Support Plan MP

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I am 19 and live at home with my mum and dad. I would like to introduce myself and all of the people who are important to me. This is me.

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I also have three sisters. XXXXX is 24, she is a doctor and lives in London. XXXXX visits me a lot and it is fun. XXXXX is 23, she is a nurse and lives at home. XXXXX often helps me and keeps me happy and safe. XXXXX is 21, she works at a special school and is training hard to be a teacher. XXXXX lives very close and also helps look after me.

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This is a picture of XXXX who is XXXXX’s partner. He is also a Doctor and lives in London. XXXX is my friend. This is a picture of XXXX who is XXXXX’s boyfriend. He often comes round and has a laugh with me. This is a picture of XXX who is XXXXX’s boyfriend. He is also my friend and sometimes helps look after me.

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As well as my family, I have lots of people who come in to our home and help care for me. My main carer is xxxx. He has helped me for a long time and he is my very best friend. xxxx also helps train other people who work with me. xxxx is very good at helping me manage my behaviour and really helps Mum and Dad.

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xxxxxx and xxxxxx work for a company called Inner resources. I want to spend some of my budget on keeping this involvement going. xxxxxxx especially has helped me and my whole family in times of crisis and we would not have managed without him. xxxxxx and xxxxxx have been coming in to our home for a very long time. They started coming when I left school about five years ago; that was because I made it clear that I would feel happier being educated at home.

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This is a picture of xxx who is another of my carers I have not known xxx for very long but we are becoming good friends, and I trust him. He helps me feel safe and manage my behaviour. This is a picture of xxxx who is another of my carers I have only known xxxx for a short while but he is helping me lots.

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These are the things I like doing best with the help of my carers Riding my Bike I have a special three wheel bike. When I go out I always have to have at least two people to help keep me safe as I do not see danger myself. Going out in My Car I have my own car and I do enjoy going out in it. It is very important that I have lots of people who can drive it, so I can get the full benefit from it and also be kept safe. Cooking I love cooking and really enjoy making things like cakes and spaghetti bolognaise. I need lots of help, as I do not see the danger with hot or sharp objects. Walking Sometimes when I am out in my car I like to stop and go for a walk. This requires I have at least two carers with me who understand the dangers as I do not. For example, I do not understand about the dangers of traffic. Sometimes when I am out I can get angry and hit out at people, so my carers have to be very aware of that. It should be noted that while xxxxxx enjoys all of the below activities, he will often need massive encouragement to participate. Often he becomes obsessed and stressed with certain aspects of the activity which can be very problematic

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In the garden I love playing in the garden. In my garden I have a large purpose built swing that Mum and Dad had built for me; when I got too big for the old one. I also have a special safety trampoline which helps me use up a lot of my energy. Also in the garden I have a table which I can use for different activities, such as painting, sand and water, drawing and play dough. Sometimes I play with my large parachute or big floating cube. I also enjoy football with xxxx and the boys, and bubbles with xxxxx and xxxxx. I enjoy interacting with my carers in the garden, but gardens can be dangerous so I need people to look out for me.

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Sex and relationships It is important that people recognise that I have sexual urges. At these times I like to be left alone and given some space. This is different than when I get stressed and anxious and need quiet time on my own. Eating I have a good appetite and really like eating. I often ask for different things using my PECS. I need lots of help with this so that I keep to sensible limits. I will often try to eat things to get rid of them and my carers help make sure that this does not happen. Indoor leisure Sometimes I spend time indoors listening to music, or watching films and television. I also have a projector, which I watch on a big screen. I like watching things where there is lots happening such as Gladiators or Monster Trucks. I also like cookery programmes and music videos. I dislike people shouting or violence as this can make me very distressed.

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How I see my short term future I would like my present situation to continue but I think it is important that mum and dad start to step back from some of my care. I would like to use more carers to help me but my needs are not always clear and sometimes quite challenging. So finding people to work with me has been quite a challenge. However the people that do work with me are very good foundation for the future. I need at least two people to ensure my own and other people’s safety at all times. I would like to purchase an air conditioner which fits out side of the room and blows air in. This is because my windows have to be closed as I throw things out. How I see my Long term future Through my actions I have clearly made it known that I am happiest and most secure at home with people that I know and trust and that understand me. Mum and Dad are getting older and at some point in the fairly near future will not be able to supply the high levels of care that I need. It might not be totally what I want, but Mum and Dad will not be able to keep going like this indefinitely. Mum and Dad will move out of our house so that I can live there with a team of carers looking after me. They will always be involved with me to a degree, but not at the levels which they currently are. So my long term aim is to achieve independent living in my own home.

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xxxxxx currently lives at home with us his parents and one of his sisters. At present, we provide the majority of his care with some input from outside agencies. However, because of xxxxxx’s condition and behavioural problems, and also the fact that we are getting older, it is becoming increasingly difficult for us to cope with our current level of support. After considerable reflection we strongly feel that because of his specialised care requirements, and in his best interest, xxxxxx would be most appropriately managed in his home. Indeed, previous and current experiences assure us that this is also what he wishes. He has demonstrated a distinct preference to continue to live in his home surroundings by a variety of means. And we would eventually would like xxxxxx to achieve independent living. In our opinion, the most suitable way to approach xxxxxx’s continuing care is for family involvement with direct day-to-day care to decrease in a carefully planned and gradual manner, while building up a trusted portfolio of carers. The eventual end point would be for us, his family members, to move out of the house. xxxxxx would then be living independently xxxxxx’s budget would be used in order to provide appropriate care cover to achieve the above aims. Of course the amount of his budget would need to be reviewed in a stepwise manner to reflect this. Mum’s, Dad’s and family views

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Individuals need to be carefully selected for their suitability to provide for xxxxxxs care needs and for their ability to deal with his extremely challenging behaviours. The company “Inner Resources™” are an invaluable part of xxxxxx’s support network and we feel that it is extremely important for his wellbeing for their input to continue in the future. Our plans for xxxxxxs budget includes ensuring that xxxxxx continues to be able to access “Inner Resources™” necessary and specialised help, and we would use part of his budget to ensure this. We are currently employing some very good people for xxxxxx. We actively recruit always looking for suitable people to join his team. This is a role we are happy to continue, so eventually xxxxxx could achieve independent living. Also because of the problem of heat in his bedroom we would like to purchase on xxxxxxs behalf a wall mounted air conditioner so that all xxxxxx would see in his bedroom would be a grill which would help reduce his frustration. This would also give him a chill out zone on hot days. This is something which is a real problem at the moment because his current air conditioner is only really effective out of its cupboard something which is not possible when he is in a aggressive frame of mind.

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Communication xxxxxx does not communicate verbally, although he does understand much of what is said to and around him. He will follow clearly given instructions or suggestions such as when participating in cookery, playing in the garden or being told to go to his room. If he wants to communicate something, he will either take the person physically to what he wants or use his PECS book. (Short for Picture Exchange Communication System, a pictorial system of communication in which xxxxxx selects a picture of the item or activity he wants and shows it to his carer.) Lack of ability to communicate his wants and needs clearly to others can be a big source of frustration to him, and patience is often required to deduce what he wants. The Inner Resources™ team has played an essential role in developing xxxxxx’s communication, both by working with him personally and with us and carers to aid our understanding of his actions. All the carers that currently work with xxxxxx work very hard to achieve good communication with him.

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These are examples of some of the different communication aids that xxxxxx uses every day.

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xxxxxxs Behaviour xxxxxx has always exhibited challenging behaviour, which over the years has been quite problematic. Much of the time he has a pleasant and happy nature, however carers must be aware that his mood may alter rapidly and he may display types of behaviour that are difficult to deal with. The most problematic feature is aggression. Others include ritualistic and obsessive tendencies, typically centred on organisation of his surroundings, food and clothing. Aggression Very rarely, there may not be an obvious cause for xxxxxx’s mood, but generally, aggressive behaviour is precipitated by external stimuli such as loud noise, e.g shouting, arguments, violent television programmes. His behaviour takes the form of yelling, destruction of the physical environment around him and he may target a specific person if not given enough space or handled inappropriately. If he targets a person he will invariably approach them growling and yelling , biting his left hand and attempting to strike the person with his right arm in a downwards thumping motion. He will only target someone if they are in his immediate area and does not plan his actions or pick up objects to use as weapons. Extremely rarely, if he is very agitated and has the upper hand in a situation, he will attempt to bite the person he is hitting.

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xxxxxx does have medication to use as needed when he is agitated or aggressive and this is generally effective at helping him to calm down. The duration of an aggressive episode is typically short and he will rapidly return to his usual pleasant demeanour. xxxxxx is highly reactive to the situation around him, so for example, if others are angry or tense, he will tend to pick up on those feelings and they will influence his behaviour. For experienced carers, who know how xxxxxx is likely to react and behave, many of these difficulties can be overcome by appropriate management of the situation. Home adaptations His home has been adapted as far as possible for maximal safety for himself and others. All glass in the windows is safety glass, most doors and furniture are solid wood. Every light fitting in the house has been sunk into the ceiling as xxxxxx in the past has sometimes pulled light fittings down. All cupboards and doors are locked with a star lock to control xxxxxx’s access to breakable items, food and clothing. In xxxxxx’s bedroom. The bed is custom made which is secured to the floor and the mattress is strapped down to prevent him ripping it up as at night he may occupy himself by attempting to shred his mattress and bedclothes. Also there is a sensory light board above his bed which again we had made it shines lights in time to music and can be very calming.

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Other challenging behaviour Food: xxxxxx requires supervision to ensure that he eats an appropriate diet. Left to his own devices, he would often choose to eat large amounts of sweets and chocolate which may negatively affect his behaviour. The kitchen needs to be kept free of leftover food and drinks as he will eat or drink anything that is left unattended due of an obsessive need to be rid of it. Clothes: With unrestricted access to his wardrobe, xxxxxx may change clothing many times a day. To avoid undue amounts of laundry, his access must be limited. Of course, if his clothing is soiled he should be given a new set. Doors and environment: xxxxxx may become very preoccupied with the positioning of objects in the house and garden. For example, he likes certain doors to be closed and others open, he becomes distressed if there is a new furniture layout and dislikes the use of a wooden prop to hold up the washing line. He may spend large amounts of time ensuring that these things are arranged correctly and become distressed if they are persistently altered. He has an air conditioning unit in his bedroom, which is in a purpose made cupboard. However this has become inefficient due to it only being effective out of the cupboard which is not possible when he is in a aggressive mood.

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We hope that this document has given any one who reads it a good idea of xxxxxxs life, also a clear idea of his and our vision of the future. We have tried to give a clear a picture as possible what xxxxxxs life is like. Also we have tried to show how essential consistency is in his management. To summerise For things to continue as they are in the short term. For us to use xxxxxxs budget to keep Inner Resources™ involvement continuing. For us to use his budget to continue employing xxxxxxs current carers. To actively look for new carers to work with xxxxxx. For us to begin to bring to fruition our long term plan of moving out of our home. This would be a gradual transition. For xxxxxx to achieve full independent living with his own care team.