Simon

Simon, an autistic 26-year-old, spent five years in hospitals under section after his residential school said it could not cope with his needs and behaviours.

Almost daily, staff would hold Simon to the ground to control his aggressive behaviour. He was restrained on average 27 times a month. One month, Simon tried to hurt himself or staff 120 times. He had two staff with him constantly and was on high doses of a mood stabiliser and two antipsychotic drugs.

Simon’s mother contacted his current support provider to ask if they would be able to help facilitate his move from hospital. From the start, the provider worked in partnership with her, hospital staff, the local authority and the multi-disciplinary team, including occupational therapists and a psychologist. Together, they created a plan that made it possible for Simon to move.

It was a complex process that took almost two years. Hurdles to negotiate included Simon’s own anxiety about being able to manage outside of hospital, which was related to his previous experiences. And it was a challenge to find a suitable property, detached and with a garden, close to Simon’s family. But the commitment of all parties to get it right for Simon created an environment where he felt safe and was able to take the next step.

Simon’s support team was recruited especially for him. He and his mother developed job profiles detailing the necessary skills, attributes and interests, to attract the right people to the role. Once appointed, staff were given a bespoke induction based on Simon’s requirements, parts of which his mother attended. The induction emphasised understanding the impact of the trauma Simon had experienced in hospital. This included Non-Abusive Psychological and Physical Intervention training which promotes de-escalation and the least restrictive support interventions.

When Simon first moved to his new home in 2018 it was hard for everyone. He was in poor shape, physically and mentally. Staff needed to get to know Simon all over again after this big change in his life and he had to adapt to his new environment too. During this time the team was supported by a dedicated service manager, Positive Behaviour Support professionals and external trauma support partners. The local authority and multi-disciplinary team stayed closely involved too.

Almost immediately, his quality of life began to improve. His new home is about 40 minutes away from where he grew up. Close enough to have regular contact because the continuing family connection is integral to Simon’s wellbeing, and that of his family.

Within two months, Simon went swimming for the first time in six years. A year later, he hosted his first family Christmas. In the years since leaving the specialist hospital, Simon has visited several beaches, including childhood favourites. He loves paddling and eating fish and chips by the sea.

The dosage of one of the anti-psychotic drugs Simon takes has been reduced by 80% and the mood stabiliser by 50%. The use of restraint has fallen to an average 10 incidents a month and the initial four-to-one staff support has dropped to two-to-one during the day and night. A flexible care plan means a third support worker is available on days when Simon needs more help.

The team’s positive, collaborative relationship with Simon’s family is vital to his support. They continue to help train new staff, explaining his needs and preferences. Senior managers from the provider remain involved. They liaise with family and commissioners as needed to make sure that any changes that may impact Simon’s day-to-day support are managed. A good working relationship between the provider and commissioner facilitates flexibility in the care budget to increase the staff support when needed (like having a third member of staff available).