Children’s Learning Disability Team – Wigan Borough

What does the Children’s Learning Disability Service do?

The Learning Disability Children’s Nursing Service, based at Platt Bridge Health Centre, provides support in managing behavioural issues for children aged 4-16 with a learning disability.

Our aim is to provide a high quality, holistic, needs led service, focusing on health and behavioural needs of children and young people with learning disabilities.

The team work in close collaboration with Families and Carers to manage behaviour issues for children and young people aged 4-16 years in the home environment. Support offered will reduce risks to the child, to other children and to the family.

The team work closely with parents and education staff in schools and colleges to enhance the skills of others in supporting children and young people with learning difficulties to manage their behavior.

The focus of the service is to have a positive effect on a child / young person’s behaviour in order to enable participation in social situations, maximise their educational opportunities and their social opportunities.

Self management, by parents, is the aim of the service.


Positive impact of our service

Our aim is to work with children and their families / carers to effect a reduction in difficult behaviour.

This is done by carrying out an assessment to identify the function of a particular behaviour, the outcome of this assessment informs the intervention required in order to reduce the frequency, duration and intensity of the difficult behaviours.

Behavioural assessment is carried out by interviewing parents /carers / teachers. In addition, direct observations are carried out usually in the home and school setting.


Our values

As a team we adhere to the organisational values of Bridgewater Community Healthcare NHS Trust.   We provide a patient centred service by focusing on the child / young person and the team around the family looking to make a positive difference to their lives.

We constantly strive to evaluate our service and look for new, more effective and innovative ways of working.

We value all forms of communication and aim to communicate in an open and honest way that enables an atmosphere of trust and respect throughout.

We offer a professional quality service, following local and national professional guidelines with a comprehensive management structure, support and training packages that ensure best evidence-based practice at all times.

We are locally-led and flexible about the settings of our intervention to best meet the needs of the child and family.

We are efficient and use our resources wisely to ensure quality care and value for money.


Where is the service located and what areas does it cover?

The Children’s Learning Disability Nursing Service is based at:

Platt Bridge Health Centre
Rivington Avenue
Platt Bridge
Wigan
WN2 3NG

We work across the whole of the Ashton, Leigh and Wigan area.

Appointments are offered to families within the home environment as this is usually the most appropriate place to carry out the behavioural assessment and implement recommendations.

The service also arranges to see children/young people in nursery/school settings as part of the behavioral intervention.


What  does the Children’s Learning Disability Service Provide?

Young People and their families can access expert knowledge in the following aspects

  • In depth functional assessment of behaviour issues
  • Advice on behavioural issues
  • Advice on eating and drinking difficulties, of a behavioural nature.
  • Advice on sleeping issues.
  • Advice on toileting issues
  • Support for implementing strategies in the home such as structured timetables, symbols, social stories

Working with our partners

Evidence shows that the best results are achieved when we work with those in daily contact with the child and young person.

This enables those around him / her to promote positive behavior in a variety of meaningful environments.

The service works with Parents / Carers, Paediatricians, Allied Health Professionals, Education staff, G.P’s, Social Workers and Private and Voluntary Organisations as a team around the child.

The services works in a variety of settings to deliver support as appropriate, integrating management strategies and techniques into daily life.

We aim to form a partnership with families and professionals to support others to  maximise the child’s potential.

Parents are a significant member of the team who hold a unique insight into their child and whose contribution we value.  Our role as Specialist Nurses is to provide support and coaching to the significant people in the child’s life.


How can I start using this service?

Making a referral:

We offer an open referral system.  Referrals, on correct referral form, can be accepted from:

  • Parents/carers (telephone referral accepted)
  • Paediatricians
  • Therapy Staff e.g. Physio, Occupational Therapy, Speech & Language Therapy
  • Social Workers, (Targeted disability service).
  • General Practitioners
  • Other Health Professionals

On referral form sent to:

Children’s Learning Disability Service
Platt Bridge Health Centre
Rivington Avenue
PlattBridge
Wigan
WN2 5NG

Telephone 01942 481347

Once a referral has been received families are usually seen for an initial screening assessment within 3-4 weeks.


How are decisions made about who can use the service?

The service can be accessed by children/young people aged 4-16 with a learning disability and challenging behaviour.

Information gathered during the initial screening assessment will determine if the referral to the Children’s Learning Disability Service is appropriate, the outcome of this will be discussed with families and the person making the referral. Signposting to other services will be made where appropriate.


What is a Learning Disability?

The term learning disability is currently used in the UK to describe a person with impaired intelligence and impaired social functioning present since the person’s childhood.

Learning disability is also referred to as special needs, intellectual disability and developmental disability.

The Current Department of Health Definition:

Learning disability includes the presence of:

  • A significantly reduced ability to understand new or complex information, to learn new skills (impaired intelligence), with;
  • A reduced ability to cope independently (impaired social functioning); which started before adulthood, with a lasting effect on development.
    (GB.DH 2001)

The most commonly used definition of challenging behaviour is:

‘Behaviour of such an intensity, frequency and duration that the physical safety of the person or others is likely to be placed in serious jeopardy, or behaviour that is likely to seriously limit the use of, or result in the person being denied access to ordinary community facilities’ (Emerson 1995)


Moving on – transitions and discharge

Once the family is self sufficient with managing behavior the role of the Specialist nurse is over.

Children are discharged from the service following a successful intervention package that has seen a reduction in the difficult behaviours presented at the time of referral.   Discharge usually follows a monitoring period to ensure behaviours remain settled.

It is sometimes necessary to refer on to the adult learning disability team to continue behavioural support.

This is done in advance of the young persons sixteenth birthday to allow for a smooth transition and introduction / handover to the new service.

The decision to discharge to the support of all others in the child’s life will always be discussed and agreed with the child or young person, their family and other relevant professionals.


How does the team communicate with families and involve them in decision making and planning?

Families can expect clear communication from the team members both face to face and in writing.

All other relevant professionals involved with the child including the GP and referrer will be provided with copies of any written information.

Families will be fully involved and contribute to all decision making and planning for the child.


What families can expect:

  • That the Children’s Learning Disability Service fully respects the family’s detailed knowledge of their child.
  • To be fully involved in a detailed assessment including in depth collation of information about the child to inform behavioural assessment and plan intervention.
  • A person centred approach in order to meet the child’s needs
  • To be fully involved in the development of a management plan for their child
  • That the plan will contain clear measurable goals and expected outcomes
  • That the goals will link to strategies for families and others to implement on a daily basis
  • Families can expect programmes that they and relevant others, such as nurseries and schools, are to implement on a daily basis.
  • Families can expect that they and important others, such as teaching staff, develop their own skills in using the appropriate strategies to support their child on a daily basis.
  • Coaching sessions (up to a maximum of 6) for parents to learn behavior management strategies.
  • That all who work with the child have written information which is always copied to the family
  • That where appropriate the Specialist Nurse will contribute to Education, Health and Care plans and reviews for children and young people with additional needs
  • Families can expect signposting to other agencies and services where appropriate and when families consent to this beneficial support
  • That where relevant, goals and management plans are provided jointly in order to work in a holistic and meaningful way with families.
  • A detailed assessment is carried out in order to gain the information needed in order to plan the appropriate support.
  • Families are fully involved and participate in the assessment and development of a management plan for their child.
  • The child’s management plan contains clear, measurable and meaningful goals and expected outcomes for the child and that these are fully discussed and explained.
  • A joined up approach is taken in working in a holistic manner with families.

Methods of seeking views from families

The Children’s Learning Disability Service is always keen to seek the views of service users and value their feedback.

This includes regular review of the  effectiveness of the intervention strategies.

Experience based questionnaires are also used to gain feedback from families.

amilies are also requested to complete Talk to Us Forms at various stages of involvement:

TalktoUs


Is the Children’s Learning Disability service fully accessible?

Accessibility is not an issue as appointments are carried out within the home environment.

However, on the rare occasion this is not possible, all buildings used by the team are fully accessible and contain appropriate facilities for families and children with additional needs.


What training do the team members have?

Staff working within the Children’s Learning Disability Service are DBS checked and have the appropriate professional qualifications.


Who can I contact for further information?

In the first instance parents/carers of a child with a learning disability who have concerns about their child’s behvaviour can contact their family health visitor or GP or discuss their concerns with their consultant paediatrician if they have one.

Families of children attending educational settings can also seek advice and support from these staff.

Families can also contact the service directly if they have concerns about their child’s behaviour.


Further concerns

Patient services are a point of contact for families seeking advice or information about services or to raise issues or concerns.

Information sharing

In order to offer integrated, high quality services for children, all of our Childrens Services work closely with preschools, nurseries and schools.

We share information about the outcomes of assessments and the strategies recommended in order that preschools, nurseries and schools implement the same strategies on a daily basis.

We also inform preschools, nurseries and schools when a parent does not attend an appointment.

This will greatly help your child, but it you do not wish information to be shared you may withdraw your consent at any time.

Useful links

Challenging Behaviour Foundation

Autism.org.uk

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