When Tom came to us Before the start of his placement at Broughton House, Tom was previously at a specialist school for young people with autism and learning disabilities. During times of high arousal behaviours, he would require a staff ratio of five to one due to safety concerns. These behaviours and stress levels also increased the risk of epileptic seizures. Tom’s bedroom walls were padded due to self-injurious behaviour, as it was stated at the time he was severely depressed. He was refusing to wear clothes and was on the at risk register. His trajectory was for section two under the Mental Health Act. Today Tom is now on a one to one staff support ratio and is even enjoying accessing meaningful activities in the community with his peers. He is able to wait in queues whilst shopping and follow his schedule. He will now happily remain within a structured environment for up to one hour, with now and next activities lasting for ten minutes of each activity. Tom is now off his cocktail of anti-psychotic medication and is starting to tolerate personal items in his bedroom. “I now have my son back, he feels safe and is now enjoying life.”Parent He uses a communication grab sheet. This incorporates objects of reference and access to a choice board; with all activities being in his field of view and having tangible positive individualised rewards.