A- Case Study
A has a history of unsuccessful short lived community placements, primarily due to persistent physical and verbal aggression and property damage. Due to this he was on a trajectory towards requiring high staffing levels to meet his needs.
In April 2019, he was arrested following significant property damage at his family home and was subsequently detained under Section 3 of the Mental Health Act (1983) at Sherwood Lodge, Assessment and Treatment facility. He remained there until September 2020 when he was transitioned to Marcus and Marcus Supported Living Service, Lausanne Rd.
Personal history
Born in London with Italian heritage, A met early developmental milestones but struggled with social interactions in mainstream nursery. He attended Durant Special School until 16, followed by Oaktree School, where he was diagnosed with Asperger’s Syndrome.
Due to behavioural challenges, he moved from his family home to Aspen House Conifers Care in 2013, but the placement quickly broke down. This pattern repeated in three further placements until his admission to Sherwood Lodge.
Approaches, Strategies & Interventions
Communication & Structure
A is articulate and quick-witted but struggles with reading facial expressions. Staff maintain a relaxed, confident approach, adjusting communication sensitively.
Predictability is key: A staff rota board, daily planner, and calendar has helped A with activity planning and anticipating events. A weekly menu board with visuals aids meal choices.
Emotional Self-Regulation
A occasionally swears and shouts but typically calms down on his own. Staff remain present, avoid confrontation, and allow him space to self-regulate.
A stable and patient staff team has been essential as A takes time to form relationships. A has learned that when he is anxious, he can speak about it with his staff or family. The PBS team have also been involved in supporting A with his emotional self-regulation.
Interaction style and building rapport
Staff use simple and clear language when speaking to A and provide enough time for A to process information.
A loves to joke and humour is used by staff to aid interaction and engagement with A. A has a suite of TV comedies that he has grown up with, his favourite being “Only Fools and Horses”, and staff sharing an interest in these TV comedies provides a useful shared platform to build upon.
Outdoor Activities & Sensory Needs
A enjoys social outings like bowling and dining out but dislikes unpredictability, traffic, and police presence ( following his previous arrests) , which can trigger agitation and aggression. He experiences sensory sensitivities, particularly with sound and touch. Noise-cancelling headphones have been introduced to help manage this.
Building Independence & Quality of Life
A has expressed a desire to be more independent. He is learning cooking, budgeting, and shopping skills and has started making small purchases at local shops.
He maintains strong family ties, visiting them weekly and receiving home-cooked meals.
He enjoys cooking (especially pizza, pasta, and pancakes) and socialising with staff.
Outcomes & Achievements
Lausanne Road is the first placement where A has remained stable for over four years, succeeding where others failed. He has developed positive relationships with his support team.
During his placement A has:
Progressed in many aspects of his daily living skills and independence.
- Has improved social skills and confidence.
- Is accessing the community on a regular basis and engaging in a range of community
activities. - He has not destroyed one item of furniture in his flat since living at Lausanne Road.
- Has improved wellbeing and quality of life.