Tag Archives: risk assessment

Off target…

At one point when Eedy was in his early teens he was assessed as needing male staff only. This had come out of the blue, so I questioned it with his then care provider. “It’s all legit,” I was told, “it’s from his risk assessment”. I further asked if his aggressive behaviour had increased without my knowledge. It hadn’t but I was firmly informed that Eedy had a history of ‘targeting female staff’, and the management of this was to ensure he only had male staff supporting him from now on.

Funnily enough, I was still able to have Eedy home. I was still able to go out with him. I was still able to drive a car with him as the single passenger. He could still be on his own with his little sister. And even funnier… we didn’t feel there was any threat.

So Eedy’s staff team became male. He came home one weekend, shortly after the changes, and I asked him if what he knew about it all. “I target females,” he told me. I asked him if he knew what that meant.

“Oh yes”, he replied confidently “It’s when I run at the women to get them to make those nice high pitched squealing noises like Nanny does!”

Me: …..

One size doesn’t fit all

When Eedy was 18 he was living in a flat with 1:1 support. He was there for just over a year and had two different ‘supported living’ service providers. Both had a ‘one size fits all’ approach to challenging behaviour.

I guess the fault really was with the commissioned hours from social services. On a 1:1 it’s extremely risky to have any sort of hands on intervention. So immediately Eedy was at risk.

When Eedy is stressed, anxious, frustrated or worried he is likely to hit out. Verbally and physically. Things were worse in the days of The Bill on television, as he would (in his world) become a policeman with the job of restraining his staff member.

When he lived at home things didn’t get too bad. When he lived in children’s services he learned from his peers. And added their misdemeanours to his own repertoire.

By the time he hit ‘transition’ his behaviour had escalated and his staffing numbers had reduced.

Eedy moved to a flat on the third floor – all very nice, with two bedrooms a kitchen/lounge and bathroom. He had 107 hours support a week and 7 sleep-in’s. So was always with a staff member. Except when times got bad.

The staff were instructed that they were to leave as soon as Eedy showed any form of agitation. Eedy quickly worked this out and did everything in his power to ensure the contrary.

  • If the staff gave an indication they might leave, Eedy would rush to the door and stop them leaving. So now he was holding them hostage in the flat
  • If Eedy couldn’t get to the door before they left he would run to the balcony and threaten to throw himself off
  • If the staff got out of the front door, Eedy would run to catch them and try to push them down the stairs

All seriously high risk events.

Yet the risk assessment continued to say that the staff must leave. If we’d had a chance to discuss things, if we’d been involved in the risk assessment process we would have been able to give examples from Eedy’s past that evidence that leaving him is the worse option.

Example 1

When Eedy was in children’s respite the staff told Mogs and I that all attention was to be withdrawn if he showed ‘behaviours’. Eedy duly attempted to throw a cup of juice over his sister. The staff indicated to us to remove ourselves, with the rest of the staff to the kitchen and lock the door. This incited more anger in Eedy and he raged and banged the door.

It went quiet for a moment and then more irate shouting, “you’ll have to come out now, as you’ll get too hot. I’ve turned up the heating!”

With a back door to the kitchen this attempt failed, so Eedy upped the anti. The next brief quiet moment was followed with the sound of fire alarms. He’d set off the call point.

As this was a council run centre, all fire alarms linked to the local fire station. Eedy successfully got us out of the kitchen, back talking and interacting with him and learned himself a valuable skill which has stayed with him ever since.

Example 2

When Eedy lived in a children’s home, again staff withdrew when he showed any agitation. The staff office was upstairs, and on one occasion he was on a 1:1, the other couple of guys he lived with had gone out with the other staff.

Eedy had already been up to the office and pounded on the door a few times whilst screaming threats, expletives and any other derogatory remarks he could think of.

The final trip upstairs was, by his standards, successful. “You’ll have to come down now, I’ve started a fire!”

The staff member reacted and found Eedy had put a tea towel into the toaster and turned it on.

More learned responses…

Currently ‘positive behaviour support’ is all the rage*. It’s in, it’s trendy. It is supposed to look at functional analysis. What does the behaviour mean?

Most ‘behaviours’ show either a need for something or a need to reject something. Pretty obviously Eedy is screaming ‘don’t leave me’. But hey, funding won’t allow the risk. Informing people that the risk just gets bigger falls on deaf ears. It’s a funding issue after all.

So, supported living wasn’t for Eedy. And isn’t likely to be in the foreseeable future. Certainly not with a company who fail to assess individual needs. He’s living in a small residential home – so there are staff available to step in, not aggressively, not in a ‘control and restraint’ sorta way. Just to be available to keep him safe. His ‘incidents’ have reduced in duration. True support would look at meeting Eedy’s needs and safety. Y’know that phrase.. they would be person centred. There are companies out there I would trust, but unfortunately the larger the company the more likely they would have blanket procedures in place. And that’s the only experience Eedy has had.

My lasting memory of supported living for Eedy was the day I got the call that Eedy has been unsupported for over 6 hours as Eedy would not calm and the staff had been banned from returning. I got there as soon as I could finish work. As I opened the door to his flat he was sat on his sofa in the suit he had worn to my wedding. After checking he was ok, I asked him why he was all dressed up. He answered me that when, some weeks previous, he had been cautioned by the police for assaulting his staff he had been told by the copper “next time you’ll be in front of the judge”.

As Eedy saw this as the next time. He had dressed in preparation.

 

*…No apologies for the pun 😉