergoes an assessment to ensure they meet the criteria for the service.

OBJECTIVES

To provide packages of care at home for technology dependant patients or children with multiple health needs in agreement with commissioners.

To enable children and young people with complex health needs achieve and maintain their optimum health living at home and supporting the family/carer to achieve this.

To work closely with multi-disciplinary agencies and partner organisations to provide optimum complex support to the child, families, and carers.

Complex care packages require the input of several agencies and the ongoing case management and review of a person being supported.

Well defined management support is provided to staff.

Our Children and Young Person’s Continuing Care Team Leader will:

  • Oversee finance of care packages and pull together costings for new care packages.
  • Co-ordinate the process of assessment and delegate this as required.
  • Identify overall training requirements of both trained and support staff and implement training programmes as required.
  • Recruit workforce planning.
  • Facilitate a system of monitoring the competence of support staff on an agreed basis.
  • Co-ordinate the review process with the agreed case manager.
  • Risk Management.
  • Provide appraisals and clinical supervision.

Our Children and Young Person’s Continuing Trained Nurses will:

  • Deliver specific nursing care as appropriate.
  • Undertake nursing and associated risk assessments.
  • Act as case manager where appropriate.
  • Co-ordinate and review the nursing care as required.
  • Deliver specific training as required for each care package.
  • Train and support health care assistants as required.
  • Liaise with all relevant partner agencies.

HOW CAN A CHILD BE REFERRED FOR ASSESSMENT.

A referral can be made by any professional involved in a child’s care,

the Child or Young Person must reside in and be registered with a GP within the South and Vale Royal Clinical Commissioning Areas. Cheshire East and Cheshire West catchment area. A referral is made via the Integrated Care Board. 

 

WHO WILL CARRY OUT THE ASSESSMENT.

The assessment will be co-ordinated by a Senior Practitioner for Children who will visit you and your child and obtain reports from the team of Doctors and Therapists who are involved in the care of your child.

An important part of the assessment is to capture the preferences of the child or young person and their family. Therefore, the health assessor will always remain in open communication with you and you child. The assessment will take approximately 6 weeks to complete and will be submitted to the Integrated Care Board decision panel for consideration. If your child needs immediate support, for example if they need palliative care, there is a fast-track process to ensure that their care can be put in place as soon as possible.