Case study - supporting better health through PBS - Avenues Group
30 - 1993-2023

Case study – supporting better health through PBS

Wednesday 25th of May 2022

When we started supporting Daniel, the greatest challenges he faced were his anxiety levels, and the distressed behaviour which this caused.

His autistic sensitivity had meant he’d lost out on opportunities for new experiences and the development of relationships. It also seriously affected his general health and wellbeing.

His behaviour was unpredictable and not understood, and his previous support provider’s approach had been to limit access to the community.

This included services such as GP health checks and tests, which he was assessed as being unable to tolerate. For Daniel, these are essential to monitor any side-effects of his anti-seizure medication, which can sometimes can affect the liver.

Since he moved into Coleman’s Stairs Road, the support team has worked determinedly to give Daniel the support he needed to live a happier and healthier life.

Photo of Daniel

Daniel has clinical diagnoses of profound autism and learning disability. He has also historically experienced frequent episodes of extreme distress, which he commonly expresses through physical aggression. His unpredictable behaviour meant that he had extremely limited access to the external community, and primary care health services.

Following two years of consistent Positive Behaviour Support (PBS), Daniel’s anxiety and distressed behaviour significantly reduced. He was out in the community, doing his own shopping and enjoying walks along the beach in Birchington. But the team were still concerned by his lack of ability to access primary care services. Through the trust they had built with him, they felt the time was right to overcome the barrier around health checks, specifically blood tests.

Service Manager Teirry Etheridge said: “When Daniel moved in with his brothers in 2019 the idea of him allowing a GP to put a needle in his arm was laughable. But we knew it wasn’t impossible, given time.

“We met with his learning disability nurse Des Clarke who has known Daniel for a number of years, about how we could support Daniel to have a blood test.

“We developed a detailed plan with all health partners, and the family, putting Daniel’s best interests at the heart of it all. There was the risk around needle stick injury however it was felt that with a robust risk assessment and planning, this could be managed.

“Phlebotomist Mark Foster came to the service to discuss with us where Daniel might be most comfortable to have the blood test. We discussed about Daniel’s distress triggers and how to reduce the risk of anxiety and needle stick injury.

“Daniel met Mark on a couple of occasions so they could build rapport  – it worked well and he showed Mark all his canvas photos of him and his brothers in his living room. A risk assessment was then signed off by the GP, and Mark agreed to carry out the blood test here at Colemans Stairs Road, where Daniel feels comfortable.

“Assistant Service Manager Cloe and I then met with three of our support staff who have built up a consistent, trusting relationship with Daniel over two years. We discussed the risk assessment and the most effective ways of supporting Daniel with the test, such as verbal encouragement, engagement and praise.

“Through all this work and preparation, on the day it went extremely well! He accepted the needle and the whole thing went without a hitch. Daniel was supported brilliantly and he did an amazing job himself. Afterwards we made sure he could enjoy his favourite treat – doughnuts!

“It’s incredible to see how far Daniel has come now he is in place he feels is his home, with the support he needs. It’s one example of the huge steps he’s making, and the confidence he is building in all aspects of his life.”