Successful outcomes

Case studies

Sam

Sam has autism and communicates primarily through signing and gestures. He has lived at Selwyn Care since 2003 first living in a multi-occupancy home with seven other individuals, sharing many of the facilities (lounge, kitchen etc.). Sam frequently experienced moments of intense rage, targeting furniture, walls, doors and occasionally individuals he lived with. It became increasingly difficult for staff to understand what Sam was trying to convey and dangerous for people living with him. Sam was no longer able to leave the grounds and pursue his areas of interest, which are churches and trains. He became isolated and withdrawn which increased the frequency of behaviours others found challenging.

In 2006 an intervention was sought. During this multidisciplinary intervention it was decided that Sam might be better suited to living on his own, supported by a core key group of staff. This way he would always recognise who was supporting him and not feel stressed by being introduced to different staff members. The key staff members were identified and they learnt how to communicate with Sam and eventually Sam was introduced to his new home (still within the same grounds, but with his own kitchen, lounge, bedroom, and staff sleep-in room).

Over the time Sam has spent at Selwyn Care, the frequency, duration and intensity of incidents have dropped dramatically. Sam is now far more tolerant of others; he attends a disco every week and although it is only for 20 minutes that is something he could never have previously done. He frequently goes for long walks to the shops to purchase his own groceries etc. He is now able to visit churches and train stations and is also being supported by a wider range of staff, along with his original key team.

Shaun

Shaun came to Selwyn Care as an emergency, possibly temporary, placement. Shaun is on the autism spectrum and has Tourette’s, being displayed as gross motor tics, not language, as well as many other complex additional needs not known or understood at this time. Shaun had been in long-term foster care, having been abused by his birth parents. However, the type and severity of abuse were again not known at this time. Shaun would frequently self-harm by banging his head, sometimes making himself bleed. He would frequently stay in bed for most of the morning, getting up and having breakfast as lunch, lunch for dinner, etc. He became fixated on food and certain drinks (all very sugary or fatty foods) and when they were not available he would self-harm. Plans were put into place to help Shaun monitor the amount of sugary snacks and drinks he was consuming. At this point Shaun remained very inactive, displaying behaviours staff found very challenging if they tried to motivate Shaun in any way. Activities Shaun had previously enjoyed had all ceased and the frequency and duration of incidents increased.

The staff team came up with a plan of care and all agreed on the approach to be taken; they agreed to be assertive and not give into demands for sugary foods, which initially many of the staff found difficult to understand. They gradually introduced Shaun to the garden, and then progressed to the on-site day centre. He would also go out for drives. Shaun enjoyed all of these activities and started to become less agitated, his tics became less frequent and he spent less time in his room, choosing to sit in the communal lounge. Shaun now attends the day centre, where he sits and enjoys a cup of tea. He is also going swimming and walking more.

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