Children's Case Study 2

Child with high spinal cord injury requiring ventilation

Charlotte is an eight-year-old girl who was involved in a road traffic accident at a much younger age when she was travelling as a backseat passenger. She sustained a very high level spinal cord injury which left her tetraplegic and unable to breathe independently, requiring 24-hour ventilation.

The biggest part of our role during the first year of our involvement was to coordinate discharge planning between the hospital and local PCT as statutory management of this process was so poor. This involved the coordination of a complex range of professionals and services by our case manager, organising and attending many MDT meetings.

A major part of our role once Charlotte was discharged home was the setup and management of a 24-hour care package, which was particularly difficult to manage due to some very complex family dynamics. The package required detailed and extensive care plan documentation to reflect Charlotte's complex needs. The case manager also worked very closely with training providers to develop in-depth competency documents for the carers and to make sure that overall responsibility for clinical governance was led and managed by the PCT.

Our case manager has also been closely involved with the management of two separate and significant safeguarding issues which were investigated by the local authority, one leading to the implementation of a formal child protection plan.

Over the years of our involvement we have also instructed and coordinated a wide range of therapy and professional services including a physiotherapist, family therapist, play specialist, alongside specialists in the provision of technology, seating and posture, wheelchair provision and adaptation.

Following lengthy explorations with the family into the possibility of adaptations to their home, our case manager ran an architectural competition for the design of a new build property, with guidance from the Royal Institute of British Architects.

Charlotte has attended mainstream education and we have been very closely involved, providing advice and assistance in relation to matters of inclusion, and helping the school to deal with special educational needs and implementation of Charlotte's statement.

The barrister involved in the case said: "I was extremely impressed with their case management of a ventilated tetraplegic 6-year-old client of mine whose care regime and medical and accommodation requirements were about as complicated and demanding as you could possibly imagine."