Additional Needs Nurses – Halton

What does the Additional Needs Nurses do?

The Team works in close collaboration with Families and Carers to manage behaviour issues for children and young people, with learning disabilities, attention deficit hyperactivity disorder (ADHD) and autistic spectrum condition (ASC), aged 0-19 years, in the home environment.

We work very closely with parents to help them develop a consistent approach to managing their child’s behavior.

By reducing the frequency, intensity and duration of inappropriate or challenging behavior the child / young person is enabled to improve their participation in social situations and maximize their educational opportunities


What is a learning disability?

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

The term ‘Learning Disability’ is defined by the Department of Health as follows:

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)


What is a challenging behaviour?

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)


What  do the Additional Needs Nurses provide?

Expertise available to families.

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

  • In depth functional assessment of behaviour issues
  • In depth assessment of sleep difficulties
  • Advice on behavioural issues
  • Advice on eating and drinking difficulties, of a behavioural nature.
  • Advice on toileting issues
  • Support for implementing strategies in the home such as structured timetables, symbols, social stories
  • Individual parenting advice and support based on Stepping Stones, a specific parenting strategy for parents of children with Additional Needs/Learning Disabilities.

Team members are involved in multi disciplinary assessments in co-ordination with our professional colleagues where appropriate.


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

The Additional Needs Nurses are based at:

Woodview Child Development Centre
Crow Wood Health Park
Crow Wood Lane
Widnes
WA8 3LZ

The service covers the Halton areas of Widnes and Runcorn.

Appointments are offered to families within the home environment and within clinic settings, according to the best provision for that child and family.

The service may also  see children/young people in nursery/school settings as part of the behavioural assessment, intervention and evaluation of support.


Our values

As a team we adhere to the organisational values of Bridgewater Community Healthcare NHS Foundation 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.


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 behaviour 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 service works in a variety of settings to deliver support and integrate management strategies and techniques into daily life to improve the potential of the individual child/young person.

We aim to form a partnership with families and professionals to enable 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 a Specialist Service is to provide support and coaching to the significant people in the child’s life.


How are decisions made about who can use the service?

The service can be accessed by children/young people aged 0-19 with a Learning disability and behaviour that.requires additional support.

Children under 5 who do not have a diagnosis of learning disability  may be seen as part of the Early Years Assessment.

Inappropriate referrals will be signposted to the appropriate service where possible.


How can I start using this service?

Referrals, on correct referral form, can be accepted from:

  • Pediatricians, Hospital Consultants
  • Physiotherapy , Occupational Therapy, Speech and Language Therapy .
  • Social Workers
  • General Practitioners
  • Nursery, School, SENCO, Educational Psychologist
  • Other Professionals: e.g. Family Support Workers, Mentors

Referrals to be sent to:

Woodview Child Development Centre
Crow Wood Health Park
Crow Wood Lane
Widnes
WA8 3LZ.

Telephone: 0151 495 5400

Once a referral has been accepted, families are assessed and initial advice offered.


Moving on – transitions and discharge

Following the completion of the behavioural assessment, strategies are agreed with the family and these are reviewed as indicated, usually once a fortnight.

Once the intervention has been successful and there has been a reduction in the frequency, intensity and duration of the difficult behaviour, a child/young person will be discharged from the service.

Children and young people can be re-referred to the service if the behaviour reoccurs or a new behaviour emerges.

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.

It is sometimes necessary to refer on to the adult learning disability team to continue behavioural support.  This will be done in consultation with the young person and the family


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. Families will be informed and give consent for relevant information to be shared with professionals working with the child/young person.


What families can expect

  • That the Additional Needs Nurses 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 the behavioural assessment, plan intervention and evaluation.
  • 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 for parents to learn behaviour management strategies.
  • That all who work with the child have written information which is always copied to the family
  • That where appropriate the Specialist Practitioner 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 Additional Needs Nurses are 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.

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


Are the Additional Needs Nurses fully accessible?

Accessibility is not an issue as appointments are usually 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?

The Additional Needs Nurses are DBS checked and have a range of Professional Qualifications and additional training and experience relevant to support Children and Young People with additional needs.


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 behaviour can contact their family health visitor, school nurse or GP.

They may 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.


Further concerns

Patient services are a point of contact for families seeking advice or information about services or to raise issues or concerns, you can contact them on 0800 587 0562.

Talk-to-Us


Information sharing

In order to offer integrated, high quality services for children, all of our Children’s 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.


Leaflets

Tackling sleep difficulties in children


Useful links

Challenging Behaviour Foundation

Autism.org

Mencap.org


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