Aspire Support Ltd

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Asa and Zoe’s mission is to work to support Cornish people to return to or remain in Cornwall.

Near their families  – In their own homes.

 

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Partnership Working

Bringing together separate organisations so that they can benefit from pooled expertise, resources and power sharing. 

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Active Lifestyles

We believe that creating meaningful balance through taking a highly individualised approach to support and structure underpins good Physical and mental health.

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PBS

Positive Behaviour Support is values led and supports human rights and promotes respect, dignity, inclusion and a life without unnecessary restriction (UK PBS Alliance 2019).

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Asa

Asa

Lives in Cornwall and enjoys riding around the county on his motorbike and spending time with his family. 

Has been working with both adults and children with learning disabilities who present with behaviours that challenge services for 28 years. In that time he has been a registered manager for both adult and children’s services, worked in community learning disabilities teams both as a support worker and as a behavioural advisor. 

Worked in long stay hospitals, working to discharge individuals into community settings, and owned and ran a care company providing education and residential services for children with emotional and behavioural needs. 

He holds a qualification in Management Studies and project management and Has completed the Center for the advancement of Positive Behaviour Support at BILD (CAPBS) Positive Behaviour Support Coaches program.

Zoe

Zoe

Zoe Lives in South Devon in a damp cottage on the edge of Dartmoor with her family. She loves crochet, dogs and laying on the sofa.

She has worked with people with different abilities and unusual problem solving methods for nearly 25 years.

Starting in Residential care, through in-patient units, and creating and managing NHS specialist community teams.

She currently works for Salutem Healthcare as their Group Head of Positive Behaviour Support and has studied with the Tizard Centre and Cardiff University in Positive Behaviour Support.

Families

Do you have a family member who needs.full, or temporary support?

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Values

View our values and Care Commission statement of purpose.

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Funders

Looking to provide support for someone in need?

Making a Referral

Recruitment

We offer a range of opportunities fixed or flexible, part-time or full-time.

Vacancies

Aspire Support Ltd

Suites 3&4

BFM House,
The Parade.
Liskeard.
PL14 3UT

Company Number: 12200272

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Partnership Working

Partnership 2
  • With the person: 7 keys to Citizenship
  • With the community: Community Mapping
  • With organisations: Building the right support and small supports

Citizenship 

Aspire are members of the Citizen Network Community and use the Seven Keys Framework to help shape our services and grow the people we support, work with and employ. 

“Citizenship is a funny word – and it can have several meanings – but it is a useful word, because it can be used to describe how human beings can live together – with justice and mutual respect.

 

 

Citizenship means:

  • Being respected – being able to hold your head up high and getting respect from those around you
  • Being equal – citizens all have the same fundamental worth or dignity, they don’t believe that just because someone has more money, power or a better-paid job that this makes them a better person
  • Being different – citizens are not identical, they have many different gifts which they bring together to build a better world”https://www.centreforwelfarereform.org/library/keys-to-citizenship2.html 

The 7 Keys to Citizenship are: 

  1. Purpose – having goals, hopes and dreams and a structure for life and a plan to achieve this – having our own direction. 
  2. Freedom – having control and the ability to speak up and be heard and to be legally visible in society – taking charge of our own life. 
  3. Money – having enough money to live a good life and control over how that money is spent. 
  4. Home – having a place that belongs to us where we have control over everything that happens there and feel safe – a base for a good life. 
  5. Help – having good help that enhances our gifts, talents and skills and supports our standing, freedom, rights and responsibilities. 
  6. Life – making an active contribution to our communities – sharing our gifts – making a difference – learning with others – taking risks and having fun. 
  7. Love – having loving relationships – finding friendships – enjoying life, love and sex – being part of a family – respecting ourselves and the rights of others.

 

Community Mapping

We think that the social action approach of Community Mapping is a useful way to design and develop individualised services in a range of diverse and often rural communities. The community mapping process (also known as community asset or resource mapping), acknowledges that individuals, organisations / groups, and physical places all have the capacity to create real change in their communities, but that no one can do it alone. 

With increased accountability, tight budgets, resource shortages, and fragmented services, it is a sound decision to encourage cross-agency and cross-systems co-ordination and collaboration. It is important to understand: 

  • What local agencies and relationships exist and what may need to be grown
  • What resources  and events are available 
  • What Barriers are there to inclusion and what reasonable adjustments may be required

Community mapping focuses on the positives in an area, not the problems or deficiencies in a community. It tries to seek solutions to problems arising. The process involves getting people talking about what already exists in terms of social assets (individuals, community groups and organisations) and physical assets (eg. community centres, open spaces and businesses).

 

Building the Right Support

 

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https://www.england.nhs.uk/wp-content/uploads/2015/10/ld-nat-imp-plan-oct15.pdf 

Aspire Statement of Purpose

https://drive.google.com/drive/folders/1mThcBZlGP32fk0GeJ2LrKIBGfnUc6elv 

 

Small Supports

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We are really proud to be part of an emerging small supports network in Cornwall and were delighted to have won a grant from Partners for Inclusion as part of our growth and development plan. We want to be part of a future for Cornish services that nurtures collaboration to create great outcomes for people, rather than market competition for contracts.

What are Small Supports?

  1. From the first steps the person (and their chosen family and friends) has as much control as possible and there is a commitment to this control growing.
  2. The starting point to developing great support is the person’s aspirations about where they want to live and the life they want to have; conversation about support then follows from this. Compromising on control and aspirations is when things start to go wrong.
  3. Supporters (staff) are recruited by and around the individual. They don’t work across services. Staff are not a substitute for friends, community peers, co-workers and neighbours.
  4. People choose where they live and who, if anyone, they live with. People are the tenant or owner of their own home or perhaps live with family. There is a clear separation of housing and support.
  5. Funding is sustainable and is designed and used around the individual.
  6. Small supports organisations stay with people. Change and challenges are expected so they don’t withdraw support or ‘sell’ services on.
  7. In their work, leadership, recruitment and actions, small supports organisations are rooted in their local community.
  8. The organisations stay relatively small. Knowing each person well means not growing by more than three to five people a year and finding a natural size where people are known and valued, and the organisation is financially sustainable
  9. Small supports organisations are developed around these practices. Taking some of these practices and making them aspirations within large, segregated services will not deliver the desired outcomes.
  10. https://www.ndti.org.uk/change-and-development/small-supports 

If you think that you are or could be a small supports provider and would like to get involved please get in touch:-)

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Active Lifestyle

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Active Lifestyles

We are committed to supporting people, to find the activities and routines that keep them moving and active. Physical Activity is good for everybody. It is good for our physical health, helping us to loose weight, feel fit and live longer. It can also help with our mental health, and is effective at reducing the symptoms of depression and anxiety. But it also has lots of other benefits like:

  • Meeting people and making friends
  • learning new skills
  • Improve Sleep and memory
  • Support confidence and self esteem
  • Emotional and sensory regulation

Being active isn’t just about organised sports, it includes being outside and appreciating the best of what Cornwall has to offer and can range from walking to the shops instead of driving, to cold water swimming in a river. We all benefit from being outside and thriving in nature.

Resources

Physical Exercise Easy Read

https://www.mencap.org.uk/sites/default/files/2016-04/ELDSA%20easy%20read%20v1.pdf

Activity Alliance in Cornwall

http://www.activecornwall.org/disability-inclusive-sport

Thriving with Nature Workbook

https://www.mentalhealth.org.uk/sites/default/files/Thriving-With-Nature-compressed.pdf

 

Person Centred Active Support

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People who have a Disability are often prevented from developing or expressing their independence. They may need help to do some things for themselves. The greater the severity of disability, the larger the knowledge or skills gap becomes. With good support, planning and time we can help to fill this gap together. Active Support is a model of support which ensures that people are supported to participate in every aspect of their daily lives and to take the lead in functional and meaningful activities – staff essentially becoming enablers not carers.

Active Support has 3 components:

1. Interacting to Promote Participation. People who support the individual learn how to give him or her the right level of assistance so that he or she can do all the typical daily activities that arise in life.

2. Activity Support Plans. These provide a way to organise household tasks, personal self-care, hobbies, social arrangements and other activities which individuals need or want to do each day and to work out the availability of support so that activities can be accomplished successfully.

3. Keeping Track. A way of simply recording the opportunities people have each day that enables the quality of what is being arranged to be monitored and improvements to be made on the basis of evidence.

Resources

Active Support Easy Read

https://arcengland.org.uk/wp-content/uploads/2019/04/What-is-Active-Support-Easyread-1.pdf

Handbook:

https://arcuk.org.uk/publications/files/2011/11/Active-Support-Handbook.pdf

 

 

PERMA

Some people we support will only be discussed by their diagnosis and risks. We want to change that and start thinking about a person and what brings them joy and immerse themselves in activities that recharge them.

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1. Positive emotions: As human beings, we need to be able to feel good, hopeful, and inspired by the things we do and the life we live. It’s easy to see how we can allow our positive emotions to take the lead in our life when we feel good.

2. Engagement: Engagement is sometimes also referred to as ‘flow’ (Csikszentmihalyi, 2002). It’s the process of being fully engaged and immersed in the activities, duties, and tasks that fill our lives.

3. Relationships: Relationships are a crucial part of our sense of wellbeing and happiness. Positive, useful, and inspiring connections lead to more positive emotions, enabling us to feel heard, seen, and supported. 

4. Meaning: Building a sense of purpose and using that purpose to contribute to the community help us find meaning in life.

5. Achievement:  How we challenge ourselves in positive and progressive ways and setting feasible goals that we can reach and feeling a sense of progress in how we want to live our lives.

Resources

 

Health Action Planning

People with a Learning Disability, Autism or Chronic Mental health problems are more likely to experience and have a much wider range of additional  health needs. They are often precluded from primary health care and routine screening programmes. They are less able to tell others about how they are feeling This often leads to being overmedicated or incomplete treatment plans or dying earlier .

Where appropriate we will support the person and their healthcare professions to create a person centred Health Action Plan

Areas to be covered in a Health Action Plan and Individualised pain profile

1. List of current and historical health problems

2. Review of diagnoses

3. Physical Checks and reasonable adjustments: include consideration of:

i) general needs e.g., mammography, cervical cytology, menopause

ii) specific needs e.g., family history early vascular death, ca colon

iii) particular associations e.g., atlanto-occipital instability & Down’s Syndrome

4. Health promotion needs e.g., weight, sleep and nutrition

5. Review of immunisation e.g., Covid, flu, pneumoccal and hepatitis A

6. Review of medication, efficacy and side effects

7. Infection control e.g., Helicobacter

8. Dental review

Resources

What is an Health Action Plan Easy Read

https://www.mencap.org.uk/sites/default/files/2016-06/What%20is%20a%20health%20action%20plan%3F.pdf

Positive Behaviour Support

PBS

Recovery Focused Positive Behaviour Support

 

A person may experience periods of distress for a wide range of reasons. By using a Positive Behaviour Support (PBS) Framework we are able to think about a person and what they need for wellbeing, rather than just a behaviour and how we are going to manage it.

A recovery focused approach does not assume that a behaviour must be stopped, but how can we improve a person’s life to reduce the likelihood of future distress and enable them to have a valued and active lifestyle, irrespective of their challenges. Whilst PBS started from Applied Behaviour Analysis a recovery approach is Multidisciplinary, integrating formulations and solutions from a number of modalities, perspectives and voices.

Key principles of PBS Behaviour that challenges always happens for a reason and may be the person’s only way of communicating an unmet need. PBS helps us understand the reason for the behaviour so we can better meet people’s needs, enhance their quality of life and reduce the likelihood that the behaviour will happen. 

A PBS framework:  

Considers the person and his or her life circumstances as a whole including physical health and emotional needs such as the impact of any traumatic or adverse life events and mental illness.

  

Reduces the likelihood of behaviours that challenge occurring by creating physical and social environments that are supportive and capable of meeting people’s needs.  Is proactive and preventative and aims to teach people new skills to replace behaviours that challenge – and other skills that enhance the opportunities people have for independent, interesting and meaningful lives.  

Is likely to involve input from different professionals and include multiple evidence based approaches and treatments that come from a shared value base and are provided in a coordinated and person centred manner. 

These may include trauma informed care, autism specific approaches, active support and other appropriate interventions that support physical, mental health and wellbeing.

https://www.hee.nhs.uk/sites/default/files/documents/The%20key%20messages%20about%20Positive%20Behaviour%20Support_0.pdf  

All of our teams are trained in PBS and the individualised strategies for the person they support. Where appropriate, we will create a assessment led Positive Behaviour Support Plan, (not everyone needs one). Each plan will provide assessment led examples and guidance for teams and families through a stepped approach.

Positive Behaviour Support Plans

Pen Portrait: Who the person is and their unique history and experience of the world. Who and what is important to them. How they communicate and make choices, and feel safe in their world. This may include reference to separate PERMA plan or Active Support Opportunity Plans

Proactive Strategies: Everything that is put in place that reduces the likelihood of distress; for example managing situations that you know will trigger a behaviour, changing environments, and providing opportunities for new experience and acquiring new skills. This may include structured therapies such as Hydrotherapy and counselling.

Early Intervention: These are plans for what to do if the primary strategies do not work and behaviour starts to escalate. These might include using calming approaches, changing the environment, diverting the person’s attention to an activity they enjoy. This may also include the use of medication if appropriate or Cognitive Behavioural Strategies.

Reactive Strategies: These are planned, robust strategies that are put in place to be used as a response to an incident of challenging behaviour. They aim to take control of a situation and minimise the risk to the person and others whilst maintaining dignity. This may include restrictive interventions as a last resort.

Recovery: These are post incident strategies that may include immediate reassurance, first aid and rest to avoid re-escalation and facilitate physiological recovery and psychological safety for the person and their team. It may also include debriefing and reparative activities if required.

Review: Regularly review data and gather feedback to revise and develop the support provided to make sure that it reflects their current needs, interests, health and wellbeing and risks. 

Aspire are able to provide consultancy and training to people and services in Cornwall beyond Aspire, either for a fee or a resource sharing arrangement. Please get in touch if you would like further discussion.

Resources

Positive Behaviour Support for Families and carers

https://www.challengingbehaviour.org.uk/information-and-guidance/positive-behaviour-support/pbs-an-information-pack-for-family-carers/ 

PBS awareness training (free)

https://www.bild.org.uk/free-online-pbs-awareness-course/

Wellness and Recovery Action Planning

The 6 component parts of Wellness Planning and a good Positive behaviour support plan reflect each other intimately but with subtle differences in collaboration and use. A PBSP is primarily for a persons support team and WRAP is by and for the person. The people we support may have one or the other, or both, depending on where they are in their journey. We would hope that everybody would be able to create their own WRAP plan with support and time.

There tends to be a greater emphasis on self management strategies and the wellness toolbox in a WRAP. A person can create and revise their toolbox overtime and is a useful approach for a person’s team and their own self care as much as the person themselves.

There are a number of ways we can support a neurodiverse person to create their own plan:

  • By using Total Communication toolkits and Talking Mats
  • Creating a WRAP toolkit of practical materials and activities rather than ideas
  • Using Technology such as “brain in hand” and Alexa for immediate and concrete reminders and visual strategies
  • Emotional Literacy toolkits and individualised escalation scales. (Recently this has included Marvel Heroes and Doctor Who)
  • Adapting speed, presentation and content to maximise ownership and control without re-traumatising 

https://www.wellnessrecoveryactionplan.com/what-is-wrap/ 

 

Trauma Informed Care

“Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being”.

Many of the people we support and work with have experienced often repeated traumatic events that may include repeated placements, hospital admissions and abuse. The more complex a person’s needs are, the more likely they are to experience high levels of restraint and seclusion. 

We are particularly aware of the high risk of burn out and compassion fatigue in care teams and families and endorse life long learning and reflection through inclusive debriefing, training and supervision.

We are committed to acknowledging abuse in an open and shameless way and understand that understanding a persons past can help healing and recovery. In light of this Aspire are committed to a 4 Step Approach to Trauma Informed Care inbedding the following principles into our individual, team and organisational support plans and policies. 

Aspire

  • Realises the widespread impact of trauma and understands the potential paths for recovery
  • Fully Integrates knowledge about trauma into policies procedures and practices
  • Recognises the signs of trauma in the people we support, employ and engage with
  • Seeks to Actively resist re-traumatisation

Resources

Trauma Informed PBS webinar 

https://www.scld.org.uk/wp-content/uploads/2020/09/Resources-Trauma-Informed-PBS.pdf 

Pathway from Trauma to poor outcomes

https://www.learningdisabilitytoday.co.uk/trauma-informed-care-and-intellectual-disability 

PACE

PACE is an approach developed by Dr Dan Hughes, an American psychologist who works with traumatised children. PACE stands for Playfulness, Acceptance, Curiosity and Empathy. These principles help to promote the experience of safety in interactions with young people and adults with attachment difficulties.

Acknowledging trauma and attachment difficulties are pivotal to wellbeing. PACE creates a wonderful way to articulate and prioritise what is important in a Support Workers role. Training, mentoring and supervision all come together to create accepting and resilient relationships.

Playfulness allows people to cope with positive feelings. It also gives hope. If you can help the person discover their own sense of humour, this can help them wonder a little more about life and how come they behave in the ways that they do. This is about creating an atmosphere of lightness and interest when communicating. It means learning how to use a light tone with your voice, like you might use when story telling, rather than an irritated or lecturing tone. It’s about having fun, and expressing a sense of joy.

Acceptance is about actively communicating to the person that you accept the wishes, feelings, thoughts, urges, motives and perceptions that are underneath the outward behaviour. It is about accepting, without judgment or evaluation, their inner life simply is; it is not right or wrong

Curiosity is the foundation of acceptance of whatever underlies the behaviour.  Making sense of how the the person has learnt to behave in certain ways can help with acceptance

Empathy lets the person feel compassion for them. Being empathic means the people around the person actively showing them that there inner life is important, and they want to be with them even in hard times

https://ddpnetwork.org/about-ddp/meant-pace/ 

How we support PACE in Practice

  • Step aside from confrontation using low arousal approaches
  • Opportunities to repair mistakes with collaborative debriefing and restorative activities
  • Rituals and routines that secure and reaffirm belonging and togetherness
  • Have opportunities for choice making and logical consequences
  • The team around the person are trained and supported to nurture rapport and trust
  • Time to “be” is valued and protecte

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Company Values

values

Staff Survey Survey Summary

About You
★★★★★ 4.5/5
About Your Team
★★★★★ 4.5/5
About Aspire
★★★★★ 4.5/5

Staff Survey 2022

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Full Survey
About You
★★★★★ 4.5/5
About Your Team
★★★★★ 4.5/5
About Aspire
★★★★★ 4.5/5

Staff Survey 2022

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PBS

Values 

As a service we have core values that will create a foundation to all of  our work and interactions. 

Collaboration: To work together with the person and the people who  support them to identify and take steps to meet their goals through  adapting materials and routines, ensuring they remain at the centre of the  life they choose. 

Integrity and humility: Respect and value for the people we support, the  staff we employ and the families and professionals who work with us to  meet joint goals. This is what we promise and hope for and is reflected in our  behaviours and outcomes.  

Transparency: As a service and as individuals we take care and effort to  be open about our beliefs and behaviours and remain accountable for our  actions 

Care Quality Commission Statement of Purpose

We will provide trained staff to support people with a Learning Disability and/or Autism or an Acquired Brain Injury in their own homes across a 24hr cycle to meet their needs, as described by the person, the people who represent them and the commissioning authority. The people we support may have a secondary diagnosis of a Mental Health Disorder, Physical or Sensory Disability.

Aims 

  • To enable people to be successfully discharged or avoid unnecessary placement breakdown or admission to an inpatient hospital.
  • To provide person centred care in a supportive and dynamic environment.
  • To support the person to lead an active and valued lifestyle that fosters autonomy and independence.

Objectives

  • To facilitate and nurture a valued community presence and active participation within the persons local community.
  • A robust, flexible and skilled staff team, trained and supported to meet the person’s needs and support their aspirations..
  • To be a learning organisation that commits to transparent and collaborative practice.
  • To support people to develop and maintain good physical, mental and emotional health.

Mission and Values

We will work with Commissioning Bodies to identify people most at risk either through admission or placement breakdown as a result of behaviours that are difficult to manage.

Each identified individual will have a support system built around them, from bricks and mortar up through, individual service designs, to matching staff for shared interests.

We will work closely with the person and their supporters to establish and maintain a collaborative approach that uses adaptive communication to share and review aims and actions across systems in an evidenced based way. 

Funders/Commissioners

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Online Referral

Information for Commissioners

 

Aspire is a small service that is able to create and maintain individually designed Person centred care for people with Learning Disabilities and or Autism who may display behaviour that challenges. We will enable those who wish to return, or remain, in their communities with their families and friends. 

 

Right Support 

  • We will provide Supported living and community enabling services to promote independence to people living in their own homes, who require support with daily living and personal care. 
  • There may be occasions where people would like to live together and this will be done either through existing or relationship based matching process. 
  • We will not provide accommodation, but will provide support to the person and their circle of support to create and maintain appropriate Tenancy agreements, adapting materials and support to help them make the decisions or utilising Lasting Power of Attorney or Court Appointed Guardians where needed. 
  • The properties will be sourced with the person and their families to meet their unique lifestyles and evidenced needs, located to enable them to access the communities and facilities that are important to them. 

Right Care 

  • We will enable people to have access to the activities that give their life meaning, whether that be sports based activities or socialising with friends, irrespective of their disability through positive risk taking. This might be things they used to do in the past or things they might like to try for the first time. 
  • Making choices is integral to Adult life and materials and routines will be created to meet the communication strengths and preferences of the individual such as symbols, relationships and bite sized decisions. Where a person is unable to make all of the decisions about their life, we will engage with their family and friends, whilst still adapting materials, so their voice is still present within the process 
  • Teams will use Person Centred Active Support to increase independence in identified leisure, work and home based activities by using structured teaching methods and enablement approaches “the right support at the right time” 

Right Culture


Values: As a service we have core values that will create a foundation to all of our work and interactions. 

      • Collaboration: To work together with the person and the people who support them to identify and take steps to meet their goals through adapting materials and routines, ensuring they remain at the centre of the life they choose. 
      • Integrity and humility: Respect and value for the people we support, the staff we employ and the families and professionals who work with us to meet joint goals. That what we promise and hope for, is reflected in our behaviours and outcomes. 
      • Transparency: As a service and as individuals we take care and effort to be open about our beliefs and behaviours and remain accountable for our actions 
      • Practice: We will use an evidenced based approach to care collecting outcome based data and feedback to inform decision making that will include: 
      • A trauma Informed Positive Behaviour Support (PBS) Model to enable the person, their staff and support circle to stay healthy and well. Each person will have personalised strategies to maintain good physical and emotional health, effective early intervention to respond to indicators of distress and
        robust crisis management plans. 
      • We will identify and take careful steps to Reduce all unnecessary Restrictive Practice and closely monitor the use of any remaining restrictions in a transparent and collaborative way. Staff and families, and where possible the person, will train together in the frameworks and strategies to deliver these approaches in line with the Restraint Reduction Network training standards and PBS Alliance Framework. 

How we will meet the National Service Model 

  1. A good and meaningful life
    1. Person Centred Active Support Plans that set goals for increasing independence in learning, work and leisure.
    2. Proactive and positive engagement with the local and wider community.
    3. Use of Assistive Technology to promote independence .

2. Care and support

    1. Assessment informed Positive Behaviour Support and Plans written in collaboration with the person and their circle of support.
    2. Inclusion of family and friends into the persons daily support
    3. Matching of staff for personal and professional skills and preferences.
    4. Accessible electronic support plans that include person centred outcomes and goal setting, with permissive access to family members.

3. Choice and control

    1. Individualised and proactive Health Action Plans.
    2. Accessible communication passports with personalised systems to maximise self advocacy and choice making such as talking mats.
    3. Individual Service Funds where possible.
    4. Joint working with the persons circle of support for decision making under the Mental Capacity Act when needed.

4. Support from Family

    1. Training made available for families/carers.
    2. Support staff trained in PBS, Person Centred Active Support and the Human Rights Act as part of the Induction process.
    3. The person and their families are supported to train their teams using a range of multi media tools where possible.

5. Choice of housing

    1. Housing needs and preferences are assessed prior to a property being found.
    2. In the community of the persons choosing.
    3. On their own or with a friend (with separate tenancies).
    4. Tenancies are benchmarked against the Real Tenancy Test.

6. Access to Mainstream NHS services,

    1. Proactive engagement with Primary Care Services including preparing the person and their health team for an Annual Health Checks.
    2. Creation and maintenance of individualised Health Action Plans and Hospital Passports.
    3. Reasonable adjustments made ahead of planned and unplanned care e.g. Necessity for side rooms or home visits.

7. Specialist health and social care support 

    1. Planning partnerships with specialist placement teams and NHS Community Learning Disability Services for individualised packages of support.
    2. Participation Multiagency Core Team and Blue Light Meetings for periods of Crisis.
    3. Evidenced based Monitoring and Review with Health care professionals such as data informed reduction plans. 

8. Staying out of trouble 

    1. Proactive risk assessment to reduce the likelihood of risk to others in the community including contingency plans.
    2. Engagement with people and facilities in the community to reduce points of potential conflict Eg Ways of paying, asking for help. 
    3. Adapted teaching materials and strategies to maximise capacity and good decision making Such as Social Stories and role play. 
    4. Everybody will have a debriefing system that helps them learn from mistakes and help to avoid repeating the same mistakes in the future. 

9. Accessing an acute or psychiatric Hospital

    1. We will support a fast and safe pathway back to their home making the length of stay as short as possible, working alongside family members, actively participating in a Multiagency discharge process.
    2. Maintaining contact throughout the duration of their stay, if the person’s wishes.
    3. Providing hospital staff with information and advice regarding the person’s individual support needs, particularly indicators of pain and distress.