VIKKI GERMAN is a play and activities co-ordinator for Shooting Star Chase hospice. She manages activities for young people aged up to 21, but mainly for under-fives in the hospice’s daycare setting in Middlesex.
‘I arrive at 9am. We have up to seven spaces for children staying in the hospice, as well as day users. We have a meeting to discuss which children are coming, their needs and what activities we’ll do. Between 9.30am and 10am the children arrive.
‘The criteria for children to come to the hospice is having a life-threatening or life-limiting condition. A high percentage have a disability. Children staying in the hospice might be here for three or four days of respite care, while daily attendees come weekly. We open four days a week – on Friday we plan the week ahead. We have to consider carefully which children come on which day. We want the calmer children on different days from those that are more active.
‘Until 10.15am we have free play. We adapt everything we do to meet the children’s special needs and follow one-to-one or one-to-two ratios. We start by sitting in a circle and singing our “hello” song. Some children can’t communicate verbally, so we give them a BIGmack switch. This is a recording system on which they can record a “good morning” message and press the button when it’s their turn.
‘We use other communication aids, such as the Picture Exchange Communication System. These are picture cards we hold up so the children recognise what is coming next.
‘Next we sing a weather song. We make music sensory and hand out objects to represent the weather: cotton wool for cloudy, a water spray for raining, and a spiky yellow ball for sunshine.
‘Singing is followed by a story that corresponds to our topic. Right now we’re looking at spring and growing. Again, we make the story come alive with objects and textures, such as water or mud, as some children don’t understand cause and effect in stories.
‘Snack time follows, but many of the children can’t eat. They might be fed through nasal gastric tubes or a gastrostomy – a button in their tummy. We set up feeds for these children, and also put out food on tables for food play.
‘Our work is based on the Early Years Foundation Stage, but we’re not Ofsted-registered. It would be very difficult to meet Ofsted requirements with our children. Instead we’re governed by the Care Quality Commission.
‘All our activities have to be sensory and their aim is for children to participate and experience, not necessarily the end product. In my previous jobs with children with disabilities, they have gone home with amazing work and the parents obviously knew they hadn’t done it themselves. At the moment we’re making bird feeders and planting.
‘At 12.30pm we have lunch, which tends to be rest time. We put mats out on the floor, play calming music and turn on sensory lights until 1.30pm. We also do any toileting and changing.
‘In the afternoon we do another activity, such as swimming. In the summer we go on trips to farms or the local children’s centre. But because many of our children are vulnerable, we don’t go out in cold weather.
‘The children leave between 4pm and 4.30pm. We have to make sure any medication is signed in and out. Then the team logs everything we’ve done with each child onto a database. Sometimes we liaise with other teams at the hospice, such as our therapists, if there is anything to follow up.
‘The day often pans out differently because some children might have seizures. Our team is nurse-led, but our care assistants are also trained to deal with emergencies.
‘When a child passes away we make sure it happens discreetly. Many of the children do make friendships, but their understanding is quite low so they wouldn’t necessarily know.
‘Sometimes these children are so poorly that it’s fine for them to go. It’s what’s left behind that is sadder and we provide a lot of support for the parents. We attend funerals and help them make memories with the child. Making moments count is amazing and why the job is so special.’
CV
Employment history
1989-1999: hairdresser
1999-2010: classroom assistant then senior classroom assistant, Manor Mead Special School, Surrey
2010-present: play and activities co-ordinator, Shooting Star Chase
Qualifications
NVQ3 in childcare, Brooklands College, Middlesex, 2002
NVQ4 in childcare, Brooklands College, Middlesex, 2009
Moving and handling trainer qualification (train the trainer), 2008
Sensory impairment courses
Makaton speech and language programme and PECS communication system courses
Behaviour management courses
TRAINING
There is no direct route to working in an early years hospice setting. Ms German recommends childcare or healthcare qualifications as a way into the profession.
Useful websites
• Shooting Star Chase, www.shootingstarchase.org.uk
• Hospice UK, www.hospiceuk.org
• Together for Short Lives, www.togetherforshortlives.org.uk
