Health Education Northwest

Integrated Care Demonstrator Site

Developing a Carer Skills Passport for parents and carers of children and young people with complex long term conditions

Steering Group Meeting Minutes Tuesday 12th July 2016 2-4pm

Alder Hey Childrens Hospital

Present
Dr Lynda Brook, Macmillan Consultant in Paediatric Palliative Care /
Elaine O’Brien, Long Term Ventilation Nurse Specialist, Alder Hey / Elaine.O'
Esther Bennington, Well Child Parent Educator /
Jacqui Rogers, Transition Nurse Lead, Alder Hey /
Jan Maguire, Community Matron, LCH /
Leanne Turner, Community Respiratory Physiotherapist, Alder Hey /
Mim Davidson, Community Respiratory Physiotherapist, Alder Hey /
Maire Rooney, Redbridge School /
Ingrid Bell, Children’s Continuing Care Commissioner /
Apologies
Verity Ford /
Jennifer Bayliss, Specialist Nurse Carer Skills Passport Project /
Kate Knighting, Edge Hill University /
Linda Partridge, CEO Well Child /
Agenda item / Main discussion points / Actions and outcomes / Owner and timescale /
Welcome and apologies / As above
Action notes from the last meeting / ·  Agreed as a true record subject to the amendment below.
·  Epilepsy training has moved to in-house alder hey but schools cannot release staff for training. This arrangement is related to resources and has nothing directly to do with the Carer Skills Passport. However the lack of training for buccal midazolam administration for Special Schools is a significant safety concern for the CCG and has also been raised in schools by parent-governors. / meet with Liz Johnson and epilepsy nurse specialists to discuss issues / LB Oct 2016
Phase 2 project plan / Outline proposal

·  An application has been submitted to the Health Foundation. Competition will be stiff but we have support from Health Education Northwest. It is a two stage process and if successful funding will start from January 2017
Funding update
·  We have sufficient funding to keep a Carer Skills Passport Nurse Facilitator in post for one day a week for around 18 months. However progress will be slow. There is also sufficient funding to commission the legal evaluation (see below)
Interim arrangements
·  The Alder Hey physiotherapy team is developing a training prospectus to support carer training
·  Well Child has funded a brief scoping exercise (Via Jane Coad in Coventry) to identify what level of standardization of care skills training is already in place and what care skills training is already available. They are particularly looking for evidence of difference in different areas. This work should be finished in September and a further meeting is anticipated in November to decide next steps
·  Linda Partidge is keen to develop an online resource which provides information on quality standards, accreditation and benchmarking including providing examples of good practice but does not necessarily give detail of individual competency specifications
·  Esther Bennington has now taken on the role of the Well Child Parent trainer at alder hey however her role covers the whole Northwest Region. This role is specifically to train unpaid carers although there is no absolute reason why additional places at training sessions could not be take up by paid carers particularly if the session was being co-facilitated by another trainer.
·  Edge Hill University facilitities are also badged up as “parents only” which creates a challenge when Carer Skills Passport training is intended to include professionals and paid carers side by side
·  At present care agencies will include costs for training as part of their fee. More information is needed regarding the fees that care agencies are charging and also what the NHS (e.g. Alder Hey Homecare team currently charges)
·  There was some discussion regarding parents as trainers. It was suggested that parents are experts in their own child but will not have had experience with other children. They may be able to co-facilitate or cascade some aspects of training for their child specifically but the governance and safety issues need to be carefully explored / Link in with physiotherapy programme
Discuss side by side training and use of the Well-child suite with Linda Partridge / LB/ Carer Skills Passport team Oct 2016
LB Nov 2016
Website / ·  There is a dedicated website www.carerskillspassport.org.uk . Further development work is needed. This is something that can continue whilst awaiting the outcome of our funding application
Competencies framework / ·  Lynda has met with the team at Aintree and work is in progress to finalise a master Competencies Framework taking into account competencies identified at Aintree as well as core work undertaken by the Carer Skills Passport team
·  The final competency specifications will differentiate the required knowledge from practical skills and be supported by training and assessment guidance.
·  Edge Hill University has still not finished the work on the care APPs due to resource issues. The plan is to hand these back to Well Child when they are finally completed.
·  A team from Leeds has developed a training website. This includes information on gastrostomy, ventilation, suction and oxygen but is more of a reference source than teaching programme
·  Work undertaken on nasopharyngeal suction has been published. Recommendation is that suction depth should be prescribed by a physiotherapist
Human resources / ·  Initial meetings between human resources at Alder Hey, Elaine O’Brien and the Carer Skills Passport team have identified a process for validating carers to in-reach into the trust and continue to provide care There is a draft flowchart and honorary contract as well as a declaration to be completed by the carer. The legal standard in terms of DBS checks and proof of identify is the same as any other employee. It should be possible for carers to commence working immediately subject to presentation of satisfactory documentation and this would then be followed up by Human Resources. A ward pack needs to be developed with the necessary documentation and guidance.
·  It was acknowledged that there may be a perverse incentive for care agencies to claim that employees are more highly trained and competent. Honest feedback to agencies regarding the performance of their staff is essential.
·  The next step was to take this to the Ward Managers meeting for discussion but it has not yet been possible to set up this meeting. It is essential that we have buy-in from the Ward Managers if this is going to be successful. This will need to include lean efficient processes for instance limited form-filling, particularly out of hours, with the majority of the administrative burden falling on the Human Resources department in normal working hours. Out of hours the Clinical Support Nurses would be best placed to provide support. During the daytime there should be a ward manager or senior nurse aware of the process on each ward.
·  Hopefully agencies will recognise the potential benefits of the Carer Skills Passport and can be proactive particularly for children and young people who are known to be likely to be admitted to hospital. / Develop documentation pack and arranged to discuss with Ward Managers / LB/EO’B/MS Oct 2016
Piloting the training / ·  The proposed next phase will include piloting the training materials developed as well as developing and piloting further materials. In the meantime, given the limited resources we will be concentrating on competency development rather than training
Carer Skills Academy – training the trainers / ·  The proposed next phase funding will concentrate on developing a Carer Skills Academy to support Care Skills trainers with training materials and train-the-trainers training. This will provide a much greater capacity for training and increase flexibility in line with what we already know about the demand for training to fit in with family commitments and staff shifts
Legal assessment of liability, accountability and responsibility when parents, paid or unpaid carers deliver care in different care settings / ·  This will be commissioned from Hill Dickenson as soon as possible. We have sufficient funds and it will be beneficial regardless of the outcome of the funding application for the ongoing project / Commission report / LB Nov 2016
Any other business / ·  None identified
Date and time of next meeting / ·  Tuesday 11/10/2016 14:00 – 16:00 at Alder Hey Children’s Hospital (rescheduled to 15/11/2016)

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