Case Study: Paul’s Journey

Paul’s* history

Paul is a young man with diagnosis of autism, learning disability and, more recently, post traumatic stress disorder (PTSD). He attended a number of residential schools throughout his teens which were later found to be overly restrictive and a very negative experience for Paul. He had very challenging behaviour and due to the number of incidents which subsequently resulted in the over use of physical restraint, he became extremely untrusting of staff.

When Paul came to us

When Paul arrived at Devon Lodge he was still trying to cope with the trauma from his previous placements, he didn’t trust staff and had no motivation to engage with them or anyone else. His incidents were happening daily including self-injurious behaviours. It was clear that Paul was in crisis and the Devon Lodge team worked alongside the local learning disability team to ensure he had as much support in place as possible. Paul was a highly anxious individual, with change being a big trigger for him, however he felt secure in his bedroom and did not want to leave his safe space.

Paul’s care

Due to Paul’s previous experience of care, the team recognised it was very important for him to feel comfortable, safe and in control. They knew that transitioning would be difficult and allowed him time and space to settle in. They didn’t use any physical restraint throughout his incidents, instead supporting him through his feelings and emotions and building understanding. It was important to show him that he could trust the staff.

Due to Paul’s anxieties around staff and change, the staff mix was very important. It was always ensured that any new members of staff supporting Paul were accompanied by members of staff he knew to give that consistency. He was initially on 3:1 staffing.

Person-centred care is something that Devon Lodge strive for with all the residents, and as Paul settled in he was able to guide his own care. All goals and activity plans were led by him, he engaged with the educational activities offered at Devon Lodge and the staff worked to his ability to support his learning. His staffing needs reduced and he was able to spend more time in the community and with his family.

Paul today

Paul is extremely happy and settled at Devon Lodge, he is friendly towards all the staff and enjoys the freedom to plan his own time and engage with his hobbies. His family are now comfortable knowing that Paul finally feels at home. Paul enjoys spending time in the garden and often uses this space to self-regulate. He also enjoys going for long walks with the staff and then picking up his favourite foods on the way home. Paul is currently waiting to start a course of art therapy and a second creative programme based in the community. The team hope this will be a positive outlet to help Paul continue to progress.

Family testimonial

“Paul came to Devon lodge with some really difficult challenges, he had a lack of confidence in people and was scared. He did not mix with other residents at his previous setting as this was discouraged due to challenging behaviours. He never relaxed and spent a lot of time on high alert, thinking what may happen so was tentative and unable to engage. His hair was shaved as he had been abused by a previous setting and he would not allow himself to have hair as someone could grab it.

Over a period of 2 years he has slowly allowed himself to relax gaining confidence in staff and residents alike. His confidence has grown, and he has allowed himself to mix with both staff and residents.

He has grown his hair and is no longer worried about it. His incidents of anxiety have reduced as he is well supported by staff who he has built a great relationship with. In turn he has started to make visits to home again, with a strict care plan in place. This has worked well, his contact and relationship with family is very strong and important to him. Staff support visits by transporting Paul home and back to Devon lodge.

Paul is in a much better place in himself than when he came to Devon Lodge, as a family we are very grateful, seeing him happy means the world to us.

Because Paul has had a bad experience in the past with previous staff, new staff can be difficult for him and there has been a recent management change which I thought would be tricky for him. However, he has remained settled throughout the change as he has been so well supported. We hope he will continue to gain confidence and enjoy being at Devon Lodge long into the future.”

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*Name has been changed to protect his identity

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