Transforming Care, Transforming Lives: J’s Story

J is a young man with complex care and support needs who has faced numerous challenges, including multiple placement breakdowns. These disruptions led to ongoing instability, unmet support needs, and increasingly challenging behaviour. Diagnosed with Autism, ADHD, and a Learning Disability, J spent much of his life without the specialised support or environment necessary for him to thrive. He moved from one placement to another, each time hoping to find a place he could truly call home.

J struggles to express his needs and emotions verbally, so his behaviour often reflects his mood. He can become easily frustrated, and his behaviour can escalate quickly, requiring highly trained staff to anticipate his needs and emotional state before incidents occur. At 18, J was placed in a shared, non-specialist-supported living provision. Unfortunately, it wasn’t long before the placement began to break down. J has difficulty tolerating loud noises, busy environments, and changes to his routine without thorough transitional support. These factors, combined with the new shared living situation, triggered severe behaviours that posed risks to himself and others, and his mental health rapidly deteriorated. Staff became fearful of J, affecting their ability to provide the meaningful care and support he deserved. Eventually, J was sectioned under the Mental Health Act, and this cycle of instability continued into his adulthood.

During J’s time in seclusion in Rotherham, his interactions with others were minimal. Isolated from his peers and the community, his behaviours escalated as a result of heightened anxiety, with a lot of time spent alone on his iPad. Thankfully, a referral was made to iBC Healthcare, recognising our expertise and ability to offer a highly personalised transition to a single-occupancy property. Unlike previous experiences, iBC Healthcare approached J not as a set of challenges or risks but as a person who deserved understanding, respect, and the chance to flourish on his own terms. The process was not without its difficulties. Obstacles around funding, the urgency of the move, and the need to advocate for J every day persisted for months. However, iBC Healthcare remained confident in our ability to make a significant impact on J’s life. Once the placement was approved, we carefully planned a gradual transition while J’s new home in Sheffield was being refurbished. We collaborated closely with the Rotherham, Doncaster, and South Humber NHS Foundation Trust to prioritise moving J from the seclusion suite to an open ward. During this time, we reviewed J’s past placements, identifying what worked and what didn’t to build the foundation for a sustainable placement, with the goal of ensuring J would never face this situation again.

In close partnership with J’s multidisciplinary team (MDT), iBC’s Positive Behavioural Support (PBS) Lead, James Punch, visited J over a six-week period to establish a relationship. During transitional visits to J in seclusion, we observed J to spend much of his day pacing his room with a sheet over his head, he would hoard pieces of paper, not engage in personal care and staff members would observe J via CCTV, periodically placing food on the floor and quickly closing the door. James Punch understood that J was lacking significant interaction, so began taking small steps to connect with J, such as placing a sheet over his own head and playing with a sensory ball. J was engaged and watched James, which the staff expressed he had not done before. Sometime later J said hello to James and started laughing at his movements, which was notably the first positive interaction he’d had in some time and the first step towards a good relationship. Knowing that trust is essential for J, James worked with the hospital team to share strategies, such as intensive interaction, positive risk-taking, and meaningful play, while developing a robust PBS plan for his eventual move. JJ developed a strong connection with James, even requesting photographs of his new home and for it to be decorated in his favourite colour, blue!

“Feedback from the ward was excellent regarding James’s approach with J and the work you are doing to support J in coming out of seclusion,” – Rotherham Commissioner

After several visits and J repeatedly asking for the door to his seclusion suit to be opened, James worked with the hospital to prepare a lounge for J, ensuring it was safe and there were activities and toys waiting for him. James supported the hospital staff to help them feel confident in their interactions with J in preparation for his seclusion suite door to be opened. It was anticipated that J would present with risk behaviours in the lounge however reflecting the power of positive risk-taking, this wasn’t the case.

“When the doors opened, J appeared so happy. He spent of time in the lounge playing with a selection of toys that I had left around the room, and he interacted positively without swearing. He moved around the rooms freely and showed no behaviours of concern.” said James.

With the access to the lounge going so well, iBC now wanted the opportunity to interact with J outside. James said: “J played football with me and danced in the rain. We sat and played with Lego for hours, building a fish and a house!” Notably very different to the way J was described as “hiding” from staff members before the transition began. Just a few weeks later, J was ready for discharge, and his bespoke bungalow in Sheffield, complete with a dedicated, person-centred staff team, was waiting to welcome him.

In May 2024, J moved into his forever home and has since made remarkable progress. Milestones that once seemed out of reach have become part of his everyday life. J now engages with his community, shops for groceries, visits the barber, and even cooks his meals. His support ratio decreased from 3:1 to 2:1 within just 12 weeks—a significant indicator of the reduction in incidents and the positive relationships he has built with his support team. Since moving into his new home nearly six months ago, there have been only two incidents, both managed calmly and effectively by a team that truly understands him, preventing escalation.

J’s support ratio was reduced from 3:1 to 2:1 in just 12 weeks – Milestones that once seemed out of reach have become part of his everyday life.

But perhaps the most profound testament to the transformation iBC Healthcare has fostered is J’s own recognition of his happiness. For someone who spent so much time feeling confined and misunderstood, expressing satisfaction with his home and the support he receives is an incredible achievement.
J’s story isn’t just about changing a placement, it’s about transforming a life. His journey is a powerful reminder that everyone deserves the chance to be understood, supported, and given the opportunity to live their life to the fullest. Today, J is living the life he wants, free from the seclusion that once defined him.

A huge thank you to J, his incredible support team, iBC’s PBS team, the operational colleagues of Supported Living South Yorkshire, and J’s MDT. We look forward to all that J will undoubtedly accomplish in his bright future ahead.

#DoAmazingEveryDay