Learning Disability Home Care Training for the Support Team in Managing Challenging Behaviours.
Learning Disability Home Care Case: 11-year old boy with a brain injury and learning disabilities.
Who engaged Dynamis: The Case-Manager who administrates and supervises the care-package being delivered to support the client at home with his family.
Why Dynamis was asked to help this Learning Disability Home Care Team:
- the young man was presenting infrequent but severe combative behaviour
- mainly grabbing staff by the hair or by the throat
- occasional inappropriate sexual behaviour in public
- has assaulted his school escorts in the taxi to/from school
Our initial analysis:
- Our advice and training for this project would be driven by Department of Health guidance issued in 2002 regarding the use of restrictive physical interventions with children and young people with Autistic Spectrum Disorder and Learning Disabilities. This guidance would form the core of any advice we offered the Learning Disability Home Care team to help them make the best possible decisions about the young man’s care.
- This training would be delivered in a ‘workshop’ format for the Learning Disability Home Care team, gathering information directly from the care team as we examined the guidance together. The most serious and most frequent behaviours would attract the most focus in the initial stages of the training, to offer the staff and service user greater security and safety.
- Techniques would likely be drawn from the Dynamis system of physical interventions, specifically the Non-Harmful Methods of Control, which are designed to offer secure holding techniques which do not cause pain to the client.
Gerard O’Dea (Dynamis Principal Trainer) began by gathering information from the Learning Disability Home Care team about the behaviours which were most challenging for them to deal with, as well as information about the methods the carers were currently using to deal with agitation, frustration and combativeness. This was followed by a discussion of core principles, derived from the Dept. of Health guidance.
Much of the discussion focussed on robust decision-making about the use of force with vulnerable people – why and when and how it may be necessary to use physical interventions, and when it may instead be abusive.
The later sessions were devoted to the practice and development of physical intervention and holding skills specific to the behaviours that the staff were seeing from day to day with the subject. This session included simple separation techniques from the various grabbing behaviours that the client presented.
Outcomes: Staff and family were very happy with the training programme, commenting that they now had better approaches they could feel confident in when dealing with their client.