Case Study –
Nicholas, age 18, has ADHD and autism. When he was younger he was uncontrollable with his behaviour – running on to roads, fighting with children, throwing himself off top bed bunks. He was obsessed with super heroes, refusing to take off superhero costumes even when filthy and for school, and was unable to distinguish between make believe and reality, past the normal point of a boy his age, 7. This is when he was diagnosed with ADHD. His mother believed there was something else and kept insisting this to his child psychologist at the YPD clinic. After years of battling and his symptoms showing through more – unable to be in crowds, obsessive behaviour and a very obvious immaturity. His mother at this point requested a new psychologist as the one she’d dealt with over the years, Nicholas now 14, refused this behaviour was more than the already diagnosed ADHD and his mother had reached the end of her tether. It was at this point when the new psychologist came in that Nicholas was diagnosed with Autism – Aspergers Disorder – and his mother and the new psychologist were able to alter his life to meet his needs and make life easier for him.
1.1 Nicholas’ condition effects him through out many aspects of SPECC. In the case study it tells us about his later symptoms showing up as he gets older – the inability to be in crowds and his immaturity. This could effect him socially as interactions with friends and family may need him to be in a social situations with big crowds such as weddings etc. With him running on to roads and fighting with other children at a young age he runs a risk of not developing any interpersonal skills. These in turn could lead to him being isolated which then lead to him having problems emotionally, effecting his self esteem, self confidence and self worth. With Nicholas having trouble distinguishing between make believe and reality he is showing signs of not having well developed cognitive skills, as per the case study his senses and learning isn’t telling him doing this such as throwing himself off the top bunk and running on to roads are dangerous, this could greatly affect him physically to the point where he could break a bone.
1.2
In identifying needs using SPECC pinpoint specific problems is the first step of call. After identifying needs you can use SMART goals in the planning process. SMART stands for Specific, Measurable, Achievable, Relevant and Timely. You start with specific, specify what the need is for the individual against each part of SPECC and make a plan for them to follow. Next is measurable, how will you know that you have achieved the goal? Finding a way to monitor the care plan given is important to see if any progress is being made. You can do this through use of a wall chart, diary etc. Achievable, looking at the goals and monitoring plans you have made to see wether or not they are achievable and able to go ahead. Realistic is where it is looked to see is there is reasonable resources available to compete to set tasks and plans. Time limited, goals should be monitored and checked over a period of time, the goals set should always have a deadline for review.
1.3
It is important for Care Practises to be safe welcoming places. There are many features that contribute to achieve a positive car practise.
There are 4 parts of a care environment –
Therapeutic environment, working with service users
Organisational environment, staff and how well they work together
Physical Environment, the building and other material factors
Community environment, external links with family and the wider community
Therapeutic environments are environments in which it is aimed to provide a as fulfilling life as possible to service users whilst using creative, therapeutic approaches such as art therapy. It is as important to have a well managed and run facilities. Factors in this include such things such as ethos – the values, mission and vision, teamwork, leadership and management, supervision and mentoring and providing and supporting learning and development. The physical environment is where the facility to be well organised, hygienic, cost effective and efficient. The physical environment involves what is actually in each facility and how it looks and feels. Many facilities want to avoid an “institutionalisation” kind of environment. Things that can enhance a physical feeling of a facility are things like having service users make decisions about the physical environment, a welcoming entrance area, warm, friendly staff, attractive furnishings such as photos on the wall, photos of service users and staff – either formal or informal. The community environment is important for places of care to be as integrated into the local and wider community as possible. Ties should be developed with local resources and community services such as colleges, libraries and wellness centres. All care facilities should be seen as part of the community.
1.4
NEED
"Social –
Nicholas has difficulties socially, he puts himself and others at risk of getting into dangerous situations by fighting or running onto a busy road. Without careful watch he will likely hurt himself and/or put himself at risk of serious injury. "
"Physical –
Nicholas has a physical need for safety. He is risking serious injury daily by throwing himself from heights. "
"Emotional –
Nicholas struggles emotionally, he is not maturing at a “normal” rate for a boy of his age. He risks exclusion socially without guidance. "
"Cognitive –
Nicholas needs support cognitively. His basic human senses does not seem to sense danger and due to this he is risking serious danger daily. "
"Cultural –
Culturally Nicholas has a set of “Norms” which he follows. He refuses to remove or wear anything other than his super hero costume. This could be detrimental to his health and also isolates him from his peers. "
1.4
YPD is for young people, 18 and under, with mental health problems. The Young Peoples Department is a small multi-disciplinary Mental Health Team for young people and their families and / or carers. The service is primarily for children from birth to their 13th birthday but children with learning disabilities are seen up to school leaving age.
Nicholas feels welcomed and comforted every time he visits the clinic, they are always very warm and adaptable to needs he may have on the day he is visiting, the physical features of this place are all very positive, he never feels uncomfortable or that he is in a “clinic”. Nicholas always feels prepared and ready for meetings with them as they contact him regularly from 3 months leading unto the appointment so he knows exactly where he is going to be, who he is going to see, why this is happening and when he is to be there, this shows how well the organisational environment of the care setting is, with the whole team from the receptionist to the therapist he is seeing knowing who he is without having to ask. Through the YPD Nicholas started horse riding in the nearby stables as an attempt to improve his cognitive and social skills. The stable knew all about his condition and were very supporting and adaptive to his needs. This boasts impressive ties to the community and a great community environment. Overall YDP prove themselves to be a very positive care environment
Safe practice is very important in care. There are a number of legislative measures and regulations to support health and safety at work. These are intended to protect people in work, those using services and the wider public.
One of these pieces of legislation is the Equality Act 2010. The Equality Act 2010 legally protects people from discrimination in the workplace and in wider society. The act is 9 main pieces of legislation merged, the legislations are :
The Equal Pay Act 1970
The Sex Discriminat
ion Act 1975
The Race Relations act 1976
The Employment Equality (religion or belief) Regulations 2003
The Employment Equality (sexual orientation) Regulations 2003
The Employment Equality (age) Regulations 2006
The Equality Act 2006, Part 2
The Equality Act (sexual orientation) Regulations 2007
The act simplifies and strengthens current legislation in Britain protecting individuals from unfair treatment and promotes a fair and more equal society. It is important for a care environment to implement this act so all service users and staff can feel harmonise and equal in everything they do.
Another piece of legislation is the PVG scheme. The PVG scheme is an act in which people who desire to work with the vulnerable go through to check out their background so employers can check that they have previously been of good character. The PVG (Protection of Vulnerable Groups (Scotland) Act 2007)) was implemented in 2007. It streamlines vetting processes and makes sure no one that has been barred from working with children and protected adults can. It is vital for care settings to use this scheme so all care users and staff can be protected and no person is vunerable.