Case Studies from our network of hospitals, care home and bespoke specialist services
We are passionate about delivering great outcomes for the individuals who use our services, and they are always at the heart of everything we do.
We have made numerous positive steps towards improving the lives of many of our service users and their families, helping to manage and successfully reduce the intensity, frequency and duration of their severely challenging behaviour.
Our person centred plans of care and support are based on the assessed needs of each individual and are supported by an experienced Multi-Disciplinary Team to ensure that part of an individual’s care pathway is carefully planned and implemented.
Below are case studies of individuals that have come into our services who have benefitted from the specialist care and support our teams provide.
Case Study- Karen, High Intensity Service at Healthlinc House, Welton
Karen has a long history of living in institutional care. Prior to her placement at Lighthouse Healthcare within the Intensive Interactions Programme she had been living in a low secure service for 9 years. Following a successful placement there, her commissioning team identified that she was ready to step down from secure services, but were unable to find a suitable placement that could meet her ongoing needs around her challenging behaviours of self injury and aggression.
Karen has autistic traits, and a history of moderate to severe learning disability stemming from early childhood. She has a history of attacking patients and staff, as well as using self-injurious behaviour, particularly head banging which could result in serious injury. During assaults, Karen will tend to kick, hit, grab, scratch and bite.
Providing a bespoke solution
Lighthouse worked closely with the Karen’s managers and commissioning team to develop a new bespoke service for Karen, delivered through the Intensive Interactions Programme. This consisted of renovating a two person bungalow to provide single person accommodation for Karen, at Healthlinc House where her brother was also placed, as contact with family was important. The bungalow was carefully adapted to create a comfortable and safe environment to prevent self injury, allow enough space for her to live with two staff who are required to support her at all times and to assist with personal care. Space is important as Karen does not tolerate being close to people for long periods.
The bungalow has one bedroom, a large bathroom with bath as baths are important to Karen, a kitchen and large living room. The walls are padded at head height to prevent injury from head banging and there is a small garden.
Karen has been supported through the Intensive Interactions Programme receiving daily input from the MDT, accessing an individually tailored structured activities programme and interacting with peers, accessing activities within the community and developing her living skills.
Providing a bespoke solution
Since admission on to the Programme Karen’s incidences of challenging behaviour have decreased considerably. She engages regularly in her structured activities programme, enjoying activities with peers such as arts and crafts and she recently won the company’s Christmas card competition. She also enjoys pampering sessions with her staff and visits with her brother within the service and also her family who visit her regularly.
As Karen progresses in her pathway it is planned that the service will change with her, providing a true ‘wrap around’ service. As she will always require a bespoke setting and a highly skilled staff team, the bungalow in which she lives can be registered as a residential care home meaning she could live without detention under the Mental Health act in the community.
Case Study- Thomas, Bradley Woodlands, Grimsby
Thomas is 22 years old and has a diagnosis of a severe learning disability and associated autism. Thomas has been in services since the age of 16 and has a history of aggressive behaviour and past diagnoses of psychosis.
He was admitted to Bradley Woodlands in November 2013. Upon admission, Thomas would sleep all day and only engage with support staff when he wanted food and drink.
After the multi-disciplinary team; including Nurses, the Consultant Psychiatrist and a Speech and Language Therapist had assessed Thomas, we were able to create a flexible plan of care to address his needs and to increase his meaningful engagement with staff and activities.
A “core team” of experienced support workers who worked positively with Thomas was created and a member of his team was allocated to work with him every day. A good working relationship with his parents was established between Thomas’s named Nurse and members of his “core team”. Together, they attended regular welfare meetings to give advice and receive support from the care team. The welfare meetings enabled his parents and the care team to focus on and prioritise Thomas’s care needs. This enabled his parents to discuss their hopes for Thomas’s future, their concerns about his presenting mood and associated behaviour, as well as helping them to feel more reassured and confident in the hospital.
This collaborative working has benefitted Thomas greatly; improving engagement and his communication of his needs. Autism specific prompts were devised such as boards in his bedroom entitled ‘day’ and ‘night.’ The purpose of these was to create symbolism to enable Thomas to differentiate between daytime and night time hours.
Support staff started to use phrases that were “Now & Next”. These were introduced to provide a better structure to Thomas’s routine. Thomas responded extremely well when he knew what was going to happen and then what was to immediately follow.
Progression & The Future
Thomas is now actively engaging in activities within the community and recently went on home leave to see his family for the first time since his admission. Thomas has also coped very well when he moved to a larger and busier apartment within the hospital, which has had a positive effect on his communication and engagement skills.
Thomas has showed improvement in his presentation and functioning as measured by HONOS LD.
All of the above work has benefitted Thomas greatly and his parents are delighted at the progress he has made during his time at Bradley Woodlands. They have especially commended the input and positive therapeutic relationships that Thomas has made with both his named Nurse and his “core team”.
The discharge plan for Thomas due to the good progress he has made is that future placements are now being looked into that are closer to home and provide a less restrictive autistic specific environment. In the meantime, weekly walks into Cleethorpes have been arranged to increase his access to and his interaction with the community in preparation for him moving to a more open sociable environment.
Case Study- Mr X, The Woodhouse, Cheadle, Staffordshire
Mr. X is a 19 year old gentleman on the autistic spectrum. He is also diagnosed with a severe learning disability and a psychotic illness.
Prior to admittance to The Woodhouse, Mr. X resided in the family home and attended a special school during the week. He was also supported by the local social services team at weekends and some evenings.
There had been an abundance of incidents of violence, some serious, against his parents and siblings over a period of years. Understandably, this had a huge detrimental effect on the family.
In February 2014, Mr. X was involved in the serious physical assault of a child whilst in the community. He was arrested by the police and criminal proceedings commenced. A strategy meeting was held and it was decided that Mr. X be assessed under the Mental Health Act with a view to hospital admission. No service in his local area was able to offer the level of support, assessment and treatment necessary to meet Mr. X’s needs.
Admittance to and initial assessment at The Woodhouse
Following the strategy meeting, Mr. X was detained under Section 2 of the Mental Health Act and transferred to an Autistic specialist unit at The Woodhouse hospital, Cheadle. An individualised model of care was immediately introduced. A key component of this was the implementation of daily educational sessions in order to mirror his previous school-oriented routine and assess his educational ability and interests.
Information regarding Mr. X’s communication was compiled into a ‘communication passport’ so that those staff working with him could form a comprehensive picture of his communicative abilities. A ‘now, then and next’ board has been introduced in order to help Mr. X plan his forthcoming activities whilst minimising anxiety. In addition, social stories have been successfully used prior to events which were thought likely to cause agitation.
Nursing care plans were formulated and updated to further guide Mr. X’s immediate staff team with regards to his day-to-day care needs. In addition, a preliminary assessment of Mr. X’s risk of future violence was completed.
Mr. X has benefitted from the level of support that he has received at The Woodhouse; physically aggressive episodes have been managed and there have been no incidents of serious violence.
In March 2014, Mr. X’s detention was reclassified under Section 3; assessment and treatment will continue. It is hoped that this will help identify a suitable permanent residence within Mr. X’s local area which provides the appropriate level of support so that he can be safely discharged from hospital settings.