A referral can often follow a placement that has broken down, resulting in extreme distress for the person. Paul was one such person, whose story changed when he came to live at Shaftesbury Kenway Court.
Paul’s journey to Shaftesbury Kenway Court: a new beginning
Paul had been through a lot when a local hospital contacted Shaftesbury Kenway Court. He had been admitted to hospital from a previous care placement, because of an extremely painful mouth. Paul, who is non-verbal, expressed his pain and distress through challenging behaviours, including constant screaming and shouting. When ready for discharge, Paul’s previous care setting said his behaviours meant they could no longer support him.
Initially Shaftesbury felt unable to accept the referral because Paul had no pain management or behaviour management plans in place. In addition, Kenway staff felt supporting him would have too much of an impact on existing residents. A month later, things had improved a little for Paul in hospital, with his pain under control and a resulting decrease in behaviours, so Kenway agreed to offer Paul a placement.
After a couple of calm days, things deteriorated and Paul’s screaming escalated, day and night. He would only sleep in an armchair and refused to shower. His presence became increasingly difficult for those who lived at Kenway and for the staff team. ‘Paul’s one to one support became a very difficult shift for staff and understandably, many Kenway residents were upset and felt this wasn’t the right placement for Paul,’ says area manager Patrick Iddon.
Collaborative solutions: understanding Paul’s needs with music and personal care
Determined to avoid another placement breakdown for Paul, senior staff met to try to find a way forward, says Patrick. ‘We met with his psychologist and behaviour specialist, who advised us that Paul doesn’t like crowded areas and he enjoys music and old films.’ Paul’s previous placement also advised that he did not like profiling beds and had a new double bed still at his previous home.
When she next worked with Paul, Kenway nurse Marietta offered him a shower. When Paul began to shout, Marietta tapped into Paul’s love of music. She started singing and as Paul calmed, she took his hands and he went willingly to the shower. Other staff followed this lead when they were supporting Paul, who began smiling and dancing with staff when they sang to him or played music. Says Patrick: ‘Marietta and other staff were so determined they were going to help Paul to settle and live a good life – that was their goal and they didn’t give up.’
Another step towards Paul settling was the arrival of his bed from the former placement, which Kenway staff arranged. The night the bed arrived, Paul had his night-time cup of tea, walked over to the bed, got in and slept through the night.
Paul’s social progress: from isolation to interaction with housemates
On the social front, Paul has progressed hugely from not wanting anyone in his room, keeping the door firmly shut and curtains closed. Gradually staff encouraged him to have the curtains and door open a little bit more, and now he keeps the curtains open, the door wide and his housemates at Kenway visit frequently. He also showers regularly. ‘Considering how other people had really struggled with Paul’s behaviours and its impact on them, this is something that’s great to see, says Patrick. ‘As for staff, everyone wants to work with him now!’ Paul, who was underweight when he arrived at Kenway, is now looking healthy and eating and drinking well. Paul’s brother and his psychologist both say that Paul is the most settled they have seen him in years.
Team efforts at Shaftesbury: the key to Paul’s success
‘I’m proud of our staff team for all the hard work they put in to make it work for Paul ,’ says Patrick. ‘Our three team leaders were a driving force when it was a real struggle – they threw themselves into supporting Paul and led the way for other staff to keep going.’
‘Paul is the second person with challenging behaviours that we’ve been able to settle in our Essex services,’ says Patrick ‘As a result, we’re getting more referrals for this kind of placement. Nurses and other professionals are commenting on how well Paul is doing, compared to before he arrived here. So some of our services for complex disabilities are diversifying to welcome people with challenging behaviours. There’s a lack of this kind of provision but when you see how much more Paul is enjoying life now, it shows what a huge need there is for Shaftesbury ’s care.’