Arabella’s journey began at Royal Manchester Children’s Hospital, where she spent her first year of her life in neonatal intensive care after being born prematurely. Her discharge home marked a pivotal milestone, made possible by the love of her parents and her dedicated care team. Since then, Arabella has flourished into a vibrant toddler, achieving remarkable progress and embracing life with joy.
Arabella’s Story
Meet Arabella
We first met Arabella at hospital when she was just 11 months old. She had spent the first year of her life in the neonatal intensive care unit at Royal Manchester Children’s Hospital (RMCH), having been born prematurely in May 2022 at only 25+5 weeks gestation, weighing a tiny 1lb 4oz.
Following a referral from the hospital, we were tasked with facilitating Arabella’s long-awaited discharge home. For her parents, Sara and Daniel, bringing Arabella home meant finally being together as a family in their own space for the very first time. It was a pivotal step in her journey, allowing her to flourish in the comfort and warmth of her home environment.
During her first year of life, Arabella received care for a range of complex medical conditions, including central sleep apnea syndrome, tracheomalacia, reflux, and Patent Ductus Arteriosus (PDA) – a condition common in premature babies where the ductus arteriosus fails to close properly after birth, as it typically would in full-term infants. To support her breathing, Arabella required oxygen and was fully ventilated using CPAP. She also had a tracheostomy in situ to assist her respiratory function.
Our priority was to identify highly skilled care professionals who could provide the specialised clinical support Arabella needed. This was not only to ensure her safe discharge from hospital but also to help her thrive at home, surrounded by love, care, and opportunities to play.
Creating Arabella’s personalised package of care
With the goal of getting Arabella home with her family, we collaborated closely with all the professionals involved in her care. This included attending numerous multi-disciplinary meetings, as well as sourcing the specialist equipment required to support her transition. Together with these professionals, we carefully created Arabella’s care plan which would ensure she could thrive at home, surrounded by love, play, and tailored support.
Our first step was to search our talent pool for highly skilled care professionals based locally who could travel to RMCH for training and, ultimately, provide the clinical care Arabella needed at home. We also advertised for experienced Children’s Healthcare Assistants and Nursery Nurses, offering opportunities for them to enhance their skills and train in Arabella’s specific clinical care requirements. Arabella’s care needs were both complex and developmental. Her team was required to provide age-appropriate stimulation during her waking hours, engaging her with toys, music, singing, and reading to aid her communication and foster her development.
Mum and Dad played a key role in the recruitment process, taking part in several meet and greet sessions with carefully selected care staff. Their involvement ensured that those chosen not only possessed the necessary skills but could also fit seamlessly into family life, allowing Mum and Dad to rest assured that Arabella was in safe and caring hands overnight.
Arabella’s care team also underwent thorough compliance checks and in-house training, which included tracheostomy management, before attending RMCH to train in Arabella’s specific clinical care needs. Our two carefully selected care professionals, Sharon and Sarah, began shadowing and training at the hospital in August 2023. This also gave them a chance to get to know Arabella’s developing personality, likes, dislikes, and behaviours.
During the preparation process, we sourced all the specialist equipment Arabella needed for her home care. Due to her small size, she required a Neo Flextend Bivona tracheostomy, oxygen PRN (as needed), and equipment such as suction machines, a nebuliser, a gastrostomy feed pump, and a profiling cot.
In October 2023, Arabella was finally discharged home from hospital. Her care team provided support to her seven nights a week, allowing Mum and Dad to get some much-needed rest. The family’s shared goal was for Arabella to continue making progress, reducing her reliance on her ventilator, and eventually no longer needing it.
Positive outcomes
Arabella’s journey home was made possible with the unwavering support of her specialist care team, who provided the vital overnight care she needed while allowing Mum and Dad the chance to get much-needed rest. Throughout the night, her care team created a peaceful, comforting environment, offering reassurance and cuddles as needed, all while attending to Arabella’s clinical needs to ensure she had a restful sleep.
Over time, Arabella formed an incredibly special bond with her care team, who became like extra grandmothers to her and the family. With only one change in her team, Kathryn joined the family in July 2024 following a careful selection process, and together with Sharon, they have continued to support Arabella seven nights a week.
Since coming home, and with the loving care of her family and care team, Arabella has made remarkable progress and is now thriving.
She is a bright, happy toddler who loves being loud, cheeky, and playful. Her days are filled with the joy of exploring sounds, playing with noisy toys, watching Teletubbies and CBeebies, and singing along to nursery rhymes and Taylor Swift songs.
Arabella has achieved so much already – she has learned to walk and is preparing to start nursery school this year.
A Bittersweet success story
When Arabella was first discharged from hospital, she relied on full ventilation. Through dedicated care and determination, she came off ventilation and oxygen, and we supported her as she learned to manage her secretions independently.
We are overjoyed to share that Arabella is now completely tracheostomy-free and continues to flourish.
Her progress has been so extraordinary that our care and support concluded in March 2025, as she no longer requires complex care.
It has been an honour to support Arabella on her journey – from hospital to home – and to witness her transformation into the vibrant, happy child she is today.
We are thrilled to see her enjoying life with her Mum and Dad, doing all the things she loves most, and embracing the future with excitement and promise.
Category:
- Children & Young People
- Ventilation and Airway Management
