University Hospitals of Leicester NHS Trust Learning Disability Acute Liaison Nurse Team based at the University Hospitals of Leicester NHS Trust Annual Report April 2013 to March 2014 (Dickens)8148183 (Easy Read Version)
Content Page 1. The Service Members...3 2. What the service does...3 2.1 Aims of the Service...3 3. Groups of people seen by the team...4 4. Patients seen...5 5. Service Description...6 5.1 Clinical Care...6 5.2 Education and Practice Development...6 5.2 Training that has been carried out...7 6. Things achieved by the team...8 7. Care Achievements...9 8. Patient Contact...10 8.1 Leicester City Clinical Commissioning Group Patients...10 8.2 East Leicestershire and Rutland Clinical Commissioning Group Patients...12 8.3 West Leicester Clinical Commissioning Group Patients...14 9. Good Practice Cases...16 10. Things the team are going to do...17 11. How to contact the team...18 Page 2
Leicestershire Partnership NHS Trust The team still works with Leicestershire Partnership NHS Trust in relation to people with learning disabilities. 1. The Service Members The team currently is Katrina Dickens and Louise Hammond. Lindsey Heald went on Maternity Leave in December 2012 and gave birth to a lovely baby boy. Lindsey is now on a Career Break for 3 years. 2. What the Service Does 2.1 Aims of the Service The team continues to work with the hospital staff in the care of patients with learning disabilities at: - Leicester Royal Infirmary - Leicester General Hospital - Glenfield General Hospital The team continues to support patients with learning disabilities and their relatives/carers, when they come into hospital. To provide training about people with learning disabilities to the hospital staff. Page 3
3. Groups of People seen by the team Patients with a Learning Disability who come in to the hospitals. The team has mainly worked with adults over the age of 18 years. There have been two occasions when the team has worked with children under the age of 18. The team will talk with patients and other professionals who are changing from children to adult services. Page 4
4. People Seen Any patient from within Leicester, Leicestershire and Rutland who comes into hospital. Sometimes, the team may be involved in the care of patients from other areas such as Northampton, London or Derbyshire. Page 5
5. Service Description The parts of the Learning Disability Acute Liaison Nursing Service are: 5.1. Clinical Care There are three parts that affect patient care: 1) Communicating in and outside of the hospital. 2) Assessing individual care needs and advising on the support needed. 3) Supporting care and discharge by talking with the hospital staff. 5.2. Education and Practice Development To help hospital staff to develop their knowledge. To help hospital staff develop their skills to provide care. Page 6
5.2.1 Training that has been carried out: Learning disability awareness talk to newly qualified staff. Learning disability awareness session to the physiotherapists and occupational therapists at Leicester Royal Infirmary. Learning disability awareness session to the Nuclear Medicine Team at Glenfield Hospital. Amber Care Bundle Talk for people with learning disabilities to the community learning disability nurses. This was delivered with the primary care liaison nurse and the nurses from the hospital. The Amber Care Bundle is a simple approach used in hospitals when clinicians are uncertain whether a patient may recover and are concerned that they may only have a few months left to live. It encourages staff, patients and families to continue with treatment in the hope of a recovery, while talking openly about people s wishes and putting plans in place should the worst happen. Person centred care sessions as part of the induction with human resources trainers. Person centred care means planning the right care for what each different person needs. A 3 day programme to 74 healthcare assistants within the hospital. - 4 programmes were delivered to hospital staff. - The programme was delivered by the Practice Development Lead for planned care and the acute liaison nurses. - Sessions were provided by the hospitals safeguarding adults lead nurse and the lead nurse for older people. - This training was supported by the Divisional Head of Nursing for planned care. Page 7
6. Things achieved by the team: The team continue to: Do home visits for people within Leicester, Leicestershire and Rutland who come into hospital for planned tests or operations. The team also: Try to see patients referred to the service within 24 hours. The times when the team cannot do this is when patients are admitted at the weekend or at bank holidays. Continue the patient/carers meetings Attend County Better Health meetings Take part in any Big Health Days in Leicester organised by the primary care liaison nurses. The Big Health day is where families, carers and people with a learning disability are invited along to hear about what things the health services have done to make things better. Give out a patient s diary to patients in hospital. This will help to see what patients think of the service they receive and see what things need changing. Page 8
7. Care Achievements: A patient diary has been given to people with learning disabilities who come into hospital. 53 diaries have been received The results identified: * staff attitudes within hospital were positive * staff were helpful and kind to the patient with learning disabilities. * the diaries showed what patients/carers felt needed improving in the hospital: - for wards to give patients information. - explaining to the patient about the ward routine. - to inform patients about the acute liaison nurses when they are admitted. - to inform the patients and carers about the procedures/tests. - to involve the family in decision making. - to read the information that comes in with the patient. - Bathing facilities/shower facilities and advice on the right equipment. Page 9
8. Patient Contact - Figures The team have seen 574 people within the hospitals. This is 165 more people than last year. These numbers are made up from: Leicester City - East Leicestershire and Rutland - West Leicester - Outside Leicester - Patients who do not have a learning disability 285 patients 108 patients 113 patients 8 patients 60 patients 8.1 Leicester City Clinical Commissioning Group Patient Information Age range of people seen who live in Leicester City: 18 to 28 years 42 patients 29 to 38 years 50 patients 39 to 48 years 54 patients 49 to 58 years 72 patients 59 to 68 years 35 patients 69 to 78 years 29 patients 79 to 88 years 3 patients Gender: 126 Females patients seen 159 Male patients seen. Page 10
Ethnic Groups: 233 White British patients seen 45 Asian patients seen 4 Black patient seen 2 Mixed 1 Somalian The types of Religion patients have: - Catholic - Church of England - Christian - Baptist - Methodist - Protestant - Greek Orthodox - Hindu - Sikh - Muslim - Islamic - Anglican - Atheist Top 10 reasons for patients coming into hospital: Respiratory (chest/breathing) which includes aspiration pneumonia; asthma; pneumonia; chest infections Epilepsy Urine/kidney infections Cellulitis (infection of the skin and the tissue under the skin) Fractures and hip replacements Ophthalmology (Eye) Appointments Diarrhoea E.C.G; CT Scans; MRI Scans Catheter changes planned and not planned Sickness and vomiting Page 11
8.2 East Leicestershire and Rutland Clinical Commissioning Group Patients Age range of people seen who live in East Leicestershire and Rutland Under 18 years 2 patients 18 to 28 years 16 patients 29 to 38 years 5 patients 39 to 48 years 15 patients 49 to 58 years 31 patients 59 to 68 years 22 patients 69 to 78 years 12 patients 79 to 88 years 4 patients 89 and over 1 patient Gender: 40 Females patients seen. 68 Male patients seen. Ethnic Groups: 104 White British patients seen 4 Asian patients seen Page 12
The types of Religion patients have: - Ukranian - Muslim - Hindu - Methodist - Church of England - Catholic Top 10 reasons for admission: Respiratory (chest/breathing) which includes aspiration pneumonia; asthma; pneumonia; chest infections Urine and kidney infections Epilepsy E.C.G; CT Scans; MRI Scans Catheter Changes planned and unplanned Checking when patients have attended appointments and letting learning disability team know. Maxillofacial (treatment of diseases affecting the mouth, jaws, face and neck) Gynaecology (women s problems) Sigmoid Volvulus (patients can have abdominal pain, constipation and abdominal distension). Cardiology (heart) related Page 13
8.3. West Leicester Clinical Commissioning Group Patients Age range of people seen who live in West Leicester 18 to 28 years 20 patients 29 to 38 years 13 patients 39 to 48 years 22 patients 49 to 58 years 21 patients 59 to 68 years 24 patients 69 to 78 years 12 patients 79 to 88 years 1 patients Gender: 47 Females patients seen. 66 Male patients seen. Ethnic Groups: 99 White British patients seen 7 Asian patients seen 8 seen, not identified as an ethnic group Page 14
The types of Religion patients have: - Roman Catholic - Church of England - Christian - Baptist - Congregationalist - Hindu - Sikh - Muslim Top 10 reasons for admission: Respiratory (chest/breathing) which includes aspiration pneumonia; asthma; pneumonia; chest infections Epilepsy Urinary tract infections E.C.G; CT Scans; MRI Scans Cardiology (heart) related Cancer related Fractures Maxillofacial (treatment of diseases affecting the mouth, jaws, face and neck) Gastroenterology includes feeding tubes Falls Page 15
9. Good Practice Cases: (The patient s name has been changed to maintain confidentiality). People involved included Amy (the patient), her mother, the gynaecology consultant, the safeguarding lead nurse, the learning disability acute liaison nurse, the community learning disability nurse, Psychiatric Consultant - learning disabilities, Hospital Legal Team and The Court. Amy was referred to the hospital for an operation due to having women s problems. The gynaecology consultant tried a variety of treatments to help Amy, but none were successful. It was then decided that Amy may need to have an operation. Amy was assessed by the community learning disability nurse, Psychiatric Consultant -learning disabilities at the request of the gynaecology doctor in relation to their ability to understand complex decisions. The learning disability team sent their report to the gynaecology doctor. Amy was a young adult so the safeguarding lead nurse was involved to make sure all decisions followed capacity and consent guidelines. The learning disability acute liaison nurse was involved to help with assessing Amy in relation to the specific operation and their understanding of risks. The use of easy read information and objects of reference were used to help Amy understand. The safeguarding lead nurse and gynaecology consultant sat in on this meeting as observers as well as Amy s mum. After the meeting it was agreed that Amy was not able to understand all the parts of the operation. From a best interests point, it was agreed by all that Amy should have the operation. A detailed report was sent to the Hospital s legal team. All the information was then sent to the Court for their final decision. The Court agreed that Amy s should have the operation under best interests for their health. Page 16
10. Things the team are going to do: To develop the service alongside the Single Assessment Framework. To continue to give out the patient s diary when people come into hospital. Audit of the Emergency Grabsheet, thetraffic Light Information Booklet and DisDAT Tool. The team will see if these forms are brought into hospital when a patient comes in. Page 17
Louise Hammond will be working with the learning disability primary care liaison nurse and 3 of the community nurses. They will looking at palliative care for people with learning disabilities within Leicester, Leicestershire and Rutland. They will be looking to see what services are available for people with learning disabilities. The team will be part of the Healthcare Assistants and Housekeepers induction programme. They will deliver a session on learning disability awareness. The team will be part of the hospital student nurses training. The student nurses will spend 1 to 2 days with the team. 11. How to contact the team: To contact the learning disability acute liaison nurses Telephone: 0116 258 4382 Please leave a message if the team are not available. Page 18