Recently, Marvel comics fan Aaron interviewed for a new support worker. He contributed to cleaning his flat ahead of the interview at home and told the candidate all about his own ‘yellow porridge’ breakfast recipe. Afterwards, Aaron expressed that he liked the candidate and wanted him to stay.
This is an extraordinary turnaround.
Following his mum’s passing, Aaron – a complex young man with autism and other diagnoses – spent his life in and out of hospitals and care homes outside of his local area. Staff were fearful of him and, following procedure, would lock themselves away from him during incidents of challenging behaviour. ‘Aaron has challenging behaviour,’ ‘Aaron can be dangerous,’ ‘Aaron must be medicated,’ were accepted facts. We think Aaron himself probably came to believe this. His support providers, and the environments around him, were simply unable to meet his needs.
Dimensions was first introduced to Aaron by Ealing Borough Council in 2018. The Council had identified a building and, armed with an NHS grant to redesign it for people with severe challenging behaviour, felt that the time was right to find a provider that could support Aaron back into his home borough.
A new service manager, Emily, was recruited to lead the transition and build Aaron’s initial staff team including a full time behaviour analyst. Emily says,
Colleagues shadowed Aaron for six months ahead of the move, but to avoid anxiety Aaron was only told of the move shortly before it happened, through a social story followed by a number of visits. Throughout, Aaron’s outgoing provider and his father were enormously supportive; too often we are faced with providers withholding information or prohibiting shadowing but this time the partnership was exemplary.
On the day of the move, Aaron’s dad was there to tuck him in and there again the following morning. Being close to home makes such a difference.
Aaron’s home is his, and he is learning that he can choose what happens in it. A huge milestone was reached when Aaron learned that he could ask his staff team to leave if he was feeling stressed and at risk of lashing out. By monitoring Aaron from outside, his team can keep everyone safe whilst Aaron has control over his space.
That control extends to choosing, and welcoming, visitors. Beyond prospective new support workers, Aaron now receives home visits from his GP and the district nurse.
Emily adds, “Because Dimensions believes that restraint only ever makes things worse, we do not restrain people. All Aaron’s staff team are PROACT-SCIPr trained and receive a 4 day workshop to role play potential scenarios. Following this methodology has helped Aaron learn that his staff are not a threat to him. He does not need to fear them and they, in turn, do not need to fear him. It has built an atmosphere of mutual respect in his home and in the long run will also help him find friends.”
In the past, because Aaron was not considered safe, he was never allowed out. He could not become part of his community. Although Aaron remains at a 3:1 ratio out of his home, he now loves going to the community centre and the pub and going for drives in the car, especially to Richmond Park where he is fascinated by the deer. The next step – and it will be an important one for Aaron – will be to support him for a walk in the park. We’re currently working up a plan to make this happen.
We’re also working up plans to carefully reduce Aaron’s psychotropic medication. The side effects of this medication include a wide range of health issues such as obesity and constipation. A particular milestone was reached here when Aaron learned that ‘it’s ok to not be ok’ – now he can increasingly talk to his team, his GP and his community nurses about not feeling well. This journey may be just beginning for Aaron, but it is beginning well.
- Aaron now lives in his own home, closer to his dad.
- Aaron now enjoys going out in his local community.
- Aaron now receives home visits from his GP and the district nurse.
- Aaron and his support team have built an atmosphere of mutual respect.
- Overall he has more choice, control and freedom