A
“Prior to working with the Pod we didn’t get much in the way of help I was constantly contacting the Caludon Centre to help as had no where else to turn. We then was referred to SICol working with the Pod they have really changed the way my husband feels about life and they are constantly helping with issues we have regarding our housing the Pod is a calming safe place where we can talk freely and know we get listened to and the help we need.”
The citizen will be referred to throughout this case study as “A” and their partner will be referred to as “B”. A was first referred to the Pod on 13th June 2023 through the SICol pathway and was handed over to Liam on 25th September 2023. Mike’s involvement began on 30th August 2023 when he started B’s Carer’s Assessment.
A is a 40 year old white British male who is married to B. B is A’s full time carer due to his mental ill health. A has previously had highly paid jobs at a large international bank and a leading software and electronics company. Due to issues with drugs A had to give up their job and entered a mental health crisis. It was at this point that A met B who “saved my life”. A also had a car accident in 2022 that caused severe injuries. A continues to be in high amounts of pain, has limited mobility and experiences nightmares and flashbacks from the accident.
A has the following diagnoses:
- Complex PTSD (from childhood abuse) – A has non-psychotic visual hallucinations (monsters), auditory command hallucinations telling them to hurt others, and gustatory hallucinations
- PTSD – from a Road Traffic Accident in October 2022
- Obsessive Compulsive Disorder
- Depression/Anxiety – acute suicidal ideation and constant impulse to self-harm – B manages this risk, removes all sharps from the home, but this is not a sustainable plan
- Autism – A has been diagnosed a Consultant Psychiatrist in 2023 with Autism
- Epilepsy
B is A’s full time carer, they have not had any social care support or respite in terms of their needs. B’s eyesight is also deteriorating. Any support needs to include both A’s and B’s needs. To be able to provide support a rapport and trust needed to be built between us and A and B. A has spoken about the comfort he now feels in our company and that this enables him to be more open about his challenges and have trust that we will follow through on any agreed actions and will inform them of any issues we face.
“ A: Was hard to come to terms with diagnosis the Pod and workers sat me down and was so caring and listened still have problems dealing with all this
B:looking after A daily is a struggle as above I have failing eye sight and health issues myself so need support to help the day to day things I do”
Initially there were two priorities, support with issues of damp and mould in the property that had been ongoing for a significant length of time and the completion of a carers assessment.
The damp and mould caused substantial health issues for both A and B as well as damaging the property. There was involvement from Citizen Housing, Drain Tech and us. The previous Development Worker also sought advice and involved the Community Law Partnership. There were a few challenges faced; Drain Tech and Citizen Housing had previously attended the property but due to A being unwell when they did had to reschedule. When they did reschedule it was for months in the future which was not at all appropriate given the health issues the property was directly causing A and B. The Community Law Partnership issued Citizen Housing with Hazard Awareness Notice which still did not cause the rescheduled work to be pushed forwards. A key element of this was that Citizen Housing and Drain Tech failed to take into account the specific needs of A and B when arranging jobs or visits – not notifying them of lateness or earliness, give late notice or no notice for cancellations or showing up without prior agreement. All of these caused significant distress to A and turn B. We used a human rights and legislative approach to assert A and B’s rights with the management of Citizen Housing. A subject access request was considered but was deemed not to be necessary following these conversations with management. Reasonable adjustments were put in place and time scales were agreed and met. Citizen Housing employees would not attend the property before scheduled and would inform A and B if they were going to be late. They also agreed not to show up unannounced and to be mindful that jobs may be cancelled if A was unwell on the day and that this should not impact on future bookings.
“We now feel a little more optimistic about our approach with citizen although they still turn up with no communication but out housing needs have now changed since A accident that’s why we need to move also the mental health I have witnessed A suffer through all of Citizen failings”
The Carer’s Assessment was completed and there were priority support needs identified. There was a Carers Trust referral completed which resulted in discussions with CRESS regarding a break for the carer, B. B identified that the main barrier to them accessing things they wanted to do was being able to trust that A was being well supported.
“As the carer and wife (B) I feel A needs support outside of the home to try and gather a little independence back and as the carer B I’m tired and need a break”
An OT assessment was carried out at the property, they stated that there was nothing more that could be done with the bathroom. This assessment has confirmed for us that the property is unsuitable with limited opportunity for improvement meaning that a move away needs to be considered. This is something that exploring alongside A and B. Any move would need to be carefully managed to reduce the disruption it causes for A while ensuring that the new property is fully suited to the current and future needs of A and B.
Gaming is a passion of A, after his car accident he was unable to hold a game controller due to the injuries sustained to his arm – he doesn’t have the wrist strength to hold the controller and his fine motor functions have been impacted as well. This has seriously negatively impacted on his mental health. A has said that games allowed him an escape from the hallucinations and depression he feels daily and that missing gaming is one hardest things to deal with at the moment. We found a couple of options, the first thing we found was that Sony have released an Access Controller for people with physical disabilities which can be found at this link. The other option was through a company called Special Effect which is a charity that specialises in allowing people with physical disabilities to access gaming, they can be found using this link. We decided to initially go with Special Effect as their process included an OT assessment over the phone and was personalised. The OT call was very quick after the referral and focused on A instead B or us who were also in the room. They sent out the equipment within a couple of weeks and said that if it didn’t work they would try different equipment and failing all else would source the Sony Access Controller. They also advised that the equipment was free, returns were free and the replacement of damaged equipment was also free. A did not get on with the first set of equipment and will be sending it back and requesting alternatives in the near future.
“Gaming means the world to A as this is a form of escape from reality and the constant voices monsters that are always present”
The Pod have received tablets and mobile phones through Coventry City Council’s Coventry Connects device bank. We identified a need for A and B to have a device to use for work, to enable Teams meetings with professionals and to keep in touch with family and friends. A and B have told us that this has been really positive for them and that B makes use of it all the time.
In terms of future work, our new priority is to look at the support needs of A and B and create a support plan which meets A’s needs an provides regular short breaks for B. We have identified a model of short break that might work initially and are going to trial it ourselves before introducing new people that A and B have no rapport with. We are going to take the On Demand Bus to travel to the city centre. One Development Worker will attend a gaming café with A while the other Development Worker goes to a coffee shop with B within a 2 minute walk. If this works, we will be looking to recruit a PA specifically for A. A and B will be able to write the job description and choose who they work with giving them ultimate control over the support provided.
“A just needs to feel as though he is safe when out which is a struggle as A doesn’t leave home unless appointment or B has to encourage him and stay with him”
Something that has been discussed passionately in each of our joint meetings is A’s love of football. This alongside gaming was very important to building the rapport with the Development Workers. A hasn’t attended a Coventry City game since they were playing at Highfield Road but would love to go to a game but is concerned that he wouldn’t be able to cope. We are exploring the possibility of A attending a game in Coventry City’s sensory room and have made contact with the club. This would be in the next season but would be very meaningful to A.