Jack* (name changed to protect identity) – from hospital to home
Jack is autistic and has schizophrenia and language difficulties. When assessing Jack, Look Ahead staff found that in the past, Jack had insufficient 1:1 support. With few activities on offer, low levels of stimulation and limited opportunities to integrate into the community, he was left feeling isolated.
Jack’s isolation led to him showing increasing violence towards staff and his environment. Jack left his previous provider’s service and was found at a train station in an area he did not know. His provider gave notice.
Transition to Look Ahead
Before coming to Look Ahead, staff arranged for Jack to be assessed by a psychiatrist to determine how he could be best supported and what would be his optimum living environment.
Staff had been shadowing Jack’s provider’s service to understand what triggered his behaviours of distress and how these were being managed. It gave Look Ahead an insight into what was going wrong and what could be done to improve things for Jack.
They also examined Jack’s full case history, including historic documents from his social worker, to try and find out as much about Jack as they could.
Key to the Look Ahead approach is to build up a fully rounded picture of the individual in order to provide holistic support.
Look Ahead’s own detailed assessment process identified that Jack lacked personalised support and so staff at the East London service where Jack now lives, put together a new and comprehensive care and support package tailor-made to Jack’s needs. They worked closely with Jack to identify what adaptations could be made and put him at the centre of decision-making, whenever possible.
Staff also observed Jack on an hourly basis to identify any patterns of behaviour or possible triggers, so that they could provide him with the best possible support.
It was discovered that noise was a trigger for Jack’s behaviours and that he needed absolute quiet, with no TV or radio in his flat. Staff had identified the ideal flat for Jack and on his first visit there he immediately felt settled and did not want to leave.
Jack was initially reluctant to access the community, but was offered lots of encouragement to do so to support him in leading a fuller life. He now enjoys a very full and active life in the community.
Person-centred care and support
A multi-disciplinary team worked to develop Jack’s care plan, which included Look Ahead’s staff team, a psychiatrist, speech and language therapist, nurse practitioner and Newham’s autism commissioners. Staff also liaised closely with Jack’s mother.
Jack, a young person, requested that younger members of staff supported him, which Look Ahead arranged. This was successfully implemented and a timetable of activities, together with regular community visits, was put in place, including cinema and nightclub visits, as well as sporting activities.
Following a mental health relapse when Jack received a new diagnosis of schizophrenia, his support level was increased to 2:1 day and night. Despite this setback Jack continued to make progress at Look Ahead and currently has 1:1 support in the day and shared waking night.
Jack really enjoys going out and about. He likes using public transport and has been supported to see the city via train, taxi, cable car and on the river. He goes to a nightclub once a month, swims, plays football and badminton, cycles and enjoys the cinema and going out to lunch.
He manages his finances while out shopping and cleans his own flat. He is making friends and goes to college.
He said: “I have developed the ability to engage with people instead of hiding in my room. I like to be in the company of others at a party if the music is not too loud.”
Jack’s mental health has improved and he manages well without high-level supervision.
He has plans for the future too; to make more friends, to manage to cook a meal for himself and to get involved in re-designing his room and choosing furniture.
Rachael George, Team Leader at Jack’s service said: “Jack is a great person who is always very helpful. He has improved his ability to engage with people and lights up the room when he does.
“His friendly smile and engaging nature means that he is always interested in what others have to say. He loves to sit with staff and other customers. It has been great to see him begin to overcome his shyness and continue to work with our staff to feel comfortable in the community.”