What does the Children’s Specialist Learning Disability Nursing Team do?
The Children’s Specialist Learning Disability Nursing Team works in close collaboration with families and carers to encourage development, manage behaviour issues and promote good emotional health for children and young people, with learning disabilities, aged 0-19 years.
We work very closely with parents to help them develop a consistent approach to managing their child.
Our aim is to provide a high quality, holistic, needs led service focusing on the behavioural and developmental needs of children and young people with learning disabilities, Autistic Spectrum Conditions and Attention Deficit Hyperactivity Disorder.
The team also support families who are accessing the Child Development Centre for the first time by collating family information and providing information about the service they are about to receive.
The team works closely with parents and professionals supporting the child to develop a consistent approach. In order to build the skills and capacity of parents and community health staff to work more effectively with the children, young people and families who use the service, the service will offer training and development opportunities to these groups.
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.
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 is Autism?
“Autism is a lifelong disability which affects the way an individual relates to people, situations and their immediate environment. The term Autism Spectrum Disorder (ASD) is often used because the impact of autism varies from person to person.”
(Department of Health)
“It is a spectrum condition, which means that, while all people with autism share certain difficulties, their condition will affect them in different ways.
“Some people with autism are able to live relatively independent lives but others may have accompanying learning disabilities and need a lifetime of specialist support. People with autism may also experience over- or under-sensitivity to sounds, touch, tastes, smells, light or colours.”
(The National Autistic Society)
“Asperger syndrome is a form of autism. People with Asperger syndrome are often of average or above average intelligence. They have fewer problems with speech but may still have difficulties with understanding and processing language.”
(The National Autistic Society)
What is ADHD?
“Attention deficit hyperactivity disorder (ADHD) is a group of behavioural symptoms that include inattentiveness, hyperactivity and impulsiveness.
ADHD is a common behavioural disorder in children and young people. It usually starts in early childhood and some people will continue to have ADHD as adults. Severe ADHD is sometimes known as ‘hyperkinetic disorder’.
The symptoms of ADHD include being:
- inattentive – unable to concentrate for very long or finish a task, disorganised, often losing things, easily distracted and forgetful, unable to listen when people are talking
- hyperactive – fidgety and unable to sit still, restless (children may be running or climbing much of the time), talking constantly, noisy, having difficulty doing quiet activities
- impulsive – speaking without thinking about the consequences, interrupting other people, unable to wait or take their turn.
Not all people with ADHD have all these symptoms, and everyone can be inattentive, hyperactive or impulsive some of the time, particularly children. But a person with ADHD has symptoms most of the time that can seriously affect their everyday life. They may also be clumsy, unable to sleep, have temper tantrums and mood swings and find it hard to socialise and make friends.”
What does the Specialist (LD) Nursing Team Provide?
Expertise available to families.
Children, Young People and their families can access expert knowledge in the following aspects:
- Information on Learning Disability, Autism, ADHD and Emotional health and wellbeing.
- Functional assessment of behaviour issues
- In depth assessment of sleep difficulties
- Advice on behavioural issues based on behaviour modification techniques (B.F. Skinner, Pavlov, Bandura)
- Promotion of Emotional health and wellbeing
- Advice on eating and drinking difficulties, of a behavioural nature.
- Advice on toileting issues
- Advice on early play and development based on the Portage model.
- Advice on Relaxation techniques using multi-sensory facilities
- Support for implementing strategies in the home such as structured timetables, symbols, social stories
- Individual parenting advice and support based on Webster Stratton parenting programme
- Management of Autism
- Management of ADHD
Team members also monitor children and young people with a diagnosis of ADHD who are on medication as per NICE guidance, conduct QB tests, run the Developmental Play Group at Woolston Play and Sensory Centre, deliver training to parent groups and staff groups and complete ADOS assessments.
The team also contacts families when their child has been referred to the Child Development Centre to gather information and to provide information about the assessment process.
We often take on the role of Lead Professional in Family Support Meetings and complete CAF Assessments. We also contribute to continuing care decision assessments.
Where is the service located and what areas does it cover?
The Specialist (LD) Nursing Team is based at:
Warrington Child Development Centre
We work across the whole of the Warrington area.
The service is offered in Warrington from a range of suitable locations, within the community and the child/young persons’ home.
Appointments are offered at the most appropriate venue available.
The service also arranges to see children/young people in nursery/school settings as part of the assessment, intervention and evaluation of support.
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 advice to the significant people in the child’s life.
We aim to work in an integrated way with partner agencies to develop services for children and young people with additional needs.
This includes joint working at a planning level e.g. involvement in the Complex Case Panel, Short Breaks Panel, Continuing Care Panel, ADHD Foundation project and also close liaison with Social Care, Inclusion, CAMHs and Education on a daily basis.
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, ASD or ADHD. Children under 5 who do not have a diagnosis may be seen as part of the CDC Assessment.
Inappropriate referrals will be signposted to the appropriate service where possible.
How can I start using this service?
Making a referral:
Referrals are accepted via referral form. They can be accepted from:
- Hospital Consultants
- Health Visitors
- School Nurses
- Physiotherapy, Occupational Therapy and Speech and Language Therapy
- Social Workers
- Inclusion Workers
- General Practitioners
- Education staff e.g. Nursery, School, SENCO, Educational Psychologist
- Other Professionals: e.g. Family Support Workers
Referrals are accepted from parents/carers although additional information may need to be obtained.
Once a referral has been accepted, families are assessed and initial advice offered
The referral form should be sent to:
Specialist (LD) Nursing Team
Child Development Centre
Telephone: 01925 867843
Once a referral has been accepted, children and young people are allocated to the most appropriate service.
Parents/carers are contacted and invited to opt in to that service.
Moving on – transitions and discharge
As the child or young person’s needs change and skills develop, or intervention has been successful, a child/young person will be discharged from the service.
Children and young people can be re-referred to the service if difficulties reoccur or 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.
Discussion will take place with the adult LD nurses through the transition planning process in school.
If care is still active as the child reaches 18, a formal referral will be made to allow a smooth transition and handover by the time the child reaches 19 and is closed to this service.
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, over the telephone 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 Specialist Nursing Team fully respects the family’s detailed knowledge of their child.
- To be fully involved in collation of information about the child to inform the 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.
- 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.
Interpreters/translation services are available if required.
Methods of seeking views from families
The Specialist (LD) Nursing Team 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.
Families are also requested to complete Talk to Us Forms at various stages of involvement:
We operate a Patient Partner System and we would like to invite families to work with us to improve services.
Is the Specialist (LD) Nursing Team fully accessible?
Accessibility is not an issue as appointments are usually carried out at the purpose built Child Development Centre or within the home environment.
The child Development Centre is fully accessible and contains appropriate facilities for families and children with additional needs.
Families are able to contact team members using the phone and all enquiries will be responded to promptly.
What training do the team members have?
The Specialist (LD) Nursing Team 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?
If you have had previous involvement with the team, you are invited to ring them/us directly and discussion can take place regarding the appropriate action.
For parents/carers who feel their child meets the team referral criteria, they should discuss their concerns with their consultant paediatrician at their next appointment.
Alternatively it may be more appropriate to contact their Health Visitor, School Nurse, G.P., social worker or school SENCO who can offer advice and support and if appropriate make a referral to the team.
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.
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.