Anyone here work in community care for those with LD

[wonderstuff123]

Have just started out in this role and trying to figure out if what I'm seeing and hearing from staff about behaviour of clients is normal.
One particular client I visited on Thurs seems to have constant notes on his records about pushing,pulling, spitting at staff,throwing items in the house. He's pulled a gas cooker out of the wall. To the extent that the staff get to a point where they have to lock him in a room to keep themself safe when he calms down....Jesus just writing this doesn't sound normal!

He clearly should be at least 2:1 staffing but only has that for 9 hours in the day.

Just wanted to check I'm not going crazy when I think that's not a safe/normal working environment?!

I have mostly found that saying something results in the worker being blamed for not knowing the care plan and not getting out of the way in time.

I'm relatively new to this aspect of working with people, but in lots of services I've been to (a bit of agency work due to moving house) there was a service user who would hit out, sometimes every day. There were mental hospital patients who would plan and wait and manipulative to get what they wanted, to groom etc, or ones who would just lunge, or autistic people who would be triggered and react or be overwhelmed and react. One place I went to, the two youngsters there wouldn't go to another house as the lady who lived there sometimes exhibited violent behaviour and the workers would be locked in the office with pounding on the doors.

I cannot really comment too much in why this is. If it gets worse, what causes it, what's to be done. Say a staff member builds a rapport and then moves on after 15 years, that will have a huge impact on the service user. Its difficult.

All I'm saying is, it is common. I heard someone say, you know you're working in MH when you can arrive at work at 8am and step over three people restraining a service user on the floor and just say 'Morning!!'

Sometimes it is about people not being familiar enough with the care plan, but sometimes it’s actually that the care plan itself is out of date or has missing information and so is not fit for purpose. The fact that others supporting him can’t confirm whether he has a MH diagnosis would be a concern to me- that should be very clear in his care plan. It may be that he is waiting for an assessment, but again I would expect the team supporting him to know that.

The post above is quite depressing to read. Yes, these issues are not uncommon but this will never improve if we aren’t asking the important questions and just accept it. Behaviour is communication, so either he is trying to tell you something or has learnt this behaviour is the best way to get something that he needs (this could be avoiding something he dislikes/finds difficult, obtaining something that he wants or needs, or sensory stimulation)

The sad thing here is you have an individual who is displaying behaviour as a means of communication and you have a staff team who are unable to figure out what is triggering this behaviour.

I used to be a PMB instructor as well as a few other restrictive physical intervention instructor training qualifications, and I can hand on heart say that the documentation of behaviours aren’t filled out correctly a large % of the time.

Therefore when a behaviour analysis is done there is only half a story. There is a trigger here, but staff need to look at the whole picture, in essence the ABC. As for needing 2:1 at all times, this is often down to funding, or because there isn’t a clear picture of the difficulties the individual is actually facing.

Well done for identifying an issue early one. I suggest you speak to your manager.

Hi,me again. What I meant was that the person has got several diagnosis and another one has been raised by the team in the company due to his change in behaviour. However,I can't seem to find anything about it,any calls to doctors regarding it. Which I agree is worrying.

Just been looking back at the files and it seems this behaviour has been going on a few years. Recordings of pushing staff into road whilst out in community,dragging them into rooms etc. Quite historic.

Also,can I just ask about the hours..who would decide they only get 9 hours 2:1? Is that the care company or someone else like a social worker?

@Onesnowynight

The sad thing here is you have an individual who is displaying behaviour as a means of communication and you have a staff team who are unable to figure out what is triggering this behaviour.

I used to be a PMB instructor as well as a few other restrictive physical intervention instructor training qualifications, and I can hand on heart say that the documentation of behaviours aren’t filled out correctly a large % of the time.

Therefore when a behaviour analysis is done there is only half a story. There is a trigger here, but staff need to look at the whole picture, in essence the ABC. As for needing 2:1 at all times, this is often down to funding, or because there isn’t a clear picture of the difficulties the individual is actually facing.

Well done for identifying an issue early one. I suggest you speak to your manager.

Thanks for your reply,what's an ABC?

Don't worry, I found it

It’s basically a behaviour chat. Some places call them ABC. Charts, but there are many other versions which basically do the same thing.

Antecedent- what was happening prior to the behaviour
Behaviour- what was the behaviour
Consequence- what happened after the behaviour

E.g. (a simple version!)

Joe is a young man with autism and is non verbal.

A:- Joe was getting ready to go to the day centre. He was dressed and was asked to put his shoes on with laces.
B:- Joe picked up his shoes and threw them at Mandy
C:-Joe said sorry and was offered his Velcro shoes. Joe put on his shoes with Velcro. Joe was happy to then go to the day centre.

As this has happened on several occasions we can conclude that Joe does not like shoes with laces and from now on he will wear his Velcro shoes.

A very very simplified version! But I hope you get the idea.

@Onesnowynight

It’s basically a behaviour chat. Some places call them ABC. Charts, but there are many other versions which basically do the same thing.

Antecedent- what was happening prior to the behaviour
Behaviour- what was the behaviour
Consequence- what happened after the behaviour

E.g. (a simple version!)

Joe is a young man with autism and is non verbal.

A:- Joe was getting ready to go to the day centre. He was dressed and was asked to put his shoes on with laces.
B:- Joe picked up his shoes and threw them at Mandy
C:-Joe said sorry and was offered his Velcro shoes. Joe put on his shoes with Velcro. Joe was happy to then go to the day centre.

As this has happened on several occasions we can conclude that Joe does not like shoes with laces and from now on he will wear his Velcro shoes.

A very very simplified version! But I hope you get the idea.

Thank you!