We were asked to support Gillian in 2018 when the service she lived in had to be closed down due to poor practices.
Before we started to support her, Gillian never left her bedroom. She displayed challenging behaviour where she would hit people and hurt herself, so staff would bring meals to her bed to avoid the challenge of getting her up to eat.
Gillian’s health was very poor as she didn’t attend any health appointments as these weren’t considered important.
The only time she left the house was to go to the local shops once a week to buy chocolate or pop. She would go in her pyjamas as she wasn’t supported to get ready or take pride in her appearance.
We went to visit Gillian before her support was transferred over to us, and staff were left feeling unhappy when they came away as Gillian looked so sad and unkempt. Locality Manager, Jackie Milburn, takes up her story.
“When Gillian’s support was transferred to us, it was sudden as it was an emergency. Gillian hadn’t been told where she was going and she was very distressed when she arrived at her new home.
For the first few months with us, Gillian tended to be just sat in her chair and it was a bit of a struggle to get her out.
Once Gillian was feeling more settled, we began to look at how we could involve PBS, Activate and Active Support into her support plan, making her quality of life better in the future.
In the first team meeting, we followed the Activate model, breaking down areas of Gillian’s life, looking at different scenarios where she showed challenging behaviour and piecing it all back together to make it personalised support for Gillian.
Says Clare Savage, Locality Manager, “It was just breaking all these little areas down where staff felt they were hitting a brick wall, basically, and didn’t know what else to do. The most important thing the team got from that first day was the message that it wasn’t anything we were doing wrong, it was just we didn’t understand Gillian as well as we thought we did. It made everyone in the team be more involved with her support plan.”
I asked Clare what has had the biggest impact on her support:
“I think setting out Outcomes and having more structured plans for Gillian. We realised a lot of her challenging behaviour was that she was wanting interaction, so even though the staff thought Gillian was happy just sitting and doing her own thing, a lot of the time it was probably her way of telling them, ‘actually, I want to go out, I want to do this, I want to do that,’ but she couldn’t communicate it across.”
One of the first things we introduced to Gillian’s support was PBS involvement. The first thing the team discovered was that Gillian’s motivations weren’t all around food, as the team had previously thought. Explains Pam, Support Worker, “We just always assumed, “oh she just wants to go out because she’s going to get a cake” and we’ve all changed our ways of thinking around that side of it now.One of the things we’ve done which has made a huge difference has been including Gillian’s Auntie in her support. Explains Clare, “Involving her has been absolutely amazing. She’ll sit and talk about Gillian’s past history, anything you need to know you can give her a ring.”
The PBS involvement has also helped with her Activate outcomes. Adds Pam, “Everything feels more positive in how we approach it, even everyday things like her going in the shower, things like that, it just feels like she can do it, she can do more than we assumed she could. We’re all learning every day.”
The team are all really positive about the approach that has been taken to Gillian’s support. Extra training has been undertaken by the team so they can all meet Gillian’s needs consistently.
Says Pam, “She seems like she wants to do more stuff. You do get your days where she just won’t do anything at all, but she seems more motivated in herself. When we want her to do something, we all say “right, come on we’re going to do this” and she thinks about it then gets up and goes to do it now. It feels like as we’re all working together, we’re getting there to get her out and she’s got more of a life for herself.”
Another creative approach was taken by the team in achieving Activate Outcomes for exercise. One of the things the team discovered about Gillian was her love of fashion and trying on different clothes. She now tries on clothes and walks the catwalk for her support staff. Gillian loves it and she doesn’t see it as exercise.Her Auntie told her team about the skirts she used to make for her and how she used to dance in Butlin’s competitions. With this and her love of music the team have regular karaoke nights and dance nights.
Another Activate Outcome is to get her back swimming after discovering that she has medals from swimming from when she was younger.
Gillian hadn’t attended a health appointment for several years and this was set as an Activate Outcome. Working closely with the health facilitator at her local surgery, we arranged for home visits to start with before venturing into appointments. The team took into account that Gillian is not a morning person, and changed all her appointments to later on in the day. She has since had health scans, which her previous provider found impossible for her to go to, which have been very significant for her health.
Dental appointments have also been a success. She started going to appointments with the same member of staff each time, Pam, and it became their ‘thing’. For Gillian’s first appointment, Pam pretended that she was going for an appointment and she needed Gillian to go with her and hold her hand. The dentist was made aware before the appointment and played along.Explains Pam, “when we got into the dentist’s surgery room, the dentist asked ‘who’s first?’ and Gillian immediately responded with “me, me, me”, pushing me out of the way to get to the chair. After she’d had her treatment, she looked at me and said “well go on then, you get in the chair.”
Another big achievement for Gillian has been going on holiday. Particularly with the way she came to us in the first place as an emergency placement, Gillian has trust issues around not knowing where she is going or when she is coming home.
The team started off with Gillian having just one night’s stay somewhere and she chose where she wanted to go. Gillian chose Walworth Castle which is near to where she lives. She absolutely loved it. Says Clare, “Staff have said on two occasions the first thing she does on arriving somewhere is to sit in the comfy chair, kicks her feet back and says ‘ooh this is lovely.’ Gillian thinks she’s a princess and that’s why she chose Walworth Castle.”
Gillian has since had two nights away in Leeds, doing her Christmas shopping at the market. She’s build a friendship with another lady who lives with her and they’ve got a week booked in caravan in June together with their support staff.
Says Clare, “It’s just amazing to think that at one point we couldn’t even get her out of the door, but now she’s going away!”
*Not her real image used
- Gillian is now more active and enjoys going out in her community.
- Gillian and her support team have built trust.
- Challenging behaviour has reduced.
- Gillian’s Auntie is now included in her support.
- Gillian now receives home visits from her GP and attends dental appointments.
- Gillian now enjoys going on holidays .
- Gillian is building new friendships.
- Overall Gillian has a better quality of life.