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Is ‘being’ the new ‘doing’ in learning disability services?

Is ‘being’ the new ‘doing’ in learning disability services? And what can we learn from pandemic inactivity – activity?

Ambient Support’s learning disability services locked down to the outside world at the outset of the Corona virus threat, and this led to some considerable anxiety, not least amongst its staff.

Ambient use a person-centred approach to care and support and over a year ago invested in training from BILD (British Institute of Learning Disability) for a cohort of staff to train in Positive Behaviour Support (PBS). This included 38 Ambient team members working towards completing the BILD PBS Coaches programme.

This training has proved to be invaluable when meeting the challenges of a lockdown world, where prior to the pandemic, many of Ambient’s learning disability service users had thrived on a lifestyle of activity and socialising.

People enjoyed packed calendars containing a busy mix of day centre, leisure, sport and social activities, centred around their wants and preferences. The arrival of the Corona virus saw people’s routines and daily lives threatened with inactivity and disruption.

Phil Akrill, Training Consultant for Ambient’s learning disability services commented: ‘Our team of PBS Coaches represents a wide cross section of our workforce including Regional Managers, front line staff, Team Leaders and Support Managers.

They were just in the process of completing their workplace assignments when COVID-19 struck and were centring their efforts on injecting PBS values and knowledge directly into staff teams, whilst being available to offer coaching and mentoring. The effect of the lockdown has seen that integration of PBS practice and theory shared and developed within services at an accelerated pace.’

Tom Harrison, Director of Operations & Development for Ambient continued: ‘Initially we did experience a spike in some challenging behaviours from people using our services. Routines and schedules had been disrupted and we were facing the unknown, trying to keep people informed of the threat of the virus, without raising anxieties, in addition to keeping people safe in their now restricted environments and movements.’

Soon however, Ambient staff noticed differences in their services that they had not previously anticipated. Anecdotal stories and evidence started to surface that whilst things were changing for people, in many instances these changes were for the better.

Tom Harrison, continues: ‘Incredibly what our teams started to notice was that many of the people we support were showing decreased levels of anxiety. A user of our supported living services in Suffolk who had lived with Alopecia has had to have her first haircut in 7 years since lockdown began!

We have seen relationships flourish between people in supported living, who despite sharing a home for many years had never really interacted socially. People have started to form new friendships and bonds. Staff have had more space and time and actually having less choice of ‘things to do’ has given people space to have real choice.

We have examples of improved physical health with people taking full advantage of their daily exercise. One gentleman resident with us has lost over a stone in weight. He has also enjoyed a newly discovered hobby of gardening.

A service user sitting in the mini bus and smiling

Additionally, we are starting to see real hard evidence of reductions in behaviours that challenge. In one region alone a Support Manager that had been reporting up to 5 self harming incidents a month with one individual has seen this reduce to 1 a month since lockdown began. That’s a pretty powerful statistic and examples like this are mirrored in other regions.’

Whilst fully accepting that lockdown restrictions are not for everyone and there will be a huge number of people looking forward to a time when they can return to day centres and activities, they previously had enjoyed.

Tom Evans, CAPBS Development Lead for BILD commented: ‘It’s great to hear the positive stories and developments despite the challenging circumstances. I’m delighted that the lockdown has led to an acceleration of colleagues using that which they’ve learnt on the PBS Coaches programme to increase people’s quality of life. It’s also heartening to hear that there is the willingness to look again at what we do and how we support people into the future.’

A service user enjoys time in the colourful ball pitPhil Akrill and the team of Ambient PBS Coaches will be working with BILD to produce a definitive Case Study which documents some of the positive effects that people have experienced since lockdown.

Phil Akrill continued: ‘Life in lockdown has been a real learning curve and I feel sure there are many lessons we and many others in the sector will take away from it. At Ambient we will be introducing a new ‘quality of life measurement tool’ in the coming months to further evidence the fantastic work that is going on across our services.’

But perhaps the final word should go to one learning disability service user whose comment about lockdown really gives all of us working in the sector, food for thought when she said: ‘I don’t want to go back to how it was. The world finally works how I want it to work. Less people around, less crowds, less pressure to achieve or go places.’

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