Brian has recently started baking from scratch, which is a new skill for him
Brian had previously been at various places all over the country, his last placement being at an assessment unit in Dundee, none of which last any great length of time.
Brian’s family rarely visited him in Dundee and his mother used to receive phone calls from a very distressed Brian asking to come home. Brian was an extremely popular person in the last assessment unit where I met him. He is very generous; I witnessed him going over to his room to collect a packet of Jammie Dodgers, which he proceeded to hand out to everyone!
When Brian first came to the Borders he received input from Alan Morris from the Positive Behaviour Support Team. Alan introduced a communication board so Brian knew what would be coming next, however, due to staff inconsistencies, at that time; the Board only had limited success.
Alan also explained about the Support Plans in detail to the staff team. He emphasised the importance of setting up the environment, ensuring that you are prepared, the breaking down of the activity into ‘bite size’ pieces, how you communicate with Brian by using only short, clear, information carrying sentences. He highlighted that it was important to remember to give plenty of praise but also how to manage the challenges by using the ‘reactive strategy’.
Led by Alan, we also looked at the risks in Brian’s life. New risk assessments identified where the risks to Brian, staff or members of the public are, when the risks are increased and what has actually been done to reduce these risks. This reinforced how it was very important it was for Brian to be consistent whilst doing the routines.
Every week a Periodic Service Review (PSR) was carried out, where myself or Sandra, the Senior Support Worker, would monitor the quality of all the activities and support that Brian should have had in place. The PSR would be scored and marked on a graph. At a glance this would show you whether everything that should have been carried out actually was. It would also show if there were inconsistencies that could be addressed.
Brian has an extremely full weekly diary of support, which includes family visits, community activities, walking, maintaining the house, car and cleaning his fish tank. Though Brian still challenges, they are well managed using the reactive strategy that Sandra introduced as part of her course (PDA in Management of Challenging Behaviour).
Brian enjoys having a busy but predictable life. Brian has recently started baking from scratch, which is a new skill for him. He is also responsible for putting away his own laundry. A ‘praise and reward’ chart has been put into Brian’s bedroom, where he can earn up to 4 stars a day. Once he has 28 stars, he can get a new item of clothing of his choosing.
As part of her course, Sandra has also made changes to Brian’s ‘in house’ boardmaker. This means Brian knows what is happening next and can also choose the sequence in which to do these activities. Brian will remove the activity once it is complete then move onto his next choice.
Brian and staff use a community boardmaker when they are out. This can include up to 8 separate activities, which Brian removes from his wallet once he has completed the activity, to be placed into the worker’s wallet. Brian is now also able to deal with events slightly further into the future, like Christmas, birthdays and holidays by using some of the tools taught by the Positive Behaviour Support Team.