Provision of Individual, bespoke Community Packages of Care for Children and Young People aged 0 - 18 years with Continuing Care Needs to enable Children and Young People to be cared for in their home

Trained and competent care workers to meet the personal care and manual handling needs of the CYP in their care, and able to follow a plan of care where there are low decision making requirements. This type of care package may be required to assist with personal care and delivered within specific short time slots in any one session which will be based upon the needs of the CYP and family. Package step up timeframe: 8-12 weeks maximum (carer led) / 4-8 weeks maximum (nurse led)

This will be used to expedite a child home from hospital / End of Life, initially with a nurse led package and will be stepped down to a standard package after 12 weeks with either a nurse or carer depending on the level of need. The Enhanced Package is used as a temporary arrangement to expedite children and young people out of hospital as an interim measure whilst suitably trained carers are recruited. This lot is only for children and young people who continue to have complex needs but can safely receive care from highly trained care workers operating within a nursing care plan but where carers need to be recruited and trained. Framework Providers should ensure that if bidding for Lot 2 they have also bid for Lot 1. Trained and competent care workers to deliver complex clinical interventions or complex behaviour management strategies to meet the specific needs of the CYP in their care, which will require an enhanced degree of decision making and responsiveness beyond following a plan of care provided by a Registered Nurse (Child or Learning Disabilities or Mental Health). The clinical skills required will be dependent on the presenting needs of the CYP. The relationship between Framework Provider, child/ young person and their family and Contracting Authority's representative is dynamic. This type of care package may be required over a longer period within one given session. This again will be based upon the needs of the CYP and family. It should be understood by the Framework Provider that if a package starts with a Registered Nurse but is then stepped down to a Carer the Trust will revert to Carer pay within an agreed timeframe. Package step up timeframe: 1-2 weeks maximum

Qualified Nurses with the relevant training, skills and knowledge to care for CYP with highly complex needs. The care delivered will require clinical oversight from a Registered Nurse (Child or Learning Disabilities or Mental Health). Clinical decision making will be required to manage highly fluctuating levels of need. The clinical risk assessment of need will determine that this level of support and skill mix is required. Package step up timeframe: 2-3 weeks for registered nurse package

Care commissioned will require support and care provided by either a Nurse or Carer, dependant on relevant skills and knowledge to care for children with highly complex needs during pre-school and after school hours (1-2 hours). This will require support in getting the child dressed, fed and further requirements depending on package for example, but not limited to, carrying out chest physiotherapy, giving appropriate medication and or any further medical intervention that may be required. Package step up timeframe: 8-12 weeks maximum (carer led) / 4-8 weeks maximum (nurse led)

Care commissioned will require support and care provided by either a Nurse or Carer, dependant on relevant skills and knowledge to care for children with highly complex needs in school carrying out all their medical interventions, i.e. Trachy care, feeds medication seizure management catheterisation, suctioning, physio etc. The school would help support with any moving and handling procedure where more than one person was required. It may also include supporting them to and from school either on school transport, taxi or with parents in their care. Package step up timeframe: 8-12 weeks maximum (carer led) / 4-8 weeks maximum (nurse led)