Coyle Homecare provide complex care services designed to support individuals with complex care needs within the comfort of their own homes. This case study details the structured care package developed for Rob, an 11-year-old boy with cerebral palsy and associated conditions. It outlines the assessment process, care objectives, interventions implemented, and measurable outcomes achieved through a multidisciplinary, family-centred approach.
Background
Rob is an 11-year-old boy living in North London who has been receiving care services from Coyle Homecare since November 2024. He presents with complex medical needs including cerebral palsy with severe dystonia causing involuntary spasms, global developmental delay, hearing impairment managed with bilateral cochlear implants, and faltering growth requiring gastrostomy feeding via a PEG tube for all nutrition, hydration, and medication.
Rob is non-verbal and communicates through sounds, facial expressions, and body language. He requires full support for all aspects of personal care, mobility, and daily activities. His dystonia had worsened significantly prior to our involvement, resulting in his withdrawal from full-time education and placing enormous strain on his parents who were managing 24-hour care responsibilities.
Despite his challenges, Rob has a wonderful personality. He enjoys watching classic Disney cartoons, going for walks in his specialist wheelchair, playing with sensory toys, and has a profound sense of humour that brings joy to those around him.
Goals Identified
Following comprehensive assessment, Coyle Homecare identified the following key goals in partnership with Rob's parents:
For Rob:
- Maintain safe and effective management of his complex medication regime, including PRN medications for dystonia control
- Ensure adequate nutrition through careful management of his 18-hour continuous PEG feeding regime
- Prevent pressure sore development through regular repositioning and vigilant skin monitoring
- Minimise risk of aspiration through proper positioning and monitoring during feeds
- Facilitate age-appropriate activities and engagement to maintain quality of life
- Provide safe manual handling and transfers in the absence of hoisting equipment
For the Family:
- Provide meaningful respite for parents across the week to support their wellbeing
- Deliver consistent, skilled care that parents could trust completely
- Enable parents to maintain their relationship and deal with personal and household needs
- Create a partnership approach where parents' expertise was valued and incorporated
- Ensure seamless communication through detailed handovers and documentation
Support Provided
Coyle Homecare implemented a structured care package providing 1:1 carer support for 36 hours per week, scheduled across Mondays, Wednesdays, Fridays, and Sundays from 9am to 6pm.
All carers assigned to Rob completed comprehensive training including medication administration with competency assessments, PEG tube care and feeding pump operation, recognition and management of dystonic episodes using the hospital's escalation plan, aspiration risk management and positioning techniques, use of specialised equipment (wheelchair, P-POD seating system, cochlear implants), and safeguarding with emphasis on vulnerable children.
The care team established a comprehensive routine encompassing:
- Medication administration at scheduled times (1000, 1300, 1600, 1900) plus PRN medications as needed
- Continuous monitoring and management of PEG feeding at 90ml/hr, with initiative-taking pausing when signs of reflux or vomiting appeared
- Regular nappy checks every 2-4 hours and careful personal hygiene management
- Vigilant repositioning to prevent pressure sores, particularly on his left ear and chin
- Facilitation of age-appropriate activities based on his daily condition for example watching cartoons, playing with touch screen games and sensory toys, walks in his wheelchair when well
- Close observation for dystonic episodes with early intervention using the detailed escalation plan
- PEG site care and monitoring for infection or complications
- Management of cochlear implants to ensure optimal hearing
The clinical lead nurse provided firsthand training, conducted regular care plan reviews (five reviews between January 2024 and April 2025), and ensured all carers maintained competency in Rob's specialised care requirements.
Outcomes Achieved
The implementation of Coyle Homecare's support has delivered significant positive outcomes:
Clinical Outcomes:
- Zero medication errors since care commencement
- No new pressure sores developed, with successful prevention through vigilant positioning
- No hospital admissions related to care delivery issues
- Effective dystonia management with reduced frequency of severe episodes through initiative-taking monitoring and early intervention
- Maintained adequate nutrition despite challenging feeding tolerance
- Successful prevention of aspiration events through careful positioning and feed monitoring
Quality of Life Outcomes:
- Rob continues to engage with age-appropriate activities and entertainment he enjoys
- Safe participation in outdoor activities including walks when his condition allows
- Maintained dignity and comfort through skilled, compassionate personal care
- Consistent routine providing stability and security
Family Outcomes:
- Parents receive 36 hours weekly respite, enabling rest, personal time, and relationship maintenance
- Significantly reduced parental stress and anxiety
- Parents express high confidence in carer competence and judgment
- Strong partnership established with consistent communication and collaboration
- Family able to maintain home-based care rather than requiring residential placement
Service Quality Indicators:
- Consistent positive feedback from parents regarding care quality
- Strong continuity with a resolute team of carers who know Rob well
- Minimal care plan changes required across multiple reviews, indicating stable, effective care delivery
- Excellent communication with detailed handovers and documentation
- Successful collaboration with multidisciplinary team including neurodisability specialists, dietician, and palliative care
This case study demonstrates that with appropriate specialist training, genuine partnership with families, and skilled compassionate care delivery, children with profound disabilities can receive high-quality support enabling them to thrive at home with enhanced quality of life for both the child and family.
From complex clinical support to everyday assistance, Coyle Homecare's tailored care packages are designed to make a meaningful difference. To learn more about our full range of services and how we can help, please visit our Homecare Services page or contact our team today for an informal discussion.