Jacqui: “I’ve known Manish for a long time now, probably close on ten years, and when he was around the age
of 16 we started looking at transition, and what would best meet his needs, and quite
quickly David and I felt that a personal health budget would be very beneficial to Manish.
Manish has two personal assistants that work with him now, that have been successfully
employed by Manish and they do look after all of his care, so that’s in terms of his
overnight ventilation, they support him at night, I have supported them to be trained
to the standard that is required to look after Manish safely, erm that’s ongoing training,
we meet every six weeks to discuss any ongoing issues that have occurred in that time, whether
that be within his ventilation or any aspect of his care, but they also phone me on a regular
basis about anything that they’re concerned about, whether that be Manish’s nutrition,
his skin integrity, or just his mood and how he’s managing his pain relief”.
Manish: “I chose Dan, because he was good and give the nice interview. He said he’d
teach me poker, but he never did yet”
David: “Delegation is a process where a trained, registered nurse, trains another person to do something that they would have
done, so some kind of nursing care task. So for example in a school setting, it might
be far better to train a teaching assistant who is going to be doing lots of other things
for a young person, than training somebody who’s separate, who’s just doing a healthcare
task. And it is tasks of the higher level, erm, those things that you do need a very
specific training for, and I think what we’ve always understood though, is that delegation
is very different to training, training is very much about delivering something to somebody
as a one off event, whereas delegation is about doing training, doing observed practice,
working with somebody until they’ve got the skills and the competence, and the confidence
to undertake that task, and then offering ongoing support and retraining as required.”
David: “To be able to delegate something, there has to be a predictable need, erm you’ve
got to be able to put that care clearly into a protocol, and you’ve got to be able to
train people to respond in certain ways in certain situations. Er now obviously for some
of our children and young people, erm, the instability of their medical condition means
that’s not the case, and you need to make a judgement, or you maybe need to make a choice,
between a number of different things. And it’s that professional judgement that turns
it into something else, that’s what turns it into a nursing task, and we wouldn’t
delegate that.” Jacqui: “Manish has been able to be very
well supported by his PAs, overnight and in the day, and not only do they support him
at home but they also take Manish out, and he before his PAs he had very limited access
to community activities and that has changed dramatically now.”
Manish: “Er yeah, he’s a really good guy and he helps a lot to go out trips, daytime
or at night sometimes went to a comedy, the club, oh yeah, we went to man united, yep,
err we saw all the players, we’re gonna see Deadpool, which is a marvel character,
and he’s a like a anti super hero and just comedy and action and stuff all in one. It
will be really good” Jacqui: “As Manish was involved in the whole
process of er recruiting his staff, he was very clear on what was very valuable to him,
and one of the most valuable things for him was to have some people to look after him
with a sense of humour” Manish: “Come on Dan, come on camera. They
can blur your face out!” Dan: “Hi, I’m Dan. I’m one of Manish’s
PAs. Erm, I usually do nights, so that’ll be getting Manish hoisted into bed, er, his
ventilator, feed, and just getting him comfortable to sleep, and then during the night erm he
has like a doorbell which he presses, and that’ll be for his comfort, or to, any issues
with feed or anything like that. Er but I do do a day or two a week as well, and we
quite often go shopping, er cinema” Jacqui: “I make sure that that erm, that
they do feel confident in the delegated tasks by constantly being in touch with them, they
have the access to 24 hour on call, erm they also have my work mobile, so if there was
ever anything that came up that they weren’t confident about, they would be able to contact
me and I would go out and assess it with them” Dan: “When I started for Manish, erm we
started off by doing, by shadowing the NHS staff that he had previously, and also going
through the NHS competencies, er for his ventilator, his feed, and just general, like, nursing,
erm and also Manish is very good at saying what healthcare he needs as well, so he’s
very good at saying what he wants” Jacqui: “The benefits for Manish have been
that just recently when he had a hospital admission his personal assistants were able
to support him in hospital. They stayed overnight with him which was a huge support because
he felt very confident in their ability to care for him. Manish has been involved every
step of the way, from writing his job description to interviewing the staff. Erm, he’s also
been very involved in his training erm with his staff, erm he feels very erm a very important
part for Manish is that the people that are with him know how to look after him safely,
so he also signs competencies with me to say that he’s also happy that they are confident
and able to care for him” Manish: “But yeah it’s going well, so
my dad get a nice rest and like and I know when Dan or Ginnie is there I always know
that they’re there when I ring the bell” Jacqui: “In my experience it’s been a
very positive experience, it’s given this young man the opportunities that I don’t
think he would have had from any other type of package. So I definitely think that it’s
something that should be explored further”