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Supporting Josh to transition from hospital into his forever home

Josh* had been in multiple residential care homes and supported living accommodation but nothing had worked out quite right. With several re-admissions to a specialist inpatient unit for people with a learning disability, Josh had a history of failed discharges into the community. As a man in his 40’s with a learning disability, autism and a history of anxiety, we were determined to provide a supportive and stable future for Josh with Voyage Care.

Taking time to understand

Due to his previously unsuccessful placements, the process was led by our specialist behavioural support services (SBSS). This transitional journey began from the hospital, where we prepared for his discharge by working with his hospital and the professionals involved. Here we took the time to fully understand why his previous placements may have broken down and what we could learn from this.

We found creating structure and predictability reduced Josh’s anxiety and would help prevent another support breakdown. Josh is also hypersensitive so providing a self-contained setting (as opposed to his previous shared supported living) would help give him the space, privacy and environment to meet his sensory needs.

From here we worked with Josh, his multi-disciplinary team (MDT) and his social worker to create a clear transitional plan, which included continuity of care from the inpatient unit.

A collaborative approach

Working with those that support Josh, we identified key outcomes based on our experience of successful transitions from hospital to supported living. Together, we agreed on the development of crisis and relapse contingency strategies so we would be able to prevent re-admission.

As part of understanding Josh’s support preferences and routines, we had a training session from people who knew Josh well. They shared effective approaches, such as mood monitoring techniques and therapeutic interventions. This training was especially useful later on, when our team were able to proactively respond to signs that Josh was unwell through subtle behavioural changes. This ensured prompt medical intervention, the local crisis team were kept informed and Josh was soon feeling better again without an escalation in behaviours!

We also used a person-centred approach to ensure that Josh had meaningful involvement at each stage of this transition. Josh likes to engage with people on his own terms, so we made sure to introduce Josh to his new team at his own pace. Communication at each stage was vital, as was visiting the local community in preparation for his move as part of Section 17 leave.

A new outlook

Following his move to this new supported living property, Josh has settled in very well. Part of the success of this transition is down to the consistent approach of applying our learnings and understanding developed through the transition.

One of the key aims is for Josh to live a good and active life, interacting with the community in a healthy and safe way. Josh is now comfortable in his own home and local area. He enjoys a predictable, structured day, which includes meaningful activities such as jigsaw puzzles, writing and drawing.

We also saw a huge milestone achieved in under a year in his new home. As he is hypersensitive and autistic, Josh would usually get distressed during the Christmas period. Understanding this, the team supported Josh to plan his time over the festive period and avoid feeling overwhelmed. This included maintaining his structure and routine as much as possible. Josh decided to have some Christmas decorations in his new home, and we were excited to support him to do this in his own way. Both Josh, his family, us and his specialist care team were delighted with how well he coped during this time, particularly so soon after moving from hospital.

With the support he needs, Josh has lived in his own home for over a year and is looking forward to what the coming years will bring in his forever home!

To find out more about our SBSS and how they can help you, your loved one or your client, please click here.

*Names have been changed for confidentiality

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