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
?