Carol, an influential Team Leader with over 22 years’ experience in social care, is passionate about advocating a positive approach to risk-taking and support. So how has this approach had a lasting impact on the lives of the people she and her teams support, as well as the wider community?
Carol Smith has worked with North West based health and social care charity Alternative Futures Group for over 22 years, with much of this time being focused on people with complex needs and behaviours of concern. She is currently based in Knowsley, Merseyside, managing a team of 13 Support Workers.
The impact of Carol’s belief in the principles of positive behavioural support has been transformative with the people she and her teams’ support.
One key example of this is with Matthew*, a gentleman in his 50s who is on the autistic spectrum, with severe learning disabilities and complex needs.
When Carol’s team took on Matthew’s care, he was commissioned to have five members of support staff, was heavily medicated and would display assaultive behaviours. Understanding that these behaviours were likely due to pain and medical intervention was needed, Carol arranged for GP and dentist appointments – however Matthew had a severe phobia of clinical settings due to past traumatic experiences.
Knowing that Matthew needed to understand and have the choice to participate in treatment for it to be successful, Carol arranged to meet with the lead dentist at the Royal Liverpool University Hospital to discuss his needs. She arranged for Matthew to visit the hospital several times during quiet periods with no treatment taking place and requested that staff wear non clinical clothing to build trust.
This approach led to him becoming more relaxed and comfortable with being treated, which then had a transformative impact on his moods and behaviours. Carol and her team could then take positive risks with Mark’s day-to-day support, such as taking him out into the community and trips away.
The pathway Carol helped to develop is now used by the Royal Liverpool University Hospital to support other individuals like Matthew who have experienced severe trauma as an alternative to sedation, demonstrating the lasting human impact her work has had.
Another example of Carol’s approach to positive behaviour support is with another gentleman she has led on supporting called Carl*, who is in his 70s and has a learning disability,
Carl had been living in a shared house when he had a fall and did not recover use of his legs. His occupational therapy team provided a bath chair and ramp, but Carol saw that he quickly became unmotivated, wanting his support team to do things that he was still able to do himself.
Concerned that Carl’s multi-disciplinary team wanted to trial medication which had previously been reduced, Carol identified that his mood fluctuations were due to the limitations of his environment and advocated that he needed to move into a new property.
This was a challenging and emotional process, as Carl had lived in this property and called it his home for many years – but Carol advocated that it was no longer the right environment for Carl to live his life as independently as possible.
Following this difficult process, Carl is now flourishing in his new home and doing the things that he had stopped doing in his previous home such as feeding, washing and clothing himself. He has regained confidence and independence that he was at risk of losing, with his clinician stating: “The positive impact of this gentleman getting the right interventions at the right time has prolonged his life.”
It is this unwavering approach to creating a supportive environment and promoting choice that makes Carol an inspirational and impactful leader, improving the quality of life of people she supports and setting an example of best practice across the community.
*names changed to protect identity
@welcometoafg
afgroup.org.uk
