Children’s Early Years Assessment – Wigan Borough

What does the Early Years Team do?

Our aim is to provide a high quality integrated service to children who have complex needs and are aged 0-5 as part of a multi-disciplinary approach.

We can support children’s therapy and play needs in the context of complex medical, social and learning needs.

The team focus on promoting better outcomes for children with special educational needs and disabilities.  This will involve maximising the child’s skills and participation in everyday activities at home, in education and in their community.  Self management and independence is the aim of the service.


Typical activities

The team offers support for children and their families with the impact on physical, communication and play skills of:

  • Severe and global developmental delay
  • Complex medical conditions
  • Neurological conditions
  • Deteriorating and life limiting conditions
  • Social communication difficulties
  • Supported communication needs
  • Eating and drinking difficulties

Positive impact of the service

We recognise that in the early years, life with a child with additional or complex needs, can be difficult and demanding both practically and emotionally.

We aim to provide a supportive child and family centred approach.  Having an integrated team approach means that families can see a range of professionals at the same time, where appropriate and means that the advice is more joined up and co-ordinated.

We are keen to involve families in our work in order to make our goals meaningful and also to help shape our service to benefit children and families the most.

Through expert assessment, diagnosis, management and the enablement of the child and others around him, the team works to overcome the negative impact of any difficulties.


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 team is based at Platt Bridge Health Centre and covers the whole of the Ashton, Leigh and Wigan area.

Services are offered at Platt Bridge or Pemberton and Leigh Health Centres and in children’s homes and pre-school settings when appropriate ensuring that children are treated in an environment best suited to individual needs.


What service does the Integrated Early Years Team provide?

The team works with children 0-5 years with complex and additional needs.

What families can expect:

  • A detailed specialist assessment with the appropriate members of the team to identify the child’s individual needs.
  • Advice and intervention on the basis of an assessment of clinical need.
  • An individual management plan developed and agreed with parents and carers.
  • An integrated approach with joint goals and management.
  • Assessment and recommendation of appropriate equipment.
  • Dependent on the child’s needs, they may be offered a block of group sessions focussing on play and therapy with the team.  This may involve singing, messy play, and sensory stimulation with development support workers and therapists, who will coach families to implement these in a meaningful way at home.
  • Where appropriate, sessions enabling families to access the sensory room with the child and the development support worker.
  • Support for parents, carers and families with advice and coaching to enable the child to fulfil their potential in all areas.
  • Where appropriate there will be opportunities for carers to meet other families of children with additional needs.
  • Support for access to pre-school education and transition to school as appropriate.
  • Other professionals, such as nursery and education staff will be supported to develop their skills in using appropriate strategies to support the child on a daily basis through the provision of appropriate and tailored coaching and training from the relevant therapists.
  • Close liaison with professionals from universal services such as the family GP and health visitor in order to provide joined up support and advice.
  • Close liaison with all other professionals from other agencies such as education and social care involved in your child’s care.
  • Signposting to other relevant services as required.

How the team will support your child

Children’s Physiotherapist will promote your child’s physical abilities through positioning, advice and coaching. The intention is to support you to learn how to promote quality movement patterns through play to maximise independence and aim to prevent long term problems from developing. Families and other professionals can expect to be coached to support the interventions.

Children’s Occupational Therapist will assist in building skills that enable participation in meaningful activities.  This may include overall development, feeding, dressing and play.  Families and other professionals can expect to be coached to support the interventions.

Children’s Speech & Language Therapist will promote communication and eating and drinking skills. This may include understanding and the social use of language or advice about other ways of supporting communication such as signing, using pictures or technology.  Families and other professionals can expect to be coached to support the interventions.

Development Support Worker is a trained nursery nurse who has specialist knowledge of play and working with children with additional needs. They work alongside therapists incorporating therapy goals into a play context.

Therapy Assistants will work alongside therapists following advice and programmes to promote your child’s development and will support you to learn these skills.

Health Visitor with Integrated Early Years Team will work with the team and the child to offer advice with a variety of issues including emotional support.  The Health Visitor helps to co-ordinate the care and links closely with the family health visitor and a variety of other agencies.


Working with other professionals involved with the child

Evidence shows that the best results are achieved when we work with those in daily contact with the child.  This enables those around the child to promote skills to their full potential in a variety of meaningful environments.  For the Integrated Early Years Team this means working with a variety of settings and with a variety of other people including parents and professionals.

Families can expect to see strong links with all colleagues including those in universal services such as the family health visitor and GP as well as other therapists, medical consultants based in community and the Royal Albert and Edward Infirmary and the tertiary centres at Alder Hey Children’s Hospital and Royal Manchester Children’s Hospital.

Families can expect close working with partners from the local authority, both education and care.


How can I start using this service?

Making a referral:

Children should be referred to the relevant therapy professionals following the appropriate routes detailed below.

Referrals to Children Physiotherapy and Occupational Therapy are received and processed at Platt Bridge Health Centre.  Professionals referring can do this through a letter or referral form with consent from the family.  Families can request any relevant professional to refer on their behalf.


Contact details

Children Physiotherapy and Occupational Therapy Team
Platt Bridge Health Centre
Rivington Avenue
Platt Bridge
Wigan
WN2 5NG

Telephone: 01942 482457.

Referrals to Speech and Language Therapy are received and processed at The Bungalow, Longshoot Health Centre.

Professionals referring can do this through a letter or referral form with consent from the family and families can self-refer by telephone:

The Bungalow
Longshoot Health Centre
Scholes
Wigan
Lancashire
WN1 3NH

Telephone: 01942 775653/4

We aim to make contact with families in a timely manner and to keep waiting times within 12 weeks.  All children are entitled to be seen within 18 weeks.


How are decisions made about who can use the service?

If an integrated joint therapy approach is appropriate, this will be facilitated in a timely manner by the professionals involved following open and honest discussion with the family.  The decision to involve the whole team and work in an integrated way will be discussed and the benefits will be explained clearly to families.


Moving on – transitions and discharge

If your child is still working with the team at the point of transition to a mainstream school or a specialist nursery or school we will support you in transfer to the appropriate therapy team.  Families and children will be supported through the transition phase.

Self management and independence is the aim of the service.  Once the child has reached the point where their skills are at an optimum level and the anticipated level of independence has been gained, the role of the therapists in the Integrated Early Years team is over.

If it is felt that the child has no further ongoing therapy needs and the family and other professionals involved are self-sufficient in the management of any persisting difficulties then the child will be discharged following full and open discussion with the family.  The decision to discharge to the support of others in the child’s life will always be discussed and agreed with families 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 in the form of joint reports, target plans, management programmes and advice sheets.

All other professionals involved with the child including the family health visitor and GP 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.

  • The Integrated Early Years Team fully respects the family’s detailed knowledge of their child.
  • There is multidisciplinary collation of information about the child’s skills and areas of need 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.
  • The goals set are linked to other strategies that are important to the child and family.
  • Tailored coaching with advice and strategies for developing the child’s skills in everyday life is regularly offered. This may be in clinic or in the nursery or at home or a combination of all to best suit the child and family’s needs.
  • Staff will contribute to Education, Health and Care Plans where appropriate.
  • Families can expect signposting to other agencies and services where appropriate and when they consent to this support.
  • Appropriate support and explanation is provided to families for equipment where additionally required.
  • A joined up approach is taken in working in a holistic manner with families.
  • Reviews of the child’s progress are multi-disciplinary and enable families to discuss their child’s progress and any areas of concern they may have.

We value what you say

We routinely ask for feedback from you to see how we are doing. This may be a request for verbal feedback, or we will ask you to complete an anonymous feedback form.

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

TalktoUs

This information will be treated confidentially, and may be used by the team in order to improve our service.


Is the Early Years Team service fully accessible?

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?

All the staff working within the Early Years Team are CRB checked and have the appropriate professional qualifications.

The team have specialist clinical staff who ensure the quality of therapy management and all staff are compliant with a range of mandatory training as well as participating in required continual professional development work in the form of ongoing reflective clinical practice, training and research as appropriate.


Who can I contact for further information?

In the first instance families who have concerns about their child’s development 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.

This may then generate a referral to the relevant therapists for further assessment, support, advice and appropriate management.


Further concerns

Our Patient Services is a point of contact for families seeking advice or information about services or to raise issues or concerns. You can contact the team on 0800 587 0562.


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.


Other support organisations

SCOPE Website
Dyspraxia Association Website
DYSPRAXIA Foundation Website
The National Autistic Society
Muscular Dystrophy Group Website
Sensory Integration Network UK & Ireland Website
Disabled Living Website
Cystic Fibrosis Research Trust Website
Asthma UK Website
Cerebral Palsy / SCOPE Website
Muscular Dystrophy Website


Case study

The following case study illustrates how the Integrated Early Years Team works together:

Jack’s story 

Jack’s story began when I was eight months pregnant.  I had not felt any baby movements for a few hours and was beginning to get worried.  In hospital there were concerns, I had a c-section and Jack was born.  I was elated but also shocked because the doctors were worried and he had to have some scans.  Then they told us he had bleeds on his brain and for 24 hours I was a complete mess.  We thought about brain damage and wondered what this would mean and what he would be able to do.

Once we went home from hospital, the doctor referred us to the physiotherapist and we began to see the physio and OT in clinic.  They showed us how to help Jack with his movements – he liked some of the exercises but got upset when he had had enough.  We had lots of questions and the staff did their best to answer them.  We did not have a diagnosis yet and we were really hoping that with some physio he would be ok.

After a few months, the staff suggested that we attend a period of group therapy.  We were unsure what to expect but it was good to see other children with problems even though they were not all the same as Jack.  It was a relief to see that we were not on our own.  In the group we got to know other people in the team and to understand what they did.  We saw the speech and language therapist who helped Jack with his communication skills, not just his speech and the development support worker who uses play activities to encourage Jack to play with the other kids and touch things like paint which he hates.

When Jack was one, the doctor told us that he had cerebral palsy.  We knew that something was not right compared to other children but nothing prepares you and I cried when we heard it was the worst case scenario.  I hate to think what would have happened without the groups – he has really come on in leaps and bounds.

We are getting to the point now where Jack is ready to go to nursery and we have lots of questions about what will be right for him.  We want to him to be happy and to have as many chances and opportunities as any other child.


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