Ben 

In 2023 NHS England produced a case study about 'Ben' (name changed to protect identity) who My Life Choice supported through his discharge from a Secure Hospital setting in to his own home. The case study below highlights how we worked alongside key stakeholders and an extensive multi-disciplinary team to ensure that after a transition spanning over a year, Ben could successfully start the next stage of his life in his own home, fulfilling his potential. 

The Person 

Ben had lived in secure care since the age of 15 and is currently in his early 30s 
He has a Learning Disability, Autism, Tourette’s and ADHD 
He is 6ft 7 and requires a spacious, robust environment 
Ben is originally from Essex but was living in Lancashire & South Cumbria far away from his family 
He presents with anxiety and is clearly traumatised by early life events and systemic failings in his care and treatment 
Ben is easily sensory and emotionally overloaded and requires a specialised environment 
In June 2021 Ben was transferred in an emergency move from Cawston Park after it was closed due to service quality 
He was moved to a 16-bed secure ward and required the entire ward for his care 
Experiences in his previous placement came to light and it was found he was nursed in seclusion the majority of the time 
With therapeutic intervention he made significant progress in the new ward and was ready to move into his own home 

The Goal - Find Ben his own home closer to his family in Essex: 

An options appraisal was carried out and it was decided that the best option for Ben would be to have his own home in the community 
An experienced care provider was aligned and developed a housing specification in partnership with the Housing provider and current inpatient team 
The team began to search for a large bungalow in a quiet location with a large secure garden and space for family and staff 
A property was purchased that could be adapted to meet Ben’s environmental and sensory needs 
The property needed robust furnishings and fittings and required significant adaptation 
While the property works were done work was also happening to recruit and train a staff team.  
Transition began in June 2022 
The Multi-disciplinary team had fortnightly meetings to ensure an open and transparent approach 
The property was completed and Ben was able to move in September 2022 

Challenges 

Finding a bungalow large enough for Ben and his staff took longer than expected 
Ben was moving from L&SC to Essex and the North West Project Team had to manage the project from a distance 
There was a history of staff turnover due to Ben’s behaviours. Extra measures were taken to train staff and prepare them to deliver effective care. 
Ben could sense something was going to change and had increased anxiety leading up to the move 

Critical Success Factors 

The commitment and persistence of each person involved. The Local Authority, Health Authority, health professionals, GP, HOPE(s) team, and housing partner were intrinsic to achieving the ultimate goal of Ben leaving behind a hospital setting. 
The Nursing Team worked tirelessly to form a new relationship with Ben including therapeutic interventions to address his years of seclusion and associated trauma. 
The partnership working continuing post discharge with regular meetings to ensure Ben’s support/ housing run effectively. 

How Is Ben Doing Now? 

In the first 6 months incidents requiring intervention reduced from over 20 to just a few in a month's 
Ben has adapted to his new environment extremely well and has developed strong and trusting relations with staff 
The support structures in place have resulted in a resilient team with a retention rate of 94% 
Ben has been able to maintain family relationships with family visiting on several occasions 
He is able to tolerate new people 
He is increasingly able to self-regulate with ‘deep breaths’ or ‘calm down’ 
Since Ben has moved there has been a significant reduction in the need for restrictive practices (graph). In the first 6 months he went from requiring over 20 interventions to just a few a month 
He is happy in his new home