The People We Support
Young People in Transition
The transition from school or college is a critical time for young people with learning disabilities and their families. It marks the move from school to adult life and from children’s to adult’s services. Many young people, particularly those with severe learning disabilities are likely to require continuing access to a combination of support services in order to enjoy a good quality of life in adulthood.
Individual circumstances differ, but transition planning may need to consider the young person’s future in terms of their future daytime activities after leaving school (further education; supported employment; day services, or a "package" of different activities)
  • living arrangements (remaining in the family home; moving to more independent living and the kind of accommodation and support that might be required)
  • Leisure opportunities during the evenings and at weekends
  • General and possibly specialist healthcare needs
  • Entitlement to disability-related and other benefits
  • Foundation for People with Learning Disabilities
  • The Support provided through Protea
Protea provide support packages to young adults, offering the opportunity to grow as an individual and gain the necessary skills required to move on to greater independence. Support is focused around enabling the individual to be socially active and to build a network of friends and family, employment and/or education opportunities that are important elements when planning for the future.

Continuing the person centred approach, a taste of increased responsibility and reduced support can be introduced to allow the individual to plan and prepare for the future. With a structured moving on plan and the experience of increased independence, there is a greater opportunity for success
in the future.

To aid this approach, Protea offer a wide range of residential care homes, single and multi-occupancy supported living schemes, along with day opportunities, outreach and domiciliary care services.
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Learning Disability
What is a learning disability?
People with a learning disability find it harder than others to learn, understand or communicate. There are many different types of learning disability. They can be mild, moderate or severe. Some people with a mild learning disability do not need a lot of support in their lives. But other people may need support with all sorts of things, like getting dressed, going shopping, or filling out forms.
People who have a severe, or profound, learning disability and a physical disability may need a lot of support 24 hours a day. This is known as profound and multiple learning disability (PMLD).

Many people with a learning disability live independent lives. It is important to understand that people with a learning disability are individuals with their own personalities, likes and dislikes, goals and ambitions. A learning disability does not prevent someone from learning and achieving a lot in life, given the right support.

Mencap The frequency of complex health needs and behaviour that challenges occurring in people with a learning disability is higher than in the average population and increases in proportion with the severity of their disability.
Principles of Support
All people with a learning disability are people first with the right to lead their lives like any others, with the same opportunities and responsibilities, and to be treated with the same dignity and respect. They and their families and carers are entitled to the same aspirations and life chances as other citizens.

Rights
People with learning disabilities and their families have the same human rights as everyone else.

Independent living
This does not mean living on your own or having to do everything yourself. All disabled people should have greater choice and control over the support they need to go about their daily lives; greater access to housing, education, employment, leisure and transport opportunities and to participate in family and community life.

Control
This is about being involved in and in control of decisions made about your life.This is not usually doing exactly what you want, but is about having information and support to understand the different options and their implications and consequences, so people can make informed decisions about their own lives.

Inclusion
This means being able to participate in all the aspects of community, to work, learn, get about, meet people, be part of social networks and access goods and services, and to have the support to do so. Valuing People Now 2009 The Support provided through Protea.

Person Centred & Outcome Focused Approach
Support is focused around the needs and wishes of each individual, working towards independence & enabling self direction through collaboration with family, carers and keyworkers in achievement of individual goals and aspirations.

Health
Physical & mental health needs are continually assessed to ensure the best health & wellbeing for the people we support. As far as is practicably possible, Service Users are supported to manage their own healthcare needs through an individual health action plan.

Risk Management
Positive risk management recognises and builds on an individual’s strengths through the development of personal support plans and risk assessments that support and encourage potential through reasonable risk taking.

All behaviour is a form of communication that tells us how the person we support is feeling or what they are thinking. The team support people to develop alternative ways to communicate their needs.

Involving the People we Support
Individuals are supported and encouraged to take the lead in their own lives. Involvement in Service User forums, newsletters and staff recruitment is promoted and staff will support access to local community activities and opportunities including employment.

Staff Training & Development
Each service is led by a Service Manager who has relevant experience around people with learning disabilities. Mandatory and specialist staff training is developed around the needs of the people that are supported within that service.

Regulations
Services are regulated by the Care Quality Commission (CQC) who carry out regular inspections to ensure we comply with their regulations and fulfil our service obligations as providers of good quality care.

Quality Assurance & Monitoring
Quality Assurance forms a central part of determining the direction of services by encouraging Service Users, families, staff and relevant professionals to share their views, concerns, compliments and complaints to enable the service to continually improve.
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Autistic Spectrum Disorder
What is autism?
Autism is a lifelong developmental disability that affects the way a person communicates and relates to others. Many people with autism have a learning disability but all will have difficulty in making sense of the world.
The range and severity of autism can vary greatly which is why it is also referred to as autism spectrum disorder. Autism is not a condition that can be seen and does not have physical features.
What are the characteristics of autism? All people with autism have problems with social interaction, social communication and imagination. They are referred to as the 'triad of impairments' by clinicians.

Social Interaction - People with autism tend to be socially isolated and have difficulty forming social relationships. They may seem distant or
uncaring to others.

Social communication - People with autism have problems with verbal and non-verbal communication. They also have problems with understanding feelings, emotions or vague concepts. They are unable to give what is considered appropriate eye contact and have difficulty in understanding gestures and facial expressions.

Imagination - People with autism have difficulty in the development of play and imagination, and find it difficult to take part in pretend play. They prefer stability and dislike changes in routine.

Are there any treatments or therapies for autism? - There is no 'cure' for autism as it is a lifelong developmental disability. Specialist education and appropriate support can make a difference to the life of a person with autism.
Mencap
Principles of Support
The Government’s vision for transforming the lives of and outcomes for adults with autism is:‘All adults with autism are able to live fulfilling and rewarding lives within a society that accepts and understands them. They can get a diagnosis and access support if they need it, and they can depend on mainstream public services to treat them fairly as individuals, helping them make the most of their talents.

For adults with autism, this means:
  • having a right to receive an assessment of need from social services
  • getting the same opportunities for education and further education as everyone else
  • being able to choose where to live – just like anyone else
  • having relationships and social networks
  • having their health needs properly met in a way which is appropriate for someone with autism
  • being safe from hate crime and discrimination
  • living in a society where people understand, respect and accommodate difference, and
  • receiving support to live independently, as appropriate
‘Fulfilling and rewarding lives’ The strategy for adults with autism in England (2010)

The Support provided through Protea.
Person Centred & Outcome Focused Approach - Support is focused around the needs and wishes of each individual, working towards independence & enabling self direction through collaboration with family, carers and keyworkers in achievement of individual goals and aspirations.

Health - Physical & mental health needs are continually assessed to ensure the best health & wellbeing for the people we support. As far as is practicably possible, Service Users are supported to manage their own healthcare needs through an individual health action plan.

Risk Management - Positive risk management recognises and builds on an individual’s strengths through the development of personal support plans and risk assessments that support and encourage potential through reasonable risk taking.

All behaviour is a form of communication that tells us how the person we support is feeling or what they are thinking. The team support people to develop alternative ways to communicate their needs.
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Korsakoffs Syndrome
What is Korsakoffs Syndrome?
Korsakoff’s Syndrome is a severe memory disorder that is associated with excessive, long-term alcohol misuse resulting in the loss of specific brain functions due to the lack of vitamin B1 or thiamine. Korsakoff’s syndrome is included under the umbrella term Alcohol Related Brain Damage.
Korsakoff’s syndrome presents as the end-stage development of a disorder known as Wernicke’s encephalopathy. In 1881 Karl Wernicke a neurologist and psychiatrist in Germany, noticed three key symptoms in patients suffering with alcoholism:
  • mental confusion
  • Eye movement disorders
  • Ataxia - uncoordinated movements
  • Later, S.S. Korsakoff, a Russian psychiatrist, reported a new cluster of symptoms in patients with severe alcoholism:
  • Anterograde amnesia -an inability to form new memories
  • Confabulation -making up memories to fill in gaps in memory
  • Apathy-lack of spontaneity, or repetitive behaviour
By 1900 the two syndromes were connected as the first and second phases of the same condition and became known as Wernicke-Korsakoff Syndrome. 85% of Wernicke encephalopathy survivors go on to develop Korsakoff syndrome.

Once treatment is administered, initially in the form of large doses of thiamine, the progress of the disease can be halted only if alcohol is not taken. Any improvement in the person’s life and interpersonal skills may take up to two years of treatment.

Korsakoff sufferers are capable of new learning on some levels, particularly if they live in a calm, predictable and well structured environment, where any new information is cued with either visual or verbal prompts.

The Potens Support Model at the Arbennig Unit in North Wales

Using 6 Principles of Care:
Abstinence
staff will support residents to work on the issues which led them into alcohol misuse and to develop relapse prevention strategies, with close involvement of local services and Care Managers. A No Alcohol policy will be enforced to prevent further impairment.

Daily Living Skills
by using FIM FAM UK and providing a structured and predictable environment, residents are supported to carry out all daily living skills using previous skills through preserved implicit memory, and where possible learning new skills.

Improvements in Health
Improvements in mental and physical health to enable optimum performance in rehabilitation. To achieve this, close liaison with GP, Consultant Psychiatrist, Care Managers and Dietician will be facilitated and maintained.

Meaningful Activities
Staff will encourage residents to participate in alcohol free activities, within the local and wider community.

Family, Friends and Professional Involvement
where appropriate, to use family and friends to ensure complete life history is available, so that support can be based on a person’s whole life - before and after diagnosis, with emphasis on explicit memory. In addition to develop and/or recover family relationships if deemed to be beneficial for all parties.

Everyday Memory Functioning
to understand Anterograde Amnesia, and use practical everyday measures to make use of preserved implicit memory e.g. cues, arrows, whiteboards and household manuals.
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Asperger Syndrome
What is Asperger syndrome?
Asperger syndrome is a form of autism and is used to describe people at the higher functioning end of the autism spectrum. It is a life-long condition and is more commonly diagnosed in males than females.
Asperger syndrome shares many of the same characteristics as autism, such as the triad of impairments, but people with Asperger syndrome usually have fewer problems with language, often speaking fluently.People with Asperger syndrome are less likely to have learning disabilities that are associated with autism and may have average or above average intelligence. There are some differences within the triad of impairments from ‘classic’ autism.
What are the characteristics of Asperger syndrome?
Asperger syndrome shares many of the same characteristics as autism, such as the triad of impairments, but people with Asperger syndrome usually have fewer problems with language, often speaking fluently.People with Asperger syndrome are less likely to have learning disabilities that are associated with autism and may have average or above average intelligence. There are some differences within the triad of impairments from ‘classic’ autism.

Social interaction
In contrast to people with ‘classic’ autism, people with Asperger syndrome may not appear to be withdrawn and uninterested in the world around them. They still, however, have difficulties understanding non-verbal signals such as facial expressions, which makes starting and keeping relationships difficult.

Social communication
They usually have good language skills but may not be able to interact with the person they are talking to, i.e. they may not take notice of the reaction of the person listening and talk on regardless of the listener’s interest. They may also have problems understanding descriptions, explanations and jokes. They may use language in an over precise, over literal manner.

Social imagination
Whilst they are very good at learning facts and figures, people with Asperger syndrome find it hard to think in abstract ways. People with Asperger syndrome often develop an almost obsessive interest in a hobby or collecting such as remembering train timetables or the size and scope of a cathedral. They need routine and find change upsetting. Changes in routine can make a person with Asperger syndrome upset and anxious. Are there any treatments or therapies for autism? - There is no 'cure' for autism as it is a lifelong developmental disability. Specialist education and appropriate support can make a difference to the life of a person with autism.

Principles of Support
The Government’s vision for transforming the lives of and outcomes for adults with autism is:‘All adults with autism are able to live fulfilling and rewarding lives within a society that accepts and understands them. They can get a diagnosis and access support if they need it, and they can depend on mainstream public services to treat them fairly as individuals, helping them make the most of their talents.’

For adults with autism, this means:
  • having a right to receive an assessment of need from social services
  • getting the same opportunities for education and further education as everyone else
  • being supported to get a job and stay in work
  • being able to choose where to live – just like anyone else
  • having relationships and social networks
  • having their health needs properly met in a way which is appropriate for someone with autism
  • being safe from hate crime and discrimination
  • living in a society where people understand, respect and accommodate difference, and
  • receiving support to live independently, as appropriate
‘Fulfilling and rewarding lives’ The strategy for adults with autism in England (2010) The Support provided through Potens Person Centred & Outcome Focused Approach - Support is focused around the needs and wishes of each individual, working towards independence & enabling self direction through collaboration with family, carers and keyworkers in achievement of individual goals and aspirations.

Health
Physical & mental health needs are continually assessed to ensure the best health & wellbeing for the people we support. As far as is practicably possible, Service Users are supported to manage their own healthcare needs through an individual health action plan.

Risk Management
Positive risk management recognises and builds on an individual’s strengths through the development of personal support plans and risk assessments that support and encourage potential through reasonable risk taking.

Behaviour that challenges & Potens Behaviour Support & Therapy Team
Potens BST team work closely with Potens services offering advice, guidance and training around any individuals with behaviour that challenges. The team is made up of a Behavioural Psychotherapist and a Behavioural Therapist with specialist skills around behavioural issues and autistic spectrum disorder including Aspergers Syndrome.

All behaviour is a form of communication that tells us how the person we support is feeling or what they are thinking. The team support people to develop alternative ways to communicate their needs.
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Mental Health Needs
Mental illness is very common. About one in four people in Britain has this diagnosis, but there is a great deal of controversy about what it is, what causes it, and how people can be helped to recover.
People with a mental illness can experience problems in the way they think, feel or behave. This can significantly affect their relationships, their work, and their quality of life. Having a mental illness is difficult, not only for the person concerned, but also for their family and friends.
Mental illnesses are some of the least understood conditions in society. Because of this, many people face prejudice and discrimination in their everyday lives. However, unlike the images often found in books, on television and in films, most people can lead productive and fulfilling lives with appropriate treatment and support.
Principles of Support
The Care Programme Approach has four main elements:

Assessment
systematic arrangements for assessing the health and social needs of people accepted by the specialist mental health services

A Care Plan
the formation of a care plan which addresses the identified health and social care needs

A Key Worker
the appointment of a Key Worker (now Care Co–ordinator) to keep in close touch with the patient and monitor care

Regular Review
regular review, and if need be, agreed changes to the care plan The Care Programme Approach for people with a mental illness referred to specialist psychiatric services 1991 Effective Services for People with severe mental illness

Standard four
all mental health service users of CPA should:

receive care which optimises engagement, anticipates or prevents a crisis, and reduces risk have a copy of a written care plan which: includes the action to be taken in a crisis by the service user, their carer, and their care co-ordinator; advises their GP how they should respond if the service user needs additional help; is regularly reviewed by their care co-ordinator be able to access services 24 hours a day, 365 days a year

National Service Framework for Mental Health, Modern Standards & Service Models for Mental Health 1999 Mental health problems are common; they are illnesses with causes and treatments, like physical illnesses. New Horizons marks a new agreement between individuals and health and care services that ‘the greatest degree of effective recovery is gained from early identification and treatment’.

New Horizons confirms that people with mental health problems are able to run their own lives, participate in the life of their families and communities, and work productively to earn their living and contribute to the economy, to varying degrees – just like people with physical health problems. It identifies different types and levels of support that people can expect to enable them to do these things. New Horizons, A Shared Vision for Mental Health 2009
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