Welcome to the brand-new Voyage Care Podcast! For season one, we’ll be focusing on how we deliver person-centred care to the people we support. In this episode, we’ll be hearing from Yvonne, Clinical Lead, Hannah, Nurse Manager and Valaine, Nurse Educator at Children’s Complex Care. They’ll be discussing how the Children’s Complex Care team provide person-centred care to the young people and children they support.

Children’s Complex Care

We’re experts in providing nurse-led, personalised care at home. We care for children and young adults aged 0-25 with complex care needs in Greater London and surrounding counties. To learn more about our Children’s Complex Care specialism, please visit our web page.

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Read the transcript of the podcast below.

Yvonne:

Hello and welcome to the Voyage Care Podcast. Today it’ll be led by the Children’s complex care clinical team.  Today we are going to be discussing how Children’s complex care team provide person-centred care. So a little bit about the Children’s complex care team, we provide care to children and young people with complex health and social needs in various community settings. We liaise extensively with multidisciplinary team professionals in the community and in acute services to ensure all aspects of the child or young person’s need are encompassed in care and service delivery.

My name’s Yvonne Mujeri, I’m the clinical lead and I head up the clinical services at Children’s complex care. I also look at clinical policies and governance and service provision as a whole for Children’s complex care and I’m also the designated safeguarding lead for the organization.

Hannah:

Hello. My name is Hannah Eastwood, I’m the clinical nurse manager and I manage packages in the Southwest region. I’ve been a paediatric nurse for around eight years and I’ve been working for Voyage Care for over three years now.

Valaine:

Hi, I’m Valaine Wilson. I’m the clinical nurse educator for the Northwest region and I am one of a member of teams that’s responsible for education and training of staff.

Yvonne:

So we’ll just go straight into it. Person-centred care is based on the principle of holistic care and in that we view the person we support as an individual and this allows us to provide care that is bespoke to them and their family. So person-centred care essentially moves away from the hospital model of care delivery where it is primarily led by healthcare professionals, in the community care is very much focused on the person we support, their family and family members and it is more than just looking at their clinical needs, it is focusing on what is important to them, and what’s important to their immediate and extended family and how we can help them achieve their own personal goals.

So Hannah, as the clinical nurse manager how do you feel person-centred care works in our organization?

Hannah:

So person-centred practice is really key to every part of care that we provide for our children and young people. It helps to give them care that incorporates what’s important to them and it meets their individual clinical needs as well but it also allows them to have choices and allows us to help them achieve both their care and their personal goals.

So for us, I think really it starts at the initial assessment. So we go meet with the family and we discuss with the family, not only the clinical needs of the person were supporting but we also discuss things like their interests, their hobbies. If there’s something that’s really important to them, such as a bedtime routine or something they find really comforting.

These are really important to the individual and there are things we can’t capture unless we sit and have that proper in-depth discussion. Some of the other things we do to support person-centred practice are things like presents for each of the children and young people on their birthday. So we make sure that these are individual to their own likes, their own needs and their own abilities.

Yvonne:

Thank you Hannah and Valaine as the clinical nurse educator for Children’s complex care, how do you feel person-centred care works in practice within our organization?

Valaine:

Person-centred care for me as an educator it’s working jointly with the clinical nurse managers and completing these initial assessments that Hannah mentioned earlier, in providing bespoke training by using the care plans that we’ve created to plan the training needs of staff. In view of looking at things like mobility competency assessment, we incorporate it into the mobility needs of that specific child and staff are signed off competent on that particular equipment for that child. So it’s very much individualized for all the mobility assessments that we do. Also additionally looking at things like ventilators, there are so many different types of ventilators and again these are individualized competencies and each carer is signed off on the different types of ventilator that they’re working across or the children that we support.

Hannah:

What about you Yvonne, what do you think?

Yvonne:

I think everything that you’ve said is embedded in good clinical governance. You’ve both touched on assessments of risk with the care plans, clinical education, clinical effectiveness, and being responsive to the needs of the child and the family and from hearing what you’ve both said, it’s about working jointly with the parents in ensuring that care is very much centred on the person that we are looking after.

So when we talk about clinical care, it’s very important to try and understand what it is. So for those that may not have much knowledge around this, clinical care is a form of one-to-one care delivery that is essentially designed to support the child or young person that is affected by clinical health needs or conditions and clinical care is around treatment, management, prevention of illness, disease, or disability that the child or young person may have and you find that with clinical care delivery, we are essentially looking after children and young persons that may rely on specialist pieces of medical equipment such as peg tubes to assist with their nutrition, colostomy bags to assist with bowel movement and evacuation ventilators that assist with their breathing.

There is a lot of involvement from the parents and the families in care planning and ensuring that there’s that consistency. Parents are very key and are an integral part of care planning because they know their child or young person more than anybody else because they are the experts in care delivery for their child. So they give very good guidance. Would you not say this is true, Hannah?

Hannah:

Absolutely. I think it’s also worth mentioning that for some of our children, we create a bespoke document called an All About Me Booklet. So those booklets contain really detailed information on how to care for that child or young person but also around what their wants and their interests are so that we can really engage with that young person.

Yvonne:

I think we’ve got children and young people that have seizures and suffer from epilepsy and seizures present themselves in very different ways. So you can have a textbook definition and description of a seizure and a parent will be able to describe how their child’s seizure presents and this allows you as the educator Valaine doesn’t it, to teach the carer how to recognize the seizures as they have been described by the parent?

Valaine:

Yes, you’re absolutely right Yvonne, we’re also even able to show them videos of what the seizures are like, because it’s quite easy sometime to be descriptive but when you’ve got a video recording of the actual seizure, then that helps that carer to be able to recognize the type of seizure that we’re talking about because there’s so many different types.

Yvonne:

So the involvement of the parent is very important in person-centred care.

Hannah:

Absolutely. After all we do say that the parents are the expert in that child or young person so we absolutely need to be led by them as to the little intricacies that we might not see otherwise.

Yvonne:

Yes and it definitely allows us to advocate for the child, the young person and their families when we have our multidisciplinary team meetings, because we have essential information that the parents give us and we’re able to share this with a wider MDT during a meeting whether it’s a Child in Need Meeting or whether it’s a Team Around the Child Meeting or whether it is a health care review meeting.

So I’ll ask you Hannah, what would be your favourite success story in the time that you’ve worked for Children’s complex care?

Hannah:

So I think my favourite success story would be one of the young person we supported to go on a trip. So they went on a trip to a UK city. We were able to assist that young person to engage in some activities that were very much outside of their usual routine. So it included them going to the theatre, able to go boating, going out for dinner at restaurants. It involved a lot of risk assessments, a lot of planning. We liaised with a lot of the MDT, multidisciplinary team, so that was the clinical commissioning groups for approval as well. The child had a fantastic time and it was wonderful to be able to help them achieve some of their goals in life.

Yvonne:

I remember this and it was very nice and heartwarming when we saw the pictures that the parent sent over to us and I think we got very very good feedback from the parent regarding that because they hadn’t gone on a trip in a very long time.

Thank you Hannah. So Valaine what would you say would be your success story, well your favourite one?

Valaine:

So my favourite success story was a safeguarding alert for one of the young people that we look after. He wasn’t able to attend school and we had to work with the OT and physiotherapy in facilitating assessments within the home environment and ensuring that the equipment that he would have used at school, he was able to use those when he was at home as well and that being in place ensure that we had consistency with the care that was provided.

He wasn’t missing out on not being in school and ensuring that his mobility needs were met as well and once he was back at school because he absolutely loves being at school once, this was sorted and he was able to be in there it was quite noticeable how much he thrived in that environment and again, we were able to go in and support carers within the school environment in ensuring that they’re competent in managing his needs while he was at school as well and that he was able to attend school because he was getting this support from our staff.

Yvonne:

Yes, I remember this and I believe the clinical nurse manager and the educator worked extensively with the school staff and the school nurse and we held a lot of meetings in ensuring that this particular young person didn’t end up on the child protection register and supporting mom in ensuring that she continued making sure that he attended school and we’ve gotten a lot of positive feedback from the mother as well Valaine, haven’t we?

Valaine:

The joy that she sees on his face when he comes home in the evening, he’s up early in the morning ready to go into school and that for us is quite fulfilling to hear, her being quite happy for him to be back at school considering that it was a massive safeguarding alert and potential safeguarding case.

Yvonne:

I think it’s helped with his socialization as well, he had a lot of phobia around having tracheostomy changes and introducing new staff and the interaction that he has, particularly with yourself and the new members of staff it’s really good to see.

Valaine:

Yeah, he’s come a long way and he’s a social butterfly now just to see him transition and be this new person is amazing.

Yvonne:

I would say for me, my favourite success story would be a young person that we’ve looked after for a while now and I guess the success was in the transition. He had a very successful and smooth transition from children’s services into the adult services which is very difficult for a lot of young persons and their families because of the way children’s services work and transitioning into the adult model of care in the community and that transition was really good because it allowed him to continue to have the care provision that he had always had and Children’s complex care were instrumental in that because he continues to have a very stable rota and that’s allowed consistency and continuity in care and this has also allowed the parent to continue in her current employment and also have a bit of autonomy and freedom to go on holidays and to also socialize.

I think one of the other things about person-centred care for Children’s complex care is the birthday presents that we send every time the young person or the child has a birthday, wouldn’t you agree, Hannah and Valaine? We send those every year consistently and the parents are always happy to receive those.

Hannah:

Absolutely and I think it’s really key. We do spend a bit of time thinking about what might be the most appropriate present for them. So sometimes it’s a helium balloon and I know some children absolutely love those particularly children that enjoy more sensory activities that might be the most appropriate. Sometimes it’s a cuddly of toy and it kind of shows a bit of care and support for the children and families.

Yvonne:

Yeah definitely.

Valaine:

Absolutely. I must agree with Hannah, it does show that we care. It’s not just about the care that we give, as in we’re thinking about on the long-term basis, we’re supporting these families and these children and ensuring that they have that special moment and that we remember their birthdays.

Yvonne:

Absolutely. I know for the young person I was talking about is an avid Manchester United fan and his presents have always been centred around that and there was also a young person whereby the mum had sort of said in a meeting about how his ears get quite cold and for his birthday, we sent him a really nice wooly hat and mum did sort of give us that feedback that he wears it to school all the time and it’s nice to always get that positive feedback when we send the birthday presents and the Christmas presents and little cards and stuff like that and the feedback has always been positive.

Hannah:

Absolutely. I think where you’ve touched on that child being a Manchester United fan, I think that’s really important because things like that, they’re not always considered and actually for that young person, he likes to be dressed up in his Man United whenever there’s a game on. So it’s really important for us to know that so we can incorporate that in our care.

Yvonne:

Absolutely. So what would you say your experiences have been in regards to patient-centred care during COVID-19?

Hannah:

I think one of the key things were the regular welfare checks that we were having with the family. So they were really key and identifying any areas that they were struggling with discussing how they preferred care to be delivered during this time. So the clinical team and the HR department, we assisted in those welfare checks and we also did welfare checks with our community staff.

Valaine:

For me, it was about being adaptable. So there were families who wanted to shield, care was centred around the child’s needs and maintaining consistency in service provision to these families so staff were fit tested and provision of PPE, PPE was provided to ensure staff were safe while still delivering care to the families who wanted to have care.

Yvonne:

I think continuity of care at the beginning of the pandemic was key as different children and young persons we support have different health, social and educational needs and we needed to factor this when we were devising our COVID-19 risk assessments with very limited and changing information and guidance. I feel the clinical team at Children’s complex care had to be very adaptable and it was also really good that Voyage Care provided regular COVID-19 updates, informing us of latest guidance and changes to practice.

Yvonne:

So how did, if at all, COVID 19 change your delivery of person-centred care as a nurse manager Hannah?

Hannah:

Yeah, I think that there certainly was a change in how we delivered it but I think we were still able to deliver a very high level of care. I think we’ve adapted really well. Initially we moved to virtual visits and virtual meetings sitting with our families, having a chat, getting to know what’s going on.

With our schools being shut for quite a long time, a lot of our young people were needing to be home-schooled so our staff were then taking on the role of that. We were having to adapt different activities. So for example, we may have been taking all young people out in the community quite a lot and that certainly wasn’t happening for lots of our children who were shielding so we would adapt our activities.

We started to do things like spa days at home for example where they might have a bit of a massage, paint people’s nails and I think people really enjoyed those sort of activities but we had to be quite creative and adapt that but I would say the staff have played an absolutely essential role in maintaining the continuity of care. This time has been so uncertain for so many of our families having that continuity of staff has been a real asset.

Yvonne:

Thank you and Valaine how did, or if at all COVID-19 change your delivery of person-centred care as a clinical nurse educator?

Valaine:

It has changed our role in the sense that as nurse educators training was vital. It was important that we carried on but we wanted to carry on with all of us feeling safe, and we were able to maintain a safe social distancing whilst training.

Yvonne:

So I think definitely COVID-19 has had a positive impact in our adaptability and continuing to run our services safely.

Valaine:

Yes, I would agree that it’s certainly despite the challenges that we realize that we were able to still achieve the things we wanted to achieve and at a very high standard as well.

Yvonne:

So thank you Valaine and Hannah for participating in our podcast where we’ve been talking about person-centred care and how this is delivered by Children’s complex care and I would like to thank everybody for listening in and if you’d like to learn more, please visit our website.

Valaine:

Thanks for having me.

Hannah:

Thanks Yvonne.

To learn more about our Children’s Complex Care specialism, please visit our web page.

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• person-centred care
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• season 1