At Apple House care homes we strive to support residents to lead a healthy lifestyle and to be as independent as possible. We provide access to a programme promoting healthy living and wellbeing, with home cooked fresh food, regular exercise, and creative activities. This article outlines why it is important to give people with autism the opportunity to take part in creative activities and regular exercise.

Challenges for people with Autism

For people with autism, you may notice that they can have challenges in interacting in social situations as it can be overwhelming at times with direct verbal communication. We may not get a direct response or eye contact and we can wonder if we have been understood. So it may also be a struggle to build a relationship with them through words alone.

At times people with autism can have rigid mindsets as this may be their way of making sense of the world around them. So, therefore, change can be difficult as they feel reassured by a routine that gives them a sense of control. They may not always understand that a change in routine may be something beyond their carer’s or parents’ control. Such as the illness of a friend or a change in who supports them due to outside factors.  They may need help in regulating their emotions in response to these situations.

Sensory experiences

Jackie Edwards (2017) describes how people with autism may have difficulty making connections between their tactile, vestibular and proprioceptive sensory systems where they may be overactive or not active enough with how they interact with their environment.  For example, they may have a hypersensitivity to loud noise or bright light, may also be de-sensitised to tactile experiences. So, therefore, they would benefit from a sensory diet to improve sensory integration.

She advocates giving people with autism access to different sensory experiences to help improve concentration and attention. This in turn may help them to be able to regulate awareness of their surroundings more effectively as well as to help them relax and not feel overwhelmed, leading to increased socialisation and interaction, promoting less rigid thinking, creativity, and motor skills.

Benefits of exercise

At Summerwood we recognise the importance of exercise by helping our residents access their community, take part in physical exercises such as the gym and swimming, and helping with gardening, tending the vegetable patch etc.

According to Healy S, et al. (2018) research shows that for people with autism exercise can have a number of benefits:

• Reducing stereotypical behaviours or self-stimulating behaviours
• Improving social skills with sports that promote teamwork
• Helps to reduce weight gain or obesity
• Can increase a person’s attention as repetitive behaviours can decrease
• Exercise can reduce anxiety and improve the ability to regulate emotions, build resilience to anxiety-triggering situations
• Exercise can improve motor skills and coordination for people with autism

Benefits of creative activities

The creative arts is another important activity and we support individuals to participate in regular arts and music classes in the community and within Summerwood, their home.

Art can give a person a sense of control as they learn to adapt to the task in their own way. Drawing and painting can also help to improve and maintain fine motor skills. Creative arts can be an effective way to engage with the person in a non-pressurised way. Tactile art forms such as paint and clay also provide a sensory experience to fulfill the needs of the person to be able to balance their sensory experiences more effectively. Music can elicit interactive emotional responses and melodic rhythms can help them engage.

Arts and wellbeing

People with disabilities can be more vulnerable to mental health issues so we are aware that it is important to provide a way for people to communicate their emotions appropriately. Behaviours on the surface may arise due to an inability to verbally communicate how they feel. Behaviours thus can have a function so this highlights the importance of non-verbal communication and communication aids to help people communicate their needs.

For further assistance, creative arts therapy with a trained art therapist can be a way for a person to be able to express and/or regulate their emotions when words are difficult. It can also help to improve cognition and emotional regulation where the aim is to use the art materials or creative activity to access emotional wellbeing and to help a person learn to regulate their emotions and understand themselves within a safe and facilitating environment.

— By Andrew Wright, Support Worker, Summerwood Care Home, Hants (Previously Rated ‘Outstanding’ by CQC).

References and further reading

Draycot, C. (2013) Educating Autism – Art and Creativity to Engage an Autistic Child in the Classroom. The Art of Autism: Connecting through the Arts. https://the-art-of-autism.com/educating-autism-art-and-creativity-to-engage-an-autistic-child-in-the-classroom/

Edwards, J. (2017) The benefits of multi-sensory environments. Autism Journey Blog.

Healy S (2018) The effect of physical activity interventions on youth with autism spectrum disorder: A meta-analysis. Review article. Autism Research. 11(2) · April 2018.

Rudy, L.J (2017) How Does Art Therapy Help People With Autism? Very Well Health. https://www.verywellhealth.com/art-therapy-for-autism-260054

As the risk of coronavirus increases, the government is urging organisations to put in place contingency plans to mitigate its potential impact – but what will be needed and when is still uncertain.

Apple House today released our COVID-19 (coronavirus) Contingency Plan which is a working document to keep our team and people we support safe and to plan for worst case scenarios in the event the virus spreads or is declared to be a pandemic. Planning for all eventualities is a sensible step even though we all hope the current containment of the virus in this country will continue.

A copy of our Plan, as well as our policy and procedure and COVID-19 fact sheet, is available in our homes. Please ask a team member for a copy if you would like to read it. In the meantime, please see the new link on the right of our website home page for the latest Government update.

Please be assured that Apple House has in place its own robust emergency plans as well as stringent policies and procedures around infection control. The health of our staff team and those whom we support is key and we will remain vigilant and continue to monitor the situation. — Jane Montrose, Managing Director, Apple House care homes.

Situation in the UK

Two patients in England have tested positive for coronavirus. Chief Medical Officer for England, Professor Chris Whitty, has shared a statement. If more cases are confirmed in the UK, it will be announced as soon as possible by the Chief Medical Officer of the affected country.

Based on the World Health Organization’s declaration that this is a public health emergency of international concern, the UK Chief Medical Officers have raised the risk to the public from low to moderate. This permits the government to plan for all eventualities.

The risk to individuals in the UK has not changed at this stage. Our advice for travellers from Wuhan and Hubei Province remains unchanged from the below and we have added further advice for travellers from elsewhere in China.

As of 31 January, a total of 177 UK tests have concluded, of which 175 were confirmed negative and 2 positive.

1,466 passengers and 95 staff arrived in the UK on direct flights from Wuhan between 10 and 24 January.

• 162 of the passengers have already left the UK
• 53 of the crew have already left the UK
• 866 are now outside of the incubation period

Public Health England are working to contact the remaining passengers.

We have been working in close collaboration with international colleagues and the World Health Organisation to monitor the situation in China and around the world.

The Department of Health and Social Care will be publishing updated data on this page on a daily basis at 2pm until further notice.

Information about the virus

A coronavirus is a type of virus. As a group, coronaviruses are common across the world. Typical symptoms of coronavirus include fever and a cough that may progress to a severe pneumonia causing shortness of breath and breathing difficulties.

Generally, coronavirus can cause more severe symptoms in people with weakened immune systems, older people, and those with long-term conditions like diabetes, cancer and chronic lung disease.

Novel coronavirus (2019-nCov) is a new strain of coronavirus first identified in Wuhan City, China.

Advice for travellers from China

Travellers from Wuhan and Hubei Province

If you have travelled from Wuhan or Hubei Province to the UK in the last 14 days you should immediately:

• stay indoors and avoid contact with other people as you would with the flu
• call NHS 111 to inform them of your recent travel to the city

If you are in Northern Ireland, call your GP.

Please follow this advice even if you do not have symptoms of the virus.

Travellers from elsewhere in China

If you have travelled from elsewhere in China (but not Macao or Hong Kong) to the UK in the last 14 days and develop symptoms of cough, fever or shortness of breath, you should immediately:

• stay indoors and avoid contact with other people
• call NHS 111

If you are in Northern Ireland, call your GP.

Please follow this advice even if your symptoms are minor.

What this means in practice

We are asking people to take simple, common-sense steps to avoid close contact with other people as much as possible, like they would with other flu viruses.

This means remaining at home for 14 days after arriving from Wuhan or Hubei Province (or elsewhere in China if you have symptoms) and not going to work, school or public areas.

Where possible, you should avoid having visitors to your home, but it’s ok for friends, family or delivery drivers to drop off food.

Transport

You should not use public transport or taxis until 14 days after your return from Wuhan or Hubei Province (or elsewhere in China if you have symptoms).

Getting food and medicine

We recommend that you stay at home for 14 days after arriving from Wuhan or Hubei Province (or elsewhere in China if you have symptoms), and avoid public places. Where possible, contact a friend, family member or delivery services to carry out errands on your behalf.

Taking children to school

We recommend that you stay at home for 14 days after arriving from Wuhan or Hubei Province (or elsewhere in China if you have symptoms), and avoid public places. Where possible, contact a friend or family member to take your children to school.

Why the advice has changed

This is an evolving situation and the advice has changed based on emerging information from China about the number of cases and spread of the infection from person to person.

This is a highly precautionary measure to limit the potential spread of infection.

If you develop symptoms and have returned from mainland China

If you develop a fever, cough or shortness of breath, you should continue to follow the advice above. Please do not leave your home and call NHS 111 immediately.

Summary of action taken

We have introduced advanced monitoring at airports with direct flights from China.

A team of public health experts has been established in Heathrow to support anyone travelling in from China who feels unwell. These hubs will bring in rotational teams of 7 clinicians, working in shifts, who will be on hand to support patients on arrival. This is in addition to medical staff who are already permanently in place at all UK airports and the advice issued to all UK airports for people travelling to and from China.

The government has issued clinical guidance for the detection and diagnosis of novel coronavirus (2019-nCov), and infection prevention and control.

The Chief Medical Officer, Medical Director at PHE and Medical Director at NHSE/I have issued advice via a CAS (Central Alerting System) alert to frontline staff to increase awareness of the situation and any actions to take.

Most people who develop symptoms will get them after leaving the airport and so the priority is providing UK residents and travellers with the latest information to make sure they know what to do if they experience symptoms, and the NHS and PHE have an established plan to respond to someone who becomes unwell.

China has also introduced port-of-exit screening so people already exhibiting symptoms are not allowed to leave the country.

Diagnosis and analysis

Based on current evidence, novel coronavirus (2019-nCov) presents with flu-like symptoms including a fever, a cough, or difficulty breathing. The current evidence is that most cases appear to be mild. Those who have died in Wuhan appear to have had pre-existing health conditions.

The UK is now one of the first countries outside China to have a prototype specific laboratory test for this new disease. Healthcare professionals who are contacted by a patient with symptoms following travel to Wuhan have been advised to submit samples to PHE for testing. Individuals should be treated in isolation

After the experience of severe acute respiratory syndrome (SARS) in 2003, PHE developed a series of diagnostic tests to detect any member of the family of coronaviruses. These have been used for several years, and were able to detect the first UK case of Middle East respiratory syndrome (MERS) in 2012.

With the first reported publication of the genome sequence of a 2019 novel coronavirus, PHE was able to rapidly develop further specific tests for this virus, working with WHO and global network of laboratories.

When a clinician suspects novel coronavirus (2019-nCov), they take samples from the nose, throat and deeper respiratory samples, package and send them safely to PHE Colindale. PHE can provide a laboratory result from this specific virus on the same working day.

PHE also has the capability to sequence the viral genome and compare this to published sequences from China, if a case occurs. This will provide valuable information on any mutations in the virus over time and allow an improved understanding of how it spreads.

Further information

• Statement from the four UK Chief Medical Officers on Novel Coronavirus
• British nationals in Hubei Province: Foreign Office statement
• CMO for England statement on novel coronavirus (2019-nCov) (24 January 2020)
• joint statement from DHSC and PHE on novel coronavirus (2019-nCov) (22 January 2020)
• clinical guidance on novel coronavirus (2019-nCov)
• Novel coronavirus (2019-nCov) and avian flu: advice for travel to China
• Novel coronavirus (2019-nCov) – NHS

Published 24 January 2020 
Last updated 31 January 2020 + show all updates

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“Help protect yourself, your family and the people you support. Get your free flu jab”. — Romaine Lawson, Director of Operations, Apple House care group.

For the coming 2019/20 flu season we at Apple House are part of the Public Health England and NHS England & NHS Improvement campaign which focusses on the protective benefit of the flu vaccination using a “Shield” motif.

If you work with people in health or social care, you’re more likely to be exposed to flu – and to pass it on. That’s why the flu vaccination is free to all frontline health and social care workers and we promote this as the preferred route for all of our teams.

Being healthy won’t stop you getting flu or passing it on. The flu virus can infect anybody, and even someone with no visible symptoms is still at risk of passing the virus on. Flu virus strains change, so it’s important to have a flu jab every year ahead of the flu season. And remember, having a flu jab can’t give you the flu.

Help protect yourself, your family and the people you support. Get your free flu jab.

–Romaine Lawson, Director of Operations, Apple House care group.

Some years ago, D dreamed of being a karate black belt. At the time it seemed such a far off aspiration–where to start? One step at a time, we suggested, with the very first lesson, that initial moment of excitement and possibly fear.

Yesterday D was presented with his black belt, after years of dogged determination and hard work and he couldn’t be happier!

D has given his kind permission for his photo and wonderful achievement to be shared with you:

Mr * discovered his passion for the martial art some years ago and, through dogged determination, has moved through each stage and a rainbow of belt colours in striving for his dream of attaining a black belt.

Thank you Mr * for permitting us to share his image and his good news!

We went through the health check first and then I signed the consent form. The flu vaccination is a great way to have peace of mind that I will be as protected as possible from the strain which can be so debilitating to myself but would also have such a big impact on those around me.

The vaccination is quick and easy and I didn’t feel a thing.

As part of our ongoing Health, Safety and Welfare monitoring for Apple House Ltd we remind and recommend that all of our employees take up the opportunity to have the influenza vaccination.

Every year we, as a company take on board the latest guidance to be issued from NHS England and encourage all people working for Apple House Ltd to be vaccinated. We have historically always paid for this for our teams as we know how important it is to remain healthy for ourselves, colleagues and for the people we support.

This year NHS England have confirmed that free flu vaccinations are available in 2018/19 for social care workers who offer direct care to people using services.

This is open to all health and social care staff, employed by a registered residential care/nursing home or registered domiciliary care provider, who are directly involved in the care of vulnerable patients/clients who are at increased risk from exposure to influenza. Vulnerable means those patients/clients in a clinical risk group for flu or who are aged 65 years and over.

NHS England have confirmed that this includes staff directly involved in the care of vulnerable people who are at increased risk from exposure to influenza who are working for registered:

• residential care homes;
• residential nursing homes;
• domiciliary care services;
• Shared Lives schemes;
• extra care housing services;
• supported living services.

Let’s all stay well this year and banish those bugs.

You can get more information from the NHS website HERE

— Romaine Lawson, Director of Operations, Apple House care homes.

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