Liam’s* History

Liam has a diagnosis of autism, a learning disability and behaviours that challenge. He lived in the family home until his father was no longer able to cope as his aggression and challenging behaviours were increasingly difficult to manage. The family felt that he needed more intensive support and after a community placement broke down, Liam was referred to a hospital.

During Liam’s time in hospital he refused to engage with the staff, spent long periods of time in his room sleeping during the day and would not get dressed. Physical interventions and PRN medication had been used to manage Liam’s high levels of aggression and behaviours.

When Liam came to us

It was felt that Liam would benefit from a move out from the hospital setting and so he transitioned to Broughton Lodge. Liam was anxious and unsettled by the move and required 2:1 support initially, this soon increased to 4:1 for periods of the day at times of challenging behaviours.

When staff tried to support Liam with his personal care, he became very upset as he did not like close contact. Liam was unable to access the community due to this, along with his high levels of anxiety.

Liam’s care

The onsite clinical team reviewed Liam’s medication and felt that he may be better suited to an alternative, this was discussed with his mum before being introduced and is still reviewed fortnightly. The medication supported a reduction in Liam’s anxiety and, consequently, his challenging behaviour.

As Liam is non-verbal, the team worked closely with his parents to establish activities that he liked, anxiety triggers and routines that worked for him. Staff worked together on Liam’s routine, the multi-disciplinary team (MDT), service manager and support staff meet weekly to discuss. They continue to do this as his needs continue to change and develop as he progresses.

The MDT at Broughton Lodge completed frequent observations in order to select interventions that could support Liam to progress. A ‘now and next’ picture board was introduced, which helped his understanding of the day ahead and subsequently reduced his anxieties. They also recognised that time between activities was key to keeping Liam calm, therefore they allowed downtime for him to return to baseline after tasks or activities.

Once Liam felt more settled at Broughton Lodge he was able to access more activities and community leave, the activity coordinator linked in with his senior support workers to arrange suitable activities in and out of the house such as sensory sessions, watching films and arts and crafts. The team built up his community access in stages from short car rides until he was able to go for walks.

Liam began to accept support from the staff to complete his personal care and would get dressed in the morning. He built a positive relationship with the staff and incidents reduced significantly. They also worked with him on his eating habits, he had always eaten with his hands, and so staff purchased some adaptive equipment to help him with this.

Liam today

Liam has a great relationship with the staff, he loves to sit with them and enjoys trips out with them. He often has family visits where his mum is able to join them out in the community.

“Working with Liam from when he arrived to now – he is a different young man.” – Deputy Home Manager

With the help of his positive behaviour support plan his incidents have more than halved in the short time he has been there. Liam now has good sleep hygiene and sleeps through the night, meaning he can access the activities he enjoys throughout the day.

Liam’s next goals are to gain more community access and increase his independent living skills. The team are currently sourcing Liam his own vehicle to keep onsite to allow more regular trips out once he is ready. Both the team and his family are proud of Liam’s progress and are working towards his next goal of completing a home visit.

Family testimonial

I feel that Liam has progressed loads in a short time of being at Broughton Lodge. His challenging behaviours have calmed, even when out in the community sitting in traffic, it used to be a major issue but now he sits patiently.

Encouraging Liam to eat with a spoon and a fork instead of his fingers is a massive achievement for him. Even watching Liam take his dishes and put them in the dishwasher, I am so incredibly proud, I know he has a long way to go but he will get there.

I can honestly see a massive improvement in him every time I visit him at Broughton Lodge. I can see and feel the team are dedicated and it puts my mind at rest. The kind helping staff supporting Liam with his everyday needs is a blessing to watch, I have to hold back my tears I am so proud of him and, of course, I can’t thank the team enough.

*Name has been changed to protect his identity.