'A' is a customer who has a diagnosis of Autism spectrum disorder and behaviour of concern . When he came to live at his current service , he was very anxious and the changes in his life , including his new home and staff did not allow him to settle well , he displayed behaviours of concern, and these escalated in severity over a short period of time.
It was thought that this presentation was due to his Autism , staff reacted quickly and involved other professionals , such as Psychiatrist , Social worker, GP , staff worked very closely with the other professionals involved and as a result of this early intervention , it was assessed that the gentleman had mental health concerns that needed further treatment , A plan of care and support was implemented by the Psychiatrist, supported by the Positive behaviour Support team.
'A' had sufficient capacity to be fully included in this process ,the staff team ensured that they supported him to follow his positive behaviour plan in place and then ensured that he took his prescribed medications .
During one of his key working sessions with his keyworker in 2022, he informed her that he would like to go holiday to Bognor Regis. During the conversation, his keyworker said that he preferred to go on holiday by train rather than by car , he also stated that he did not want a group holiday , this was such a breakthrough in his improved lifestyle, and it was good to see that his health was improving and that his Behaviours of concern had lessened. 'A' and Staff discussed his wants and wishes with the manager and the Holiday booking commenced.
His keyworker ensured that 'A' was fully involved in the holiday planning , including booking of the train tickets, deciding the holiday destination, doing his holiday clothes shopping, and planning the activities to do while on holiday. The management team also ensured that his sister and financial appointee were in supporting making decision regarding the cost of the holiday to him because he lacks capacity to make decisions relating to management of his finances.
The Holiday happened as planned and 'A' had the most fantastic time , he enjoyed everything that they had planned, and his family too were overjoyed to see that his first holiday was such a success.
'A' fedback that he really enjoyed the holiday and was so proud that he did not feel anxious or have any reactive behaviours of concern towards himself or others , What an achievement .
As 'A' enjoyed himself so much and it was clear that we had met his needs fully , it was so good to then plan and book weekly activities place which included bowling , cinema, trip to local theatre and so on and the best bit is 'A' is always looking forward to going out and he always reminds staff of what he is going to do the next day.
In 2022, staff supported 'A' to watch the Bob Marley experience, Pop forever and Motown at local theatre with his flatmates and some customers from nearby service .
He also took part in the planning of an indoor Halloween party, Bonfire night party, Christmas and New year Karaoke .
What a success !
'B' is a 19-year-old man with Learning Difficulties, Autistic Spectrum Disorder and displays Behaviours of Concern. He demands a lot of positive social interaction but will force others to interact with him, whether in a positive or a negative way, and will use behaviours of concern towards others if these prove to be successful in getting a response.
'B’s behaviours included attempting to pull the toilet seat out from the floor, pulling down curtains or blinds. 'B’s cognitive ability is such that he finds it difficult to negotiate day to day demands and his capacity to monitor and control his impulses are limited.
When 'B' moved into one of Outlook care supported living Service, Staff began recording 'B’s behaviours of concern, daily and certain patterns of reactive behaviours of concern were observed.
Based on detailed records, a Behaviour Support Plan was developed. 'B' was given lots of positive attention and feedback throughout the day and evening. Staff continued to offer this regardless of any behaviours of concern he may have shown.
His behaviours were identified as serving three or more functions:
Alerting staff and others to emotional distress
Wanted staff attention, whether positive or negative
Escape from demands he either did not want to comply with or did not fully understand.
After spending some time with 'B' to get to know him well, 'B' was offered a structured daily time activity routine which was developed based on his preference:
using the trampoline
going out to the local park to play basketball
1:1 chat, go through his iPad as he may want a social chat about what’s on his iPad.
Having put all the plan in place, the next step was to ensure that all staff providing support to 'B' were NAPPI trained and consistent in their support and positive approach when supporting 'B'.
'B' behaviours of concern was dramatically reduced and his quality of life improved. 'B' will now listen to staff when they say No. For us this is a big step for 'B' and staff believe in his ability to continue to enjoy life and enjoy every day within a service that knows his needs and wishes and work with a consistent approach within Active support and use a Positive behaviour approach .