When AFG were awarded Freddie’s care and support package in 2009, he had just been discharged from the high secure psychiatric units that he had been detained in since the age of 14.

He was highly institutionalised, due to his cognitive and neurological rehabilitation programme, which planned his every move down to the hour.

He was supported on a 5:1 support basis, with an extra member of staff on standby for 12 hours a day for any additional support that may be required. He presented with frequent and intense behaviours that challenged others, including significant physical aggression.

Our approach

Person-centred approach

Freddie’s support team developed an in depth understanding of his needs and adopted a person-centred approach to ensure his progress. They quickly learnt that all actions and decisions required Freddie’s full involvement so he didn’t feel overwhelmed or disempowered. Any changes to staffing, routine or environment needed to be carefully considered, measured and agreed on Freddie’s terms.

Positive behavioural support

Initially, Freddie’s support team had to use a lot of restrictive practices when providing his care and support. Due to his intense physical aggression, physical intervention techniques as per Therapeutic Management of Violence and Aggression (TMVA) training was frequently required.

The number of restrictive practices were gradually reduced over time, with Freddie positively adapting to this approach by his dedicated and resilient support team.

This enabled a reduction of staff support from 5:1 to 3:1, and a significant reduction in the number of serious incidents, where previously there were multiple serious incidents reported each week.

Taking positive risks

Through careful assessment and support planning, his support team introduced community based activities, providing reassurance and distraction techniques to enable Freddie to get used to spending time in crowded spaces and interacting with others.

Freddie was supported to participate in a range of activities gradually, until he became comfortable and enthusiastic about going into the community every single day. He now regularly enjoys trips out and social activities with new friends.


Reduction in support required

Freddie previously required 5:1 support and regular Therapeutic Management of Violence and Aggression. Due to a huge improvement in his behaviours that challenge, his staffing has been reduced to mainly 3:1 support.

Hobbies and socialising

Freddie loves to go swimming and play pool at the local social club and he regularly takes part in activities and socialises with others. This includes lunch club with other people supported by AFG, going to the cinema, swimming and day trips.

Increased independence

Freddie has a tenancy for his own flat and mobility car. He previously needed intensive chaperoning during all activities in the community but he now has an increased level of independence.

Regular time with family

Freddie looks forward to spending time with his close family at least once a week. He enjoys going on holiday with them a few times a year, and also regularly spends time with extended family.