Violent special needs/autism teenager help!

eskimo26

Racheldevon wrote: »

Hi, I work with lots of child protection cases.

I would suggest that you make a formal complaint to the practice manager (this will be the social worker's direct line manager), and I would copy in the Operations Manager/Director for Social Care. If you put it as a formal complaint (and state this in your letter), they will have to initiate /follow their complaints procedures.

I would look back at the care plan, and agreed actions that you say haven't been carried out, and refer to each one as a separate paragraph in your letter. I would do this by linking it back to the assessment framework/triangle used within social care (which you can find online) and outline the way that each area that failed to to materialise from the care plan is affecting the daughter, but also the wider family. Then outside of the previous care plan, highlight any additional incidents/behaviours/developments etc and refer to the impact of each one with regards to the framework

Thank you for your quick replies.

Rachel as far as i know she does not currently have a care plan but it is something they keep telling the Parents they will do.

In the core assessment started on 1st December 2011 and finished in March, it clearly states a 'recommendation for a care package for support.'
They acknowledge they asked for overnight respite and 'there is a risk of further deterioration if no support is provided. In the core assessment started on 1st December 2011 and finished in March, it clearly states a 'recommendation for a care package for support once the provision of universal services have been explored,' and in the same sentence, 'the family are already accessing universal services and they are still struggling to meet her needs.'

I don't want to accuse the social worker of something she didn't do but suffice to say support was patchy. They might have got a carer but it was a few hour a week and very temporary, respite consisted of 2/3 overnight stays within 5 months. It's like they started but didn't finish.

The majority of what they have done is refer the parents to other services in the community [the universal services].

I'm going to check these facts with the parents.

Thanks again.

Will making a complaint help them respond faster to the immediate situation or just peeve them off? [ probably both]. :eek:

shegirl

Dunroamin wrote: »

A long as they're coping, even if only just, Social Services will let them.

That's very true.

I'm a single parent (with NOBODY to support-only even see friends 6/7 times a year lol),ds (13) severely autistic with other problems including 'challenging behaviour' which occurs in school aswell. went without our weekly overnight respite for 8 weeks in summer,I was bruised to high heaven and his disability social worker said she would 'pull out all the stops' to get transport for his normal respite for an occasion but only if I got to the point of 'really,really,really not being able to take anymore' and at breakdown point.So we had nothing at all as they know I just get on with it,no matter what.

They wouldn't do anything to help when I needed to go to hospital and couldn't walk either (not due to ds but it wasn't easy looking after him in that state!)

They can also only do what is asked of them and accepted.You need to chase them up with these things or you get nowhere.

As to whether you can get instant respite for 3-4 months I very much doubt it.Same goes with 'voluntarily putting her in care',it's not that simple with these kids.There isn't a never-ending instantaneous supply of suitable placements for them.It needs planning.

What type of care are they thinking of using the money for?

As for the 'inconsistent parenting' like it or not that will have an affect of the daughter and her behaviour,so they need to get help with that.that will then help to improve their situation.

Unfortunately,the biggest problem here is your uncles health and you all need to work out what to do.If they get carers in can he have a rest or a few days away to relax?

Have to say that I agree with the social workers view on removal and saying there are other things that can be done.Removal/residential should be the last port of call,see what is available.

shegirl

Can I ask if they see CAMHS and if the daughter is on any medication?

eskimo26

shegirl wrote: »

That's very true.

I'm a single parent (with NOBODY to support-only even see friends 6/7 times a year lol),ds (13) severely autistic with other problems including 'challenging behaviour' which occurs in school aswell. went without our weekly overnight respite for 8 weeks in summer,I was bruised to high heaven and his disability social worker said she would 'pull out all the stops' to get transport for his normal respite for an occasion but only if I got to the point of 'really,really,really not being able to take anymore' and at breakdown point.So we had nothing at all as they know I just get on with it,no matter what.

They wouldn't do anything to help when I needed to go to hospital and couldn't walk either (not due to ds but it wasn't easy looking after him in that state!)

They can also only do what is asked of them and accepted.You need to chase them up with these things or you get nowhere.

As to whether you can get instant respite for 3-4 months I very much doubt it.Same goes with 'voluntarily putting her in care',it's not that simple with these kids.There isn't a never-ending instantaneous supply of suitable placements for them.It needs planning.

What type of care are they thinking of using the money for?

As for the 'inconsistent parenting' like it or not that will have an affect of the daughter and her behaviour,so they need to get help with that.that will then help to improve their situation.

Unfortunately,the biggest problem here is your uncles health and you all need to work out what to do.If they get carers in can he have a rest or a few days away to relax?

Have to say that I agree with the social workers view on removal and saying there are other things that can be done.Removal/residential should be the last port of call,see what is available.

Hi,
They have a behavioural nurse who has been working with them for about 5 years.

The thing is at this time they are at breaking point, his 63 with half a lung left and on oxygen every night and he has had a stroke in the last week.

I think his health is serious at risk, the stress is very likely to have caused the stroke. They are very loving parents but it takes a very strong person to meet these kind of care needs, and i would not describe them as strong at all.

They have no problems with the other twin she is in mainstream secondary aiming at high GCSE's results but she doesn't need anyone to take the lead or be strong headed and stoic.

UPDATE:
Just spoke to my Uncle about the recommendations of the core assessments.

Since the completion of the core assessment in March respite has consisted of literally 2/3 nights over the holiday period only. There is no care plan in place currently. There has not been any official attempt to establish a carer by social services on any basis.

These were all recommended or observed to have been asked for in the core assessment. Is it cause for complaint? Was 6 months long enough to act on the core assessment and to what degree?

They also visited the offices out of desperation recently to ask for respite and where told 'its not that easy we have to find the right place for her'.

The assessment states she is currently on a waiting list for a charity that gives practical help to carers and they are unsure when she will be allocated. Should i contact them as well?

"We give practical help to carers looking after relatives or friends in their own homes by providing a flexible relief care service for the carers. Its aims are:

• to relieve stress on carers and their families
• to avoid admission to hospital or residential care of the person being cared for at home
• to strive to maintain a high standard of care.

We are run by a voluntary committee consisting of representatives from health, social services and voluntary organisations together with carers and disabled people."

eskimo26

shegirl wrote: »

Can I ask if they see CAMHS and if the daughter is on any medication?

Hi we cross-posted.

There is no involvement from CAMHS as far as i'm aware and they have asked the Doctor about medication but he claims they is nothing for her case.

My Uncle has basically sat on this for years because he was embarrassed/ashamed and has only now approached us as they are at breaking point.

shegirl

eskimo26 wrote: »

Hi we cross-posted.

There is no involvement from CAMHS as far as i'm aware and they have asked the Doctor about medication but he claims they is nothing for her case.

My Uncle has basically sat on this for years because he was embarrassed/ashamed and has only now approached us as they are at breaking point.

It's not a normal doctor you see about medication.It comes from a psychiatrist-normally after referal from psychologist.Did they ask a GP?

My son is on Aripiprazol which is an antipsychotic,normally used for adults.However,it can prove useful in reducing the height of anxiety in autistics which can then help with violence-of course you need to work on teaching methods of dealing with things aswell.It's not something given out willy nilly but,along with others,it's something that can be prescribed for kids at certain levels.

To me,it sounds a if help has never been there for them in many forms,partly due to them being unaware and not sure what to do/what is out there and partly due to social services.Either way social services need pushing,even when they do a 'carers assessment' it doesn't actually mean they'll provide everything unfortunately.

The parents clearly need help on a few levels,not only with having a break but learning how to deal with things,keep their consistency etc.The saddest part is that the daughter may have escalated so much due to inconsistency and lack of input or support to the parents.

I'd be asking for referals to psychologist and psychiatrist.It's the psychologists who help with the behaviour and work with you to try to change it.You also need to understand causes and the reasoning.Hopefully,with some help paid for in the next couple of weeks and requesting referrals they may start to make some progress.

man_of_faith

Really do sympathise.

Not sure if this suggestion is of any use but is it possible to get a PRN medication (some form of medication to calm down individuals in crisis) from GP or oncall mental health team.

Not sure of what else can be done.

You could try to call out of hours Social Services and as for an urgent assessment of needs due to crisis situation.

Call on call GP possible to ask for individual to be assessed under the Mental Health Act for a section due to distressed state seeking assessment for distressed state.

With such behaviour it appears to be important that health of the uncle is paramount.

Another possibility may be that your areas SS has a contract for short term urgent care contract with social and health care providers that can provide emergency support at home at short notice. Out of hours call may be the best starting point.

Hope you get support and help needed.

Man of Faith

Fire_Fox

Involve any charity you can find and as many people at social services or in mainstream healthcare as you can, I think push the angle of the health of the parents being in crisis - GP might be able to write letters for this. A GP is not a specialist, they may not know the ins and outs of medication for the daughter's case. Consider involving the ward councillors and MP if social services are unhelpful or unsupportive.

shegirl

Fire_Fox wrote: »

Involve any charity you can find and as many people at social services or in mainstream healthcare as you can, I think push the angle of the health of the parents being in crisis - GP might be able to write letters for this. A GP is not a specialist, they may not know the ins and outs of medication for the daughter's case. Consider involving the ward councillors and MP if social services are unhelpful or unsupportive.

That's raised a point.

OP,does the parents GP have then down on their system as carers?Firstly,if not they should be,there seems to be a form of priority and support by doing so.

Also,if they go and see their GP about general health and wellbeing and their struggles with caring for their daughter the doc may offer (or they can ask) contact with social services based on this.

nlj1520

I have been in a very similar situation and I did get emergency respite, I phoned the emergency duty team to report that there was an episode going on that I could no longer deal with (this was after an episode lasting 20 hours during which my house was trashed and I had furniture and books thrown at me as well as the usual kicking etc). I then spoke to the para-legal who was helping us prepare for an educational tribunal..........she kept phoning the emergency duty team and eventually I got respite immediately. i was too shaken to drive my son there, so a friend drove me. After a week Social Services made approaches saying he should come home with a personal budget and some respite package. On advice (from a professional who advised me off the record) I said if they sent him home I would not be there. I informed Social services, the police and the Child Protection Officer of what I had said. I was summoned to a meeting and went fully expecting to be arrested for abandonment. I just had to keep saying he could not come home. It broke my heart and I still get torn apart by grief. However he stayed in a wonderful respite place until I sorted out a residential school for him. He thrived there and is now 20 and in a supported living environment.
The thing that made the difference was Social Services staff actually witnessing an episode (and one got her glasses broken). So I suggest that the caring family call the emergency duty team (often on ansaphone) every single time there is an incident and summon them to come and help as soon as a human being answers. I was advised to call the police but was worried that my son would hit a police officer who might not understand autism so I never did.
Immediate respite is available bit you have to do things that break any loving parents heart in order to get it.
My heart goes out to the family and their situation is intolerable. But you can get through it, you have to be prepared to do some pretty painful things in order to do so. It is a nightmare, but as people with autism mature the challenging behaviour tends to reduce.
My son does take medication prescribed by a Psychiatrist..........and anti-psychotic and an anti-epileptic (not in a fit reducing dose but as a mood stabiliser) and they have worked well.
PRN just refers to any mediciine given on an 'as needed' basis. My son had Lorazepam prescribed but it didn't work and there was nothing stronger available.
All the very best.