Complex Multiple Impairment Team Julie Howard Sarah Stewart

Complex Multiple Impairment Team Julie Howard & Sarah Stewart Community Learning Disability Nurses

Who we are… • The Team is the Complex Multiple Impairment Team one of the 4 Community Learning Disability Teams in Leeds part of LYPFT services • The team is a citywide Multi Disciplinary Team and is comprised of 10 Learning Disability Nurses, 2 Physiotherapists, 3 Dietetic staff , 1 OT and 1 Speech and language therapist within the team

Client group • Adults with a Learning Disability and additional complex health needs and many with life limiting conditions • Majority of people on caseload have severe / profound Learning Disabilities and complex physical disabilities but not exclusively • We take referrals from any source – GP’s, Carers, Care Managers, Transitions team, schools, Private and voluntary care providers, other Health Care professionals in primary care and Acute hospital professionals • Each year we have a number of new referrals from paediatrics into Adult Services via the school nurse / paediatrician in the SILCS – Leeds (Transition work) • Approximately half the Service Users on the caseload live with family carers the remainder live with paid carers within Health & Social Care provision

What we do. . Provide MDT approach to care Co – ordinate between health & social care providers Ensure Continuity Care planning Assess & Monitor Hospital Liaison Family Support Advocate using legal frameworks Rights, independence , choice, inclusion

Co – ordination / MDT • Key to the successful care provision of the CMI team is the MDT working • We are based in one office, although we work across the city • We have fortnightly MDT meetings where we discuss new referrals have clinical reviews of current Service Users and discuss what MDT input is required • MDT members work closely with other care providers to ensure seamless care as far as possible

Monitor and maintain health • Assessment a regular reviews • Annual health check (maybe one slide per each point • Hospital Passport • LYPFT link to website: http: //www. yourhealthmatters-leeds. nhs. uk/get-checked-outhome

CMI Journey 24 years - Male Lives with parents Determined, stubborn & Cheeky Loves Swimming, Water and baths Attends specialist day service for people with sensory impairments walking with his walker Painting – himself Lights Swinging in a hammock Sticking Plastic trays Centre Parks Rollercoaster's Charge Syndrome Partially sighted Deaf (bsl) poor respiratory health oesophageal strictures Septal defects Previous tracheostomy Challenging behaviours Fed via Pej – re-occuring feed Intolerance Gastric Transposition Re-occuring bile reflux Constipation Scoliosis & short hamstrings Wheel chair user Poor sleep hygiene

Care Web

Monitoring / care planning Advice / Education Support with hospital appointments Traffic Light assessment (reasonable adjustments) Liaison with primary & secondary

Feed regimes Specialist advice Weight monitoring Liaison with secondary care Training

Postural management Passive Movement Specialist Seating Training

Swallow Assessment Communication support Assistive technology Sequencing and timetables

Equipment Assessment Activity screening Sensory processing Housing assessment

Thank You ?