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Supporting all families where they need us most

There is no doubt that COVID19 has affected us all in very profound and ongoing ways.

For families the past months have been incredibly difficult with many families shielding and worried about how it would affect their child.

Dawn Entwistle, Clinical Nurse Manager for CHAS at Home (CaH), speaks about how the CHAS at Home teams have adapted.

For many families, the care and support that they usually received changed almost overnight. For me and my colleagues in CHAS, our focus has been, and remains on, how we can best help and support; adapting our services to the changing circumstances.

Our teams of CHAS at Home nurses and support workers based out of Rachel House, Robin House and bases in Aberdeen and Inverness, provide hands on nursing care and support in children's own homes; meeting the individual needs of the children which can include administering their medication and feeds. Our nurses are highly skilled in looking after children with exceptional health care needs which means often visits are planned for 4-6 hours to give families the opportunity to have a much-needed and deserved break. This gives them the time and space to be able to have some time to themselves, spend time with their significant other or have that quality time with their other children.

Our nurses provide more than medical care; they also engage the children in fun activities such as storytelling, singing and doing arts and crafts. They help the children and their siblings live life to the full, creating precious memories for the whole family - helping keep the joy alive. This year alone, we've seen a 34% increase in CHAS at Home visits and a 26% increase in the hours of care delivered in comparison to just two years ago. Referrals are also up by 24% from last year. This has meant, as a team, we've had to adapt and adapt fast.

Prior to the coronavirus pandemic, a nurse and a support worker from the hospices were seconded onto CHAS at Home on a monthly basis. But during the past months, we've had to adapt and change our service provision as the hospices too have had to adapt to the restrictions set out by government. So now, on a weekly basis, we hold meetings to look at the availability of staff across the services who can increasingly support families in their homes. We have also offered shorter visits and provided more visits per day to ensure we adapt to families' changing needs.

Another way in which we've recently adapted our services is by working even closer alongside community staff. Over the last few months, we have contacted all the NHS care providers to ask them if they have any staff shortages and offered to help. We've always worked alongside community staff to keep them informed about our offering and would regularly discuss how we can offer families more support. Although we supplemented what the NHS provide for the families, we did not 'plug' the gaps in the children's community packages, but would work alongside our social workers to support the families to get the care they are entitled to. During the pandemic, we have been supporting the children's packages as their staff have been depleted.

The families, most of whom were self-isolating or shielding during these past months, have been happy to have regular contact from their keyworkers and CHAS at Home as well as the wonderful support from the virtual hospice. Providing care to their children 24/7 is intense and can be very exhausting with no breaks, so we have been working hard to provide more support to families and doubled our visits to families. The joint working between the hospices and CHAS at Home staff has meant we were able to respond quickly to their requests. As a result of this joint working we have for example been able to support a young person to get discharged from hospital supported by twice-daily visits.

I am delighted that we have been able to respond the way we have to families' needs, ensuring they received the support they needed throughout in their homes. We are looking at how we can keep supporting families even more in their homes and I am delighted that we are now working even closer with our community partners to provide the care the families need. We have become more agile and are able to deploy staff where needed, prioritising crisis and end of life care when that is required. In Lothian, we are already providing Care 24 and I am hoping we will be able to provide more out of hours care across Scotland. This will help give families real choices about where they want to receive their care, whether in hospice, in hospital or in their own homes.

And, of course, none of what we have been able to do over the past months would be possible without the unwavering support from our supporters. There is no doubt circumstances are challenging but I am hopeful that people will continue to generously support CHAS. For everyone making all of this possible, a deep felt thank you and a reminder that you are helping us reach every child and family during the hardest of times.

If you want to talk to someone about your own situation or find out more about our services, please get in touch: