Case studies

Sarah, 37 years old, is one of the people we support on behalf of St Helens Council. She has a diagnosis of cerebral palsy, learning disabilities and dysphagia.

Challenges
• Behaviours that challenge
• Severely underweight and on meal supplements
• Limited communication

Outcomes
• Use of advanced communication tool
• Discharged from Speech and Language Therapy (SALT)
• Enjoys regular activities, events and hobbies
• Measurable improvement in physical and mental wellbeing

Craig* is 40 years old and has been supported by AFG since he was 25. He has Prader-Willi syndrome and a mild learning disability.

Prader-Willi syndrome is a rare genetic condition that causes a wide range of physical symptoms, learning difficulties and behavioural challenges.

Typical symptoms include an excessive appetite and overeating, which can easily lead to dangerous weight gain, and emotional outbursts or physical aggression, both of which Craig experiences.

*name changed to protect identity

Jenny* is a woman in her 50s who was admitted to one of our independent hospitals, Oak Lodge, with a diagnosis of paranoid schizophrenia and cognitive decline, a condition where someone has minor problems with their mental abilities such as memory or thinking.

Challenges

• Regular relapses with mental health, detained under Mental Health Act
• Repeatedly refused supported living
• Misuse of alcohol and drugs
• Would regularly go AWOL from the unit
• Chronic social problems – verbal aggression, false accusations

Outcomes

• Moved to supported living service
• No longer uses illicit substances
• Improved social and daily life skills

*name changed to protect identity

Callum* is in his 50s and has diagnoses of autism, Asperger’s syndrome, a mild learning disability and type 1 diabetes.

Challenges
• Lack of engagement with staff support
• Mismanagement of health
• Limited understanding
• Communication difficulties

Outcomes
• Discharged from learning disability nurse
• Reduction of daily insulin injections from 3 to 2
• Regularly goes out in the community with friends
• Manages own weekly budget
• Built up trusted relationships

*name changed to protect identity

Freddie* is 54 years old and has been supported by AFG for 14 years. He has an acquired brain injury and a learning disability.

Challenges
– Required extremely strict and limiting routine
– Frequent and intense behaviours that challenge others, with regular serious incidents
– Unable to go out in community due to significant risk to his and others safety

Outcomes
– Reduction in level of support required from 5:1 to 3:1
– Significant reduction in frequency of serious incidents
– Increased independence, daily access to the community

*name changed to protect identity

George* is 33 years old and has diagnoses of autism and a learning disability. He is also non-verbal and presents with challenging behaviours.

Challenges
• Frequent and intense behaviours that challenge others, with regular serious incidents
• Unable to go out in community due to significant risk to his and others safety
• Underweight

Outcomes
• Significant reduction in frequency of serious incidents
• Increased independence
• Daily access to the community
• Friendships and regular socialising
• Reduction in medication and psychiatrist withdrawn support
• Healthy weight

*name changed to protect identity

Jean* is 76 years old and has been supported by AFG since 2018. She has a long-standing diagnosis of treatment resistant paranoid schizophrenia, meaning she experiences persistent persecutory delusions, auditory hallucinations and has a lack of insight into her condition.

Challenges
• Extremely resistant to medication – 5:1 support and restraint required to administer
• Regular periods of severe mental ill health
• Physically and verbally aggressive towards staff
• Refusal to go outside and engage with community

Outcomes
• Moved to supported living with own tenancy
• Reduction of support from constant staff supervision to staff oversight
• Medication no longer required
• Regularly accesses the community and engages with hobbies

*name changed to protect identity

John* is 65 years old and has diagnoses of autism, a severe learning disability and PICA.

Challenges
• Severe restrictions due to PICA around food storage
• Compatibility concerns with co-tenants
• Limited understanding
• Safeguarding concerns

Outcomes
• Discharged from professional external teams
• Move to a suitable single tenancy property
• Regularly goes out in the community
• Sensory needs able to be met
• Reduction in restrictive practises
• Significant reduction in behaviours that challenge

*name changed to protect identity

Ryan* is 23 years old and has been supported by AFG since he was 18. He has cerebal palsy, autism, is non-verbal, and can display behaviours that challenge others.

Challenges:
– Severely underweight and physically weak
– Frequent display of behaviours that challenge others
– Unable to go out in community

Outcomes
– Discharged from dietician as no longer underweight
– No meal supplements required
– Enjoys a range of activities and an active social life

*name changed to protect identity

Terry* is 48 years old and has a diagnosis of schizoaffective disorder and history of drug misuse.

Challenges
• Addiction to amphetamines, leading to periods of aggression and criminal offences
• Conviction and time spent in prison for stalking offence
• Refusal to take anti-psychotic medication
• Antisocial and aggressive behaviour – destroying damage and harming self
• Lack of daily life skills – self-care, cooking, cleaning
• Mistrust of staff

Outcomes
• Abstinent from illicit substances
• Accepts anti-psychotic medication
• No aggressive outbursts, improved social skills
• Improved daily life skills
• Enjoys activities in the community and hobbies
• Preparing to move in to own accommodation

*name changed to protect identity

Zahra* is a young woman in her 20s who was admitted to one of our independent hospitals, Oak Lodge, following an episode of psychosis in March 2023.

Challenges
• Unable to cope with auditory hallucinations and delusions
• Lack of independence and daily life skills – cooking, cleaning, personal hygiene
• No experience engaging with the community

Outcomes
• Developed coping strategies and able to manage mental health independently
• Move to supported living within six months of admission, cooking own meals and managing self-care
• Engaging with the local community – events, volunteering and education

*name changed to protect identity