Continuing Care Panel
Continuing care – care
provided over a period of time to meet physical and mental health needs that
have arisen due to disability, an accident or illness.
1.
Continuing
care + Social care – care available in a variety of settings which may include
NHS/ social services. It is described as a joint package of continuing care.
The care provided by social services is means tested.
2.
NHS
Continuing Healthcare – complete package of onoing care arranged for and funded
by the NHS. Free. Can be delivered in your home or in a nursing home. The
primary care trust (now GP commissioning consortia – so which area your GP is
located in matters) is responsible for deciding your elegibility.
A Department of Health
document – provides guidelines on assessment and elegibility for continuing
care. All GP consortia should use the same paperwork.
Eligibility for
Continuing care
Depends on…….
1.
Nature - type of needs – effect on
health/well-being
2.
Intensity
– extent(quantity) and severity (degree of needs).
3.
Complexity
– Knowledge/skill needed to monitor + manage care.
4.
Unpredictability
– changes in care that are difficult to manage.
We consider
eligibility when a patient is near discharge and the picture of their long term
needs is clearer, or when their needs are being reviewed.
3 tools are used:
-
consent
needs to be gained from the patient or their family for this process (or
lasting power of attourney).
-
Patients
can be fast-tracked for a quick decision when near the end of their lives.
1.
CCP checklist – determines if a full assessment is required. Full Ax = a) high
levels of need in 2 or more areas, b) Moderate levels in 5 or more domains or 1
high and 4 moderate, c) 1 high level of need in a priority level on the DST.
2.
Decision Support Tool – Supports decision making by providing
evidence, and focuses on health. 12 areas of need with a 6 point rating scale
from – no need to priority. 1. Behaviour 2. Cognition 3.
Psychological/emotional needs 4. Communication 5. Mobility 6. Nutrition 7.
Continence 8. Skin 9. Breathing 10.Drug therapies/medication 11. Altered states
of consciousness 12. Any other needs – the MDT completes the DST and puts
down all the supporting evidence/ observations.
3.
Health Needs Assessment – brings together all of the information
– this is then presented with the DST and a social work assessment of need to a
continuing care panel.
Areas specific to SLT
Communication
-
Ability to
communicate basic needs consistently – if not present these needs need to be
interpreted by skilled members of staff.
-
Verbal/
non verbal
-
Ability to
understand instructions, follow directions and participate in activities of
daily living.
Nutrition
-
PEG or NG –
need skilled staff members to administer a feeding regimen
-
Dysphagia –
how safe? How much supervision/ support required.
-
Risk of
malnutrition/ dehydration
An Example summary:
The patient will require support with her feeding, her PEG feed, medication, all
personal care, care of her pressure areas, toileting and medication. The
patient regularly wanders and is at risk of falling. For these reasons the
patient will require 24 hour care and
support from nurses to feed her via her PEG and administer her medication
and support from carers trained in working with people that have severe
cognitive impairments. The patients care needs can fluctuate for example she may increase her wandering at times or
may develop swollen feet and pressure sores due to sitting in her chair too
long. The patient benefits from a toileting regime and monitoring of her oral
intake. She is able to engage in some activities in a limited manner, for
example with gardening. The patient is
at risk of developing a low mood if she is not supported to engage in
activities. The Multi-disciplinary team recommends
NHS funded nursing care to ensure that all of the patients needs are met.
Feedback from my supervisor:
- Supply the following information
Nature - type of needs – effect on health/well-being
2. Intensity – extent(quantity) and severity (degree of needs).
3. Complexity – Knowledge/skill needed to monitor + manage care.
4. Unpredictability – changes in care that are difficult to manage.
- Be specific about what type of care you recommend and why.
- - Give examples
-
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