Reference no: EM133278178

Case: Jane is now 16 but her story starts from the age of 8 years. Jane has a diagnosis of Autism; she has a communication impairment and is non-verbal but communicates her needs and wants effectively. She lives in her own home with 24 hour support with a sleepover shift. Jane moved into shared accommodation when she was 10 years old as her parents could no longer care for her in the family home due to various behaviours of concern. (As an example, the older sisters' bedroom doors were locked at night as Jane would go into their rooms while they were sleeping and pull them out of bed by their hair).The family home was unable to have loose or personal items accessible as Jane would throw the items and break them. This included pulling curtain down.

Jane lives in a three (3) bedroom home in a residential street. Jane has her own room and there is a room for support workers and a spare room that is used for storage. The house is surrounded by a two metre high fence and there have been changes made to the window in Jane's bedroom - a Pyrex window was installed as Jane had broken the original window with her fist the first week of living in the house. All house items are secured to the walls so that she is unable to throw them at support workers or other people that enter the house when displaying behaviours of concern. The kitchen can be entered by the lounge or the hall way - both doors have locks on them (but they are not to be locked unless cooking or preparing meals) so that the kitchen area can be safe for Jane and the support workers.

Jane uses various medications supplied by the pharmacist in Webster/blister packs and she also has PRN medication which can only be given on approval from the manager. Jane has a general practitioner, a psychiatrist and a behaviour support team supporting her.

Jane's family visit once a week and on special occasions she goes to the family home for the evening meal. A support worker accompanies her to assist if needed. Her family picks her up for outings; this depends on what is happening in Jane's life at the time.

Jane attends the special school for five (5) days a week from 0900 till 1430 and support workers attend school with Jane if requested by the teacher. If Jane is unwell or her behaviours are concerning she stays at home and this decision is made in consultation with the manager.

Jane's behaviours include:

biting
spitting
hitting
slapping
pulling hair
pulling clothing
stripping off own clothing
throwing objects
breaking items and smashing windows
scratching
eating inappropriate objects/items.

Jane needs to be prompted and sometimes assisted with personal care, the support worker is required to sit with and eat meals with Jane, walk with Jane in the community and undertake a range of other activities with Jane. All support workers need to work consistently and ensure that plans are followed correctly. Routine is important. Jane enjoys watching TV and listening to music. She chooses when she wants to do particular activities with support workers. Jane is learning how to take care of her own home.

Jane is encouraged to spend time on her own but the support workers must know where Jane is at all times and this must be done discreetly and non-intrusively.

Support workers attend training every 2nd week to ensure that the support workers are supporting Jane effectively and consistently using the same strategies across all shifts.

Shift details are below:

Shifts: 2 people on shift through the day - 1 person sleeps over

1430 till 2200 sleep over 0600 till 0900 Monday to Friday
0700 till 0900 split shift 1430 till 2200 Monday to Friday
0900 till 1500 Saturday and Sunday 2 staff
150 till 2000 two staff and then one staff member goes home and the other works till 0900 then does a sleepover
Jane wants to be able to go to the movies, go shopping and build a better relationship with her family especially her two older sisters who at times have resented Jane because of her behaviours. Jane will complete school at the end of the year so the organisation and her parents are looking at post-school options for Jane so that she is still getting out and being part of her community and doing activities that are meaningful.

Jane is better able to take control of her behaviours of concern but still has a Positive Behaviour Support Plan and the workers are having training once a month to work together to look at different strategies to assist Jane with how to better manager her behaviours especially the ones that may cause harm to others.

Jane's chronological age and her developmental age are different, but it is important that support workers do not underestimate her intelligence and treat her like a child as she is a young adult and has been well educated by her parents and the support workers.

New support workers spend several weeks learning how to effectively provide support to Jane and how to manage situations where the worker may be at risk of being hurt etc. Jane has learned lots of different techniques to manage her behaviours and she does this generally well. Support workers have also learned some strategies and techniques to de-escalate a behaviour before it escalates.

Question 1: Provide a detailed overview of the person's current situation and needs.

Question 2: List the members of the multi-disciplinary team and their roles identified in the scenario