Step-down care

Step-down placements at The Children’s Trust support the transition from hospital to home for medically-stable children and young people aged 0-18 with complex health needs following neurosurgical procedures and prolonged stays in Intensive Treatment Units who might otherwise be staying long-term in hospital.

We support children and young people with a range of degenerative and life-limiting conditions. We are also able to support babies who may need transitional support from neonatal intensive care to home.

Children are supported on a step-down basis in our child and family-friendly setting, located in 24-acres of grounds located just south of London, in Surrey. Children receive round-the-clock specialist care in a beautiful home-from-home environment, supported by 24 hour nursing, care teams and daytime on-site medical provision. The service is enhanced by clinical assessment, a wide range of therapies, education and opportunities for play and family outings.

Planning for a child’s return home begins before they even arrive with us. We work collaboratively with the child’s family, local agencies and our community counterparts to make the transition of children to their homes as quickly and as safely as possible. For children and young people who are unable to go home immediately for medical or social reasons, we will help to identify the most appropriate care provider.

We support children of all ages, from babies to teenagers, who have severe brain and spine injuries requiring complex neurodisability management including:

  • long-term invasive and non-invasive ventilation
  • tracheostomy management (including weaning to de-cannulation)
  • severe/complex epilepsy
  • disorders of consciousness (e.g. minimally conscious)
  • enteral feeding (e.g. gastronomy, jejunostomy)
  • parenteral nutrition/TPN via a central line
  • dysphagia
  • major neurosurgical procedures
  • prolonged ITU stay for non-neurological conditions.

Each child will be considered on an individual basis on our ability to meet their needs in a setting similar to home so this list is not exhaustive.

The step-down service also includes comprehensive training for parents or carers and a period of familiarisation for the community team who will take over care supported within our service. We have on-site family accommodation which means parents can stay close by and can play an active role in their child’s care and development as if they were at home. For children who are not able to be discharged home, we also have residential accommodation for those able to attend The Children’s Trust School. This is located on-site and provides specialist services for children with complex education, health, therapy and care needs.

For further information on our step-down services and how we support the transition from hospital to home, download our specialist services brochure.

Download our specialist services brochure

Funding and referrals

We work closely with local commissioners and funding bodies to secure funding for placements. As a charity, our placements are part-subsidised by our fundraising income.

For further information on step-down care at The Children’s Trust, please contact our Placements Team on 01737 365 080.

Alternatively, to make a referral, simply download our referral form:

Refer a child or young person for step-down care


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Introduction to step-down services

Watch our short introduction to step down services provided at The Children's Trust.



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