Cathy is a young lady with mild LD, ASD, ADHD and a long-standing history of challenging behaviour.
Cathy has been placed in secure environments and detained under the Mental Health Act throughout most of her teenage and adult life. She has a diagnosis of Mild Learning Disabilities, Autistic Spectrum Condition and ADHD. Additionally, she suffered from Type 2 Diabetes, and sickle cell anaemia which resulted in sleep apnoea. Cathy also displayed complex and frequent challenging behaviours including physical and environmental aggression.
Cathy came to us at the end of 2013, aged 18, and was initially placed in Pinetree Hospital, our locked rehabilitation hospital for individuals with a primary diagnosis of learning disability and complex needs. She has since moved on to Newhouse, one of Ocean Community Service’s small step-down homes.
What did Cathy and her commissioners want to achieve?
- To significantly decrease the frequency and intensity of her challenging behaviours
- To step-down into a social care setting in the community
- To learn to self-manage her emotions
- To bring structure to her life
- To develop life skills
- To increase independence
- To build self-esteem
- To develop the confidence to participate in positive community activities
What did we do to achieve these goals?
When Cathy arrived at Pinetree Hospital the emphasis was on helping Cathy to identify and understand the triggers leading to her aggressive behaviours, and to work with her to develop self-management strategies.
We did this by working with Cathy to develop a Positive Behavioural Support plan, identifying all the slow and fast burn triggers, as well as helping her understand the specific links between her thoughts, emotions and behaviours.
Working with Cathy we set mutually agreed goals within our Building Better Lives programme, with particular focus on:
- Looking after myself
- Looking after my environment
- Understanding & building relationships with staff and others
- Developing skills in my community
What were the Outcomes for Cathy?
Cathy learnt to trust staff and ask for their support to problem solve issues in her life, reducing her overall levels of anxiety.
Sufficient progress was achieved in supporting Cathy to manage her behaviours that it was possible for her to step down to Newhouse, one of Ocean Community Service’s small, family-style residential homes in West Cardiff.
Newhouse’s quieter, rural location suits Cathy well and her progress towards her goals has accelerated. The continuity and consistency of her care management as she has moved location, has encouraged her to continue to self-manage her progress and broaden her horizons.
Her self-confidence and self-esteem have developed considerably and she now takes part in regular activities using her Motability car, which the Newhouse staff helped her apply for. She enjoys food and clothes shopping (and budgeting), nights out, meals out, trampoline lessons, attending social groups, swimming, walking, bike rides, dancing and is now attending college.
Cathy’s improved emotional regulation and wellbeing has also allowed her to work on losing weight. She has now reduced her weight significantly, which in turn has had a positive impact on her overall health and she no longer suffers from her sleep apnoea.
Cathy has progressed from 2:1 to 1:1 staffing and at times is now able to be supported on general observation.
The significant reduction in Cathy’s challenging behaviours has meant that she is no longer detained under the Mental Health Act. Cathy has developed new life skills, greater independence and self-confidence, and is an active member of her community.
