Case Study – PP

P was born at 31weeks with a diaphragmatic hernia. He spent the first 8 months of life in Birmingham Children’s Hospital due to his complex medical needs. Pau was fed by naso-gastric tube and received oxygen therapy 24 hours a day and had significant care needs. Sue and Graham Strong were identified as appropriate carers for P as they had previous experience of caring for a child with complex health needs and were matched with P. They were of similar ethnicity and lived in the same side of the city as P’s parents and were willing to open their home three times a week for contact.The agency supported the couple in their 2 weeks training at BCH to develop their knowledge and skills around a child who was tube fed and on oxygen therapy. Following this P had introductions with the couple in their home before the placement went ahead ie. P visiting and having over night stays before the placement commenced. With support from the agency, the couple soon develop skills and knowledge around P’s physical health needs whilst he was in hospital and on placement.

Be Healthy: P has developed well under the care and supervision of Sue and Graham. In the early weeks of the placement P was rushed back into hospital and had further surgery as his diaphragmatic hernia re-occurred. He was also fitted with a gastric button to aid his feeding. This required Sue and Graham to be trained on how to manage this procedure. P is seen by a wide range of health professionals including Cardiologist, Respiratory Consultant, feeding consultant, dietician, community paediatrician, community paediatric nurse, speech and language therapist etc. Sue and Graham work in partnership to ensure that all take P’s appointments are kept as they manage their diary well. The couple is supportive of birth parents and tries hard to help them in their understanding of P’s on-going health needs. One health professional commented to Sue that it was like she was caring for three children during the consultation. P is very susceptible to colds. He also does not sleep well at night so Sue and Graham can be up several times in the night. P’s emotional needs were of concern following his placement as he had been cared for in a busy children’s surgical ward where none of the nursing staff had time to spend with P around his emotional development. At the early stage of the placement when P was readmitted into hospital for emergency surgery, Sue stayed with him and it was then that P began to respond to the families love and concern and he started to flourish in placement. P’s health needs have been well met by the couple and he is now off oxygen.

Staying Safe: Sue and Graham care for P in a safe family environment in line with using a safe caring plan and his care plan. The couple manage P’s behaviour well by the use of firm and fair boundaries.

Enjoy and Achieve:P’s immune system was compromised due to his complex health needs and he was not able to mix with children his own age during the first half of his placement. Sue’s own children were the only children he mixed with and they were instrumental in supporting his development. Sue now attends a mother and toddler group with P to aid his development. P is now walking unaided. P has respite one day a week which allows Sue some time for herself and also allows P to develop his play skills with other children his own age without Sue being present. It is hoped that P will start nursery after the Easter Holidays to further develop his potential. Sue has worked hard with P with language development. Future Families have supported Sue by providing her with a DVD of nursery rhymes which were sung and signed and a book for Sue to learn some basic signs to support P in his language development. P’s speech is developing quickly now and he is showing great interest in signing nursery rhymes. Sue works well to the Care Plan and is hoping to support P on the transition of an adoption placement. The couple’s own three children are adopted and they look forward to P having a forever family of his own in line with his care plan.
Making a Positive Contribution: Sue supported P’s contact in the early days by hosting contact in her own home however this did not work well for different reasons. Contact moved to a children’s centre and Sue would take P, supported by Future Families, when Sue was being threatened by P’s father. Once the case was subject to court proceedings P has been transported to and from sessions by a contact worker and Sue has kept a diary to inform parents of P’s day to day activities and development. Sue regularly saves for P’s future as required by Future Families policy and as P does not yet have pocket money Sue saves this to provide toys to stimulate his development. Sue and Graham are competent carers and this is evident in the high level of care they provide.They have completed the CWDC course and uses supervision well to trouble shoot issues.