Tailored approach to care, from hospital to home

Published: 6th April 2021
Debbie Neill, Director of Learning Disability and Autism Services, highlights our commitment to taking measured risks that really improve lives.

Debbie Neill, Director of Learning Disabilities and Autism Services at Look Ahead

I have been at Look Ahead for just over two months and during my time here I’ve been impressed with our range of services, but more importantly our commitment to taking measured risks that really improve lives.

I give you an example. Our Hertfordshire learning disabilities team recently worked with commissioners to put place the transition for a customer Michele (named changed to protect identity) who had spent the past 22 years in a secure hospital setting. She was diagnosed with severe autism, epilepsy, bipolar disorder (recently removed from her diagnosis) and severe behaviours of concern. Life for Michelle wasn’t easy, with difficulties in her personal life compounded by the severity of her conditions.

Throughout the time she was in hospital it was clear to both her family and commissioners that her quality of life was poor and the care she received didn’t match her needs.


Finding a suitable place to live

Around October 2019 following an assessment, Look Ahead began working in partnership with a wide multi-disciplinary team made up of psychologists, nurses, Occupational Therapists, advocates and family members came together around the sole mission of finding a suitable home for Michelle within the community.

The first challenge was finding a property that would work given Michelle’s physical and behavioural needs. With the support of Grand Union Housing Association and the supervision of our Business Development Team and input from Occupational Therapist, a suitable property was found and adapted to make sure that it minimised risk or likelihood of incidents.

After this, a six month transition plan was developed which slowly introduced staff to Michelle, gradually at her pace, supporting her and allowing her to set the pace for her transition.

Transition had to come to a stop following COVID-19 restrictions on visitors, however the partnership work continued with regular meetings for updates and bespoke trainings arranged by the MDT for the staff team.

When transition restarted in the summer of 2020, the staff was provided with all necessary skills to work with this customers so to minimise the disruptions of lockdown.


Trained to support with a person-centred care plan

Look Ahead’s team in collaboration with the lead psychologist developed a set of training for staff who care for Michelle, specifically centred on her behaviour. Using the Positive Behavioural Support approach, training focused on helping the team address the motivations behind her behaviours and how to handle any possible incidents.

Staff created a positive behaviour and crisis plan, submitted to the Court of Protection, to minimise hospital readmissions and create a “crash pad” environment with strategies to increase staffing level and specialist input within 24 hours from a crisis, including on call and out of hours arrangements.

Person-centred, a constant review of these plans are fundamental to adapt the service to ensure it the environment, including the staff skills, match the needs of Michelle. This thrives on partnership with the wider multi-disciplinary team, including the family and Michelle herself.


Positive outcomes, in the community

Michelle has been with us for five months. There have been two crises at the start of the placement which were managed and de-escalated quickly, without the need of hospital admission. One was caused by her not being able to see her family due to Covid-19 restrictions, which will soon be easing and enabling more social time for Michelle.

Michelle’s support team are continually tailoring their intervention and learning how to anticipate Michelle’s behaviour. With a drastic reduction in incidents, staff have been able to introduce more activities for Michelle based on her specific communication needs using specific tools and will soon be able to access a Motability car to access the wider community and travel to the seaside and amusement parks for these are her aspirations.

Many organisations would have stayed away from Michelle’s case, labelling it too difficult. I am proud to work for an organisation that has the properties and the passion to develop bespoke, person-centred placements for people with complex learning disabilities who were previously in hospital settings. All of our placements are done in partnership with commissioners and families, including the phases of set up, recruitment, support planning, etc.

We’ve recently set up a dedicated area on our website which gives more information on our spot purchase programme. To learn more about our tailored placements, please visit our Learning Disability Referral page.