Dignity and Inclusion

1. Dignity and Inclusion

2. Number of children with complex health needs is increasing • Right to be included in services • Services need to balance risk with rights and find a safe way to include all children

3. 10 Areas to be considered The following 10 areas act as a checklist to ensure that disabled children are included in a way which is safe and balances the interests of the child and your staff. You need to consider the following areas:

4. 10 Point Plan 1. Partnership arrangements, joint policies & protocols 2. Information on the child, working with parents 3. Promoting partnership with the child 4. Consent 5. Risk assessments

5. 10 Point Plan 6. Specific care plans 7. Training 8. Written Information 9. Written Records 10. Review and monitoring

6. 1. Partnership arrangements, joint policies and protocols Achieving inclusion involves partnership Local areas need written policies and procedures so that everyone is clear about the processes for: Training, support and monitoring of staff or carers Funding arrangements Continuing Healthcare funding

7. Partnership arrangements • Individual services need own policies which reflect the joint agreed arrangements for that area

8. 2. Information on the child – working in partnership with parents • Services must have detailed written information about a child’s medical condition and health care needs Information is needed in order to: Plan the service Manage risk Ensure staff are trained and supported

9. 2. Information on the child Key holders of information – usually the parents Share information – create an ethos of honesty and openness If you are a mainstream service – do your forms pick up the information you will need or alert you to ask for more information?

10. 2. Information on the child Balance between information sharing and confidentiality Who needs to know what and how much Child-by-child basis

11. 3. Promoting partnership with the child Services should promote: Independence and self-reliance Communication Dignity

12. 4. Consent Child / young person should be involved in indicating their consent to their support Parents need to give consent to carry out clinical procedures and the giving of regular medication Need consent to share information about the child

13. 5. Managing risk through risk assessment • Purpose of risk assessment for staff • Ensure tasks are carried out in safest way • Any risk to staff is minimised Purpose of risk assessment for the child Not exposed to unacceptable risks Can take part and enjoy activities other children do ‘Think safety’ General and specific risk assessments

14. 6. Plans From September 2014 – education, health and care plans. Alongside this – may have a number of specialist plans – health care, moving and handling, emergency plans etc Arrangement of these will vary from one area to another

15. 6. Specialist Plans Service is responsible for the plan being in place Input from other professionals – e.g. Community or school nurse, OT as well as the parents Need to decide who has access to the plan Use information from the ‘school’ plan – don’t reinvent the wheel

16. 6. Specialist Plans - Examples Health Care Plan – written with input from Health professional who knows the child When you need an emergency plan: Written in plain English and easy to follow Kept in an accessible place Children on DNR or DNAR orders

17. 7. Training Staff and carers must receive training that is both general and specific to the child or young person General training – first aid; resuscitation training; general epilepsy training; general moving and handling training; general behaviour managment training Trainers – competent working with children

18. 7. Training Specific training: Agreement across an area on the process of accessing specific training Where possible use staff who already know the child to do the training Trainers – competent working with children

19. 7. Training – clinical procedures Training non-health qualified staff – RCN list Assess competence – signed off Training is regularly updated Qualified nurses

20. 8. Written Information Book provides a list of information that is needed in writing. Information – plain English, clear and easy to follow Information needs to be updated – pro-forma letters to update medication

21. 9. Written Records At an individual level, services should have written record of: When a procedure is administered. Records need to be proportionate to the task – not overwhelm staff with paperwork. Information should be passed on at points of transition – no need to re-invent the wheel

22. 9. Written Records At a service level you need to hold written information on: Training received by staff / carers Equipment logs detailing maintenance and servicing

23. 10. Review and Monitor Continual process to include: • Staff/carers’ competency • Risk Assessments - • Specific Care Plans • Training received • Training required

24. 10. Review and Monitor Good practice – when reviewing your service – remain open to new and creative ways of working with children. Keep staff training on your agenda.