DELEGATING CARE WITH CONFIDENCE CHILD & FAMILY CENTRED COMPETENCY SYSTEM

1. DELEGATING CARE WITH CONFIDENCE CHILD & FAMILY CENTRED COMPETENCY SYSTEM

2. 2001 • Increasing numbers and complexity of children. • All care delivered by qualified nurses from agencies. • Trust staff reluctant to or barred from giving training to non-NHS staff. • NHS role provision rather than training. • Major difficulties with recruitment and retention. • Inconsistency of approach, ‘many ways to crack an egg’! • Lack of a child centred approach • High cost - £1 million plus!

3. THE QUALITY OF BEING COMPETENT OR WELL EXPERIENCED, PRACTICALLY & A SOUND KNOWLEDGE BASE.

4. CHILDREN’S NSF CLINICAL GOVERNANCE POLICY AGENDA EVERY CHILD MATTERS N.M.C.

5. Child & Family Centred Safe Holistic What did we want to achieve Universal & Multi level Link with Bench- marking Aide Multi-agency working Based on a learning theory Test the assessed & the assessor

6. Exposure Participation Identification Internalisation Disseminator Know what to do & why you are doing it First you discover it Practice under supervision Like riding a bike You can teach it THE EXPERIENTIAL TAXONOMY Steinaker & Bell 1979

7. Basic anatomy & physiology Psychological implications Demonstration of skill Complications and trouble shooting Safety Record keeping Privacy & dignity

8. GASTROSTOMY BUTTON FEEDING COMPETENCY This competency is for Patient _____________________________ only. THIS COMPETENCY EXPIRES ON___________________________ This competency certifies Carer ___________________________ only.

9. IS IT SAFE TO TEACH & DELEGATE CARE TASKS TO NON NHS STAFF?

10. Some sources consider it inappropriate for C.C.Ns to assume responsibility for the training of non-nursing support workers as “in doing so jeopardise their professional position” . Murphy (2001) cited in The Textbook of Community Children’s Nursing (2005) The Health Select Committee’s first report into children & young people was published in 1997.

11. The Nursing and Midwifery Council (NMC) state: “you may be expected to delegate care delivery to others who are not registered nurses or midwives. Such delegation must not compromise existing care but must be directed to meeting the needs of and serving the interests of patients and clients. You remain accountable for the appropriateness of the delegation and for ensuring the person who does the work is able to do it and that adequate supervision and support is provided”. (NMC 2002)

15. COMPETENCY DISCLAIMER I certify that the person named, as carer on this document is competent to carry out the procedure detailed above and that I have current N.M.C. registration. Overall competency: -___________________________________________________________ Date _______ I the above named carer certify that I am happy to carry out the above procedure within the competencies detailed above. I understand the scope of these competencies. I will only use this training in respect of the child specifically named on the front of this form and I will not carry out procedures, which are contrary to or not covered by this training. I will seek further training if I have any concerns about my competency and in any event six weeks before the expiry date on the front of this form renew my training. Upon the date of expiry of this competency, if my training has not been renewed, or if I have concerns about my competency, I will discontinue undertaking the procedure detailed in this document and seek appropriate advice from a suitably qualified clinician and or my employer. In all other respects I will seek all necessary advice guidance and further training needed from time to time in order for me to continue to to operate within these competencies. NAME _____________________________ SIGNATURE _______________________________________ DATE _________ EMPLOYERS OF NON-NHS TRAINEES. We will use our best endeavours to ensure that our employee /staff member delivers care to the person named within the boundaries of this competency as outlined above. NAME _________________________________ DESIGNATION __________________________________________ SIGNATURE _____________________________________________ DATE ___________

16. AUDIT LEGAL SAFETY QUESTIONNAIIRE INDIVIDUAL KNOWLEDGE PICK UP TEACHING REQUIREMENTS QUESTIONNAIRES

17. TRAINING / ASSESSING VOLUNTARY SECTOR TRAINING / ASSESSING RESPITE TRAINING / ASSESSING MULTI AGENCY PARTNERS TRAINING / ASSESSING PARENTS / CHILD • CONTINUING CARE ASSESSMENT • COMPETENCIES • COSTING

18. Distributed to 94 PCTs Published in Including Me CCN Textbook 21 Competencies with Questionnaires & Model answers. All child centred • Used in:- • 3 acute units • across our 4 PCTs • Education • Social Services • Voluntary Sector • Private Sector • Parents & informal • carers AUDIT. Child & family feedback. Audit Forms – time to give & receive training. Commissioning services. Skill mix. WHERE ARE WE NOW? Multidisciplinary - chest physiotherapist Confident! Safe! Integrated! Council for Social Care Inspection Consistent teaching standards Integration with pre registration nursing curriculum Integration with Inter agency systems: – Warwickshire Health Directory Continuing Care Multi use / pooling of carers Single consistent Approach: - 1 way to crack an egg!

19. Areas Where The Competency CD-ROM Have Been Circulated To.

20. assessing is standard teaching is not

21. Off the shelf packs will ensure equity of teaching. Each child’s named nurse can deliver the package safe in the knowledge that all points are covered The Trust is sure all the points are covered Quality of teaching Personalised care Supports Nurse Teaching role Privacy Effective use of time Teaching & Assessing

22. Off the Shelf Teaching Packs • We have been successful in a £10,000 bid to complete this project. • The teaching packs will include: PowerPoint presentations, Teaching plans, Teaching Aids Handouts, Demonstration & playtimes. Underpinned by:- Focus Groups, Questionnaires and Research

23. FOCUS GROUP AND FUN TIME

24. NATIONAL USER AUDIT • 12 out of 52 returned! • 75% using them / adapting them • Medication competencies requested • Tracheostomy, gastrostomy and rectal diazepam are the most commonly used competencies • All comments have been positive so far.

25. ONGOING USER INVOVMENT COMPLETE OFF THE SHELF SYSTEM FUTURE EXPERT CHILD, EXPERT PARENT, REVIEWERS RESEARCH

26. David Widdas. Consultant Nurse for Children with Complex Care Needs.Warwickshire PCT & Coventry PCT david.widdas@warkpct.nhs.uk Liz Herd. Education Facilitator. Coventry PCT.liz.herd@coventrypct.nhs.uk