Sally was referred to Cavendish Homecare by her case manager following a complex series of medical events that left her requiring specialist nursing and care support. After being involved in a serious road traffic accident as a pedestrian, she sustained an acquired brain injury. More recently, she experienced a fall at home and was taken to hospital by ambulance, where investigations revealed rib fractures and a perforated oesophagus, prompting the insertion of a jejunal (J) feeding tube. With these significant medical needs and a clear requirement for both nursing and personal care support on discharge.
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Our Client’s Story…
Following her discharge from hospital, the case manager initially requested 1 live-in carer to support Sally. However, this was not possible due to the complexity of her medical conditions, including her acquired brain injury, rib fractures, needs around tube feeding, diabetes, and fluctuating mood and behaviour. It was determined that 1 nurse and 1 carer, working together in a 12-hour day and night shift, was the safest and most appropriate care arrangement. Throughout Sally’s time with Cavendish Homecare, her care needs evolved periodically. At times, 1 carer was sufficient for each day and night shifts, while at other points, 1 nurse and 1 carer were required for each shift.
In some phases, 1 carer handled day and night care each while being supported by a visiting nurse for clinical assessments and tasks. This flexibility allowed us to ensure her safety while promoting independence and dignity. Sally was living with multiple health conditions, including kidney failure, severe psoriasis, glaucoma affecting her vision, insulin-dependent diabetes, and a jejunal feeding tube for nutrition. She could communicate her needs verbally, though due to her brain injury, she would occasionally make unexpected decisions or be slow to respond. Decisions regarding her health, welfare and finances were managed by a professional deputy. Despite this, she actively engaged with her care team and enjoyed companionship and routine.
The Cavendish Approach…
All carers and nurses assigned to Sally completed specialised PEG and jejunal feeding training prior to caring for her. They were responsible for the management of her feeding regimen, which included administering nutrition supplements, flushes of cooled boiled water and medication administration. Maintaining the tube entry site was crucial, ensuring it remained clean and dry, and keeping Sally in an upright or supported position to avoid complications.
Due to incontinence, Sally’s pads were changed regularly, and her skin monitored for psoriasis-related dryness and skin breakdown. Although her communication could be delayed, the carers and nurses ensured patience, respect, and time were always given to allow her to express her needs. Sally enjoyed watching television, playing Sudoku, and being social with her small circle of friends. Daily housekeeping was provided to help her maintain a familiar and comfortable living environment.
Through all changes in her care needs, the Cavendish Homecare team continued to ensure safety, dignity, and a person-centred approach that upheld her preferences and quality of life.
The Outcome…
With the right balance of professional nursing and attentive carer support, Sally was able to remain safely in the comfort of her own home despite her complex medical and behavioural needs. Through tailored planning, clinical oversight, and a compassionate approach, Cavendish Homecare helped Sally maintain independence, dignity, and a meaningful quality of life in her own familiar surroundings.
Disclaimer: For privacy and confidentiality reasons, the names and locations in this case study have been changed. The events and outcomes described are based on real situations, but identifying details have been altered.
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