From secure hospital to king of his own castle

February 23, 2018

Born in the late sixties in Greater Manchester, Anthony has three older siblings, two brothers and a sister.  At the age of seven and living with his parents, he became known to social care services. For the remainder of his childhood and teenage life he lived in a number of children’s homes and residential school placements, these usually ended after his behaviours proved too difficult to manage and he was eventually admitted to a secure inpatient service at the age of just 17.

Once discharged, he was placed into a Local Authority hostel, where, he disengaged from all support and fell into a path of self-neglect. He found himself living rough for periods of time, sleeping on the streets or on the sofas of ‘friends’. In his early twenties Anthony found himself in trouble with the police following an altercation and he was remanded in prison, and from there was transferred to a local Hospital under the Mental Health Act.

Anthony remained living in the hospital for the next 20 years, during which time he attended various therapy sessions and treatment programmes aimed at reducing his challenging behaviours. He underwent several moves on site, usually these moves followed altercations with staff or other patients. Whilst residing in hospital he learnt new skills including cookery (he was famous for his fruit cake), D.I.Y. and dry stone walling.

Anthony had a girlfriend at the hospital, and their relationship lasted many years whilst he lived on the site. When improvements in his behaviour resulted in a move to a step down service on the periphery of service, he was not supported to maintain the relationship and sadly it ended. He was allowed only minimal visits away from the step down house, usually to visit his mother, with whom he still has a relationship. It was during this phase that he learned to cope better with social interactions and eventually he reached the point when he was deemed ready for discharge.

Consensus’ Kingarth was identified as a suitable step down community placement for him. It is an innovative seven-bedded residential home with large communal areas, led by nurses. He was provided with his own private en-suite bedroom, and shared the kitchen and lounges with peers.

Initially he struggled with the new freedoms he had living in the community, however his support team encouraged him to implement a full activity timetable during the week. Having already acquired several useful life skills in hospital, Anthony happily engaged in activities such as woodwork and had a volunteer position in a charity shop. Unfortunately though, after a few weeks in each session, his motivation seemed to wane and he began to disengage.

When he first moved to Kingarth, in keeping with his service specification, he was supported only by male staff on a 1:1 basis. This did not always work well, and it soon became clear that he would often respond better when supported by females. Risk assessments were undertaken and his support package then modified with excellent results.

When he first moved into Kingarth there were only two others who lived there. As more people moved in, he struggled to cope and his behaviour towards others suffered. When he felt irritated, he would respond aggressively by making threats to harm them and sometimes he damaged property.

As one of Anthony’s goals was to further step down, it was recognised that he would make better progress if he lived in his own self-contained space, but somewhere where he still could have access to communal areas to interact with peers. Such resources are hard to find. He is a very sociable man and the risk was that he may have isolated himself and regressed if he lived entirely alone without access to others.

As he began to successfully take on more personal responsibility, he was encouraged to access the community without support. Through positive risk taking, his team completed a road awareness course with him and identified the routes he should take to ensure that he was safe and always used a crossing.

When living on the streets he had needed to be resourceful and had sometimes tried selling watches to people, and asking strangers for cigarettes. To ensure he did not revert to his old habits, the team undertook random checks on his progress to ensure that he continued to do well.

He came to enjoy the growing freedom and the responsibility and liked to run errands to the shops on behalf of others, proving he could be trusted with the money. As he struggled with literacy, a pictorial shopping list would be prepared for him, Anthony was doing well and it was clear that he was ready to take his next step towards greater independence.

Cheshire House in Trafford, another Consensus community based service led by nurses, but which operates on a flat based model rather than a shared house like Kingarth, was then identified as an ideal move on option. While it was being readied for opening, Anthony regularly visited the service, spending time in the local town each week to get to know the area. His new team then visited him at Kingarth and eventually he began spending time in his new flat prior to his final move. Despite a few nerves, Anthony eventually took the final step and successfully moved into his new flat in 2015.

As part of the transition process, his team encouraged him to personalise his new home by making choices about the colours of the walls, selecting furniture and customising its layout. After a lifetime of living with others or on the streets, Anthony had finally achieved his ambition of living in a place of his own. He engaged well with his support, enjoying cooking, baking, playing card games and watching TV. He purchased extra items of furniture for his flat, making it even more comfortable. Anthony openly acknowledges that having his own space and garden which he maintains to an immaculate standard, is one of the things that has proved to be good for him, he values it greatly and takes great pride in what he has achieved.

Since moving to Cheshire House, he has further developed his self-esteem, patience and self-confidence, and thoroughly enjoys going to the local shops independently. He does his own food shopping, and helps support team colleagues buy items needed for the house. He has undertaken voluntary work in a shop, has helped redecorate the service, undertakes important maintenance checks is able to budget and is much more patient and empathetic with those around him.

He continues to receive support and advice from his team to maintain and build upon longstanding friendships and family relationships, which remain very important to him. He also continues to develop his independent travel skills and has re-established his relationship with his long-time girlfriend, who he now visits on a weekly basis in her hospital setting. It has been a long journey but Anthony is making incredible progress and he can be rightly proud of what he has achieved so far. He is currently involved in planning the next step along his pathway – a move into a supported living! We are all firmly behind him and wish him well.