Prior to Stacey’s care with Thornbury Community Services (TCS), she was receiving 1:1 care at EastWay Learning Disability Unit due to a deterioration in her mental and physical wellbeing. She had access to the community, but it was minimal.
Cheshire West and Chester Council and Cheshire and Merseyside Integrated Care Board (ICB) approached TCS to create a bespoke package of care for Stacey, and since July 2023, she has been making significant progress with her health, social skills and relationships.
We implemented four key elements into Stacey’s care plan to ensure she received person-centred care and support from our dedicated healthcare professionals, which matched her health and wellbeing needs.
To ensure Stacey had structure to her care, adaptive plans and routines were created to align with the changing of seasons, which Stacey has found challenging. The routines are flexible to align with the current season and to indicate to Stacey when it is daytime and nighttime.
Staff use timers to maintain a daily structure for Stacey’s breakfast, lunch, dinner, snacks, and medication.
When Stacey is receiving care from familiar staff, she is able to maintain her routine and is happy to wait for her snacks and medication at the designated times.
Staff have been working with Stacey to teach her about personal care and encouraging her to try maintaining her own personal hygiene.
The core team are dedicated to Stacey and have developed meaningful professional relationships. They continue to support her in developing her confidence and independence.
An important focus for Stacey’s care team is to continue this fantastic progression and enable her to be independent where possible.
Stacey enjoys using Picture Exchange Communications (PECs) to ask staff for things, such as a hand massage. Staff will also use the cards to let Stacey know when it’s time for her meals and medication.
Stacey has received a visit from the Speak and Language Team (SALT), who’ve implemented a ‘Now and Next Board’ for the staff to use with Stacey, so she has multiple communication methods to choose from to further develop her communication.
Stacey is non-verbal, but staff have heard her say her own name and communicate with noises, which has increased since receiving care from TCS.
Stacey enjoys sensory experiences at home and in the community. She spends time relaxing on her bean bag/pod and playing on her tablet, watching YouTube videos. She also enjoys dancing to music from Mamma Mia and Dirty Dancing.
Staff support Stacey to shower in the mornings to keep her clean due to her vomiting condition. She thoroughly enjoys the sensory feedback she gets from the shower.
She loves to watch TV and try arts and crafts activities. The staff are looking at other sensory activities for Stacey to try.
Our teams have worked closely with Stacey to create a bespoke care plan that supports her in developing meaningful relationships and positive experiences in her community.
Staff have built a strong professional relationship with Stacey and enjoy her fantastic sense of humour. The relationships Stacey has built with the staff has led to developments in her confidence, communication and ability to maintain a structured routine.
At times, Stacey displays behaviours of concern; however, due to the relationship she has with her care team, they are able to support and reassure her, which helps in de-escalation, preventing further incidents.
Stacey receives 2:1 support worker care. Then, 3 times a week, a registered nurse will oversee Stacey’s care to provide the clinical oversight for her wounds and medication support to reduce errors and risks.
Despite displaying behaviours of concern, Stacey has remained in her own home and has not been readmitted back to hospital.
Stacey was discharged at a weight of 39.7kg. With the implementation of structures, routines, trips to the community, and a big focus on building professional relationships with her TCS staff, Stacey’s weight has steadily increased.
Stacey is currently at a healthy weight and is now in the healthy BMI range for her age.
With the support of the TCS staff, Stacey has regular trips to the community, including visits to her favourite shops, bus and taxi trips and train watching.
Stacey’s team are continuing this progression and introducing new things at home and in the community to provide her with a varied day with sensory experiences.
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