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

At the most basic level, stress is our body’s response to pressures from a situation or life event. Some common features of things that can make us feel stress include experiencing something new or unexpected, something that threatens your feeling of self, or feeling you have little control over a situation. [Mental Health Foundation]

In the following article, Jayne Jackson, registered manager at Apple House care home, writes an open and very insightful reflection on how stress plans can and do have a profoundly positive impact for a gentleman she supports:

Our care plans are person centred and very individual to each of the people we support.
I was looking at environmental risk assessments & policies for stress. This centred around how we could look after staff’s health and what they/we could do to help in their day-to-day working environment, which we know at times can be stressful.This prompted me to look at the people we support [in relation to stresss]. We looked at easy read documents and set up a meeting.

The easy read document comprised general things to help lower stress/anxieties. We wanted our support plans to be personalised to suit the needs of the individual.

We worked with each person individually and discussed what we could do to help them stay settled and reduce their stress levels.

For one individual this was a massive achievement as in the past just discussing and writing information could cause him to experience high levels of stress.

We worked very closely over many years with the gentleman to help him learn to trust us. We use the phrase ‘it’s good to talk’ and this person now quotes this phrase.

This plan would not have worked for this person if they did not sign up to it.

He spent time with us, we listened to him, we built ‘his’ support plan. It is important that the person has ownership over ‘their’ plan. When he is feeling stressed we refer to the plan and this keeps it fresh in his mind. We all stick to the plan; this is key in keeping his well-being stable.

This plan cannot work without the individual being involved, it is not a paper exercise, it is a live tool.

The stress support plan runs alongside others that all interlink. He is now beginning to recognise when he is feeling troubled, or finding things difficult and, with our support, he is starting to work them out.
The individual works with us. We ensure he has time to reflect, to identify what is worrying him.

Breathing exercises, conversation and space are used; usually after 10 minutes he feels able to talk about what is happening. We must ensure that the person and staff have clarification that they have settled as this prevents further stress. A physical change can be seen within him – his body language and speech will return to pre-stressed levels, and he appears calmer. This is not just a one-off thing as this may happen a few times a day, or weeks may pass without presentation of stress.

Because of the trust we have built, continuity of the team and knowing and respecting the individual it could be said that he has a better quality of life. Sure, there are stressful days for him, we all have those, but learning to cope with them is what we support him to do.

I cannot tell you how proud I feel of him and the team; it is lovely to see the person more involved in day to day things, and by doing this it also helps him to have a renewed sense of purpose and to feel valued, staying focused forming part of his routine.

This individual wrote an additional support plan with staff which was linked to additional stress; he took it to a meeting with his psychiatric team and asked them to sign up to it which they did.

He then wrote to his link mental health team and asked to be discharged. We supported him in writing a letter and discussed the benefits, including self-esteem, that he would feel. His mental health team told us they never thought they would see they day this gentleman would be signed off [from their care].

This is a massive achievement for him!

Due to the hard work and commitment of my staff, their link team and the individual himself, he has stayed settled for over a year following years of mental health decline.

In our compliment folder, the person’s mental health team praised Apple House. They commented how well we had supported the person when they had deteriorated in their mental health and suffered episodes of depression and mania, they had never see this person doing so well. This was signed by the person’s community nurse. This person was told if they remained stable for the next year they would be signed off.

Jumping forwards a year, well its happened, he has been discharged!

We look forward to maintaining his wellbeing and will continue to encourage him to further develop and reach his personal goals.

— Jayne Jackson, registered manager, Apple House care home, Bournemouth.

🔊 Listen to this

Finalist for The Frontline Leader Award

 Rebecca Blackmore:

Here are some of the things that our manager Sharron and the team have to say about Bex:

Rebecca who is known as Bex started working in our company in 2014.

Caring, compassionate and focused on helping and supporting people to be the best they can possibly be.

One of her strengths is also her cooking ability. Utilising this skill Bex is able to support individuals with healthy eating. She uses aids such as easy read menu’s and supportive technology, supporting individuals to understand the types of foods in their meals and understanding healthy options.

Bex has also inspired the individuals during house meetings to: choose a country, plan shopping lists, discuss a menu from the country, discuss utensils needed to make the meal, along with looking up information with individuals regarding the culture or the country. This will culminate once a month with the  person preparing the meal and hosting a lovely party. This creative use of skills in enhancing peoples lives and teaching independent living skills is wonderful and a real credit to Bex.

Her confidence has grown immensely, and this has transpired into Bex working and now achieving a senior role within Redcroft, taking on extra responsibilities such as Fire Marshal. Along with supporting staff as our advocate for dysphasia, oral health and supporting staff to be more confident in themselves.

She goes the extra mile when it comes to looking for fun ways to raise money for charities; Bex has helped to raise money for Macmillan, Red Nose Day and local Dorset charities. She rallies the residents round and gets them fully involved which gives people a sense of purpose and well-being. Bex has helped to raise awareness of these good causes and wanted the people she supports to feel a part of that experience. She is a shining example of a brilliant support worker and we are proud to nominate her for this award.

Thank you Bex for everything you do and we are all very proud of you.

The National Learning Disabilities & Autism Awards offer a unique opportunity to showcase and celebrate the successes of individuals, teams and businesses in the learning disabilities and autism sector – people and organisations who really do make a positive impact on people’s lives. They aim to pay tribute to people who specifically support those with learning disabilities and autism and recognise inspirational individuals with a learning disability and/or autism who make a real difference within their communities.

— Romaine Lawson, Director of Operations

We are proud to announce that Apple House Ltd are finalists in the following categories:

The Outstanding Contribution to Social Care Award – Jane Montrose

This award will be presented to an individual who the judges think has made a long-term outstanding contribution to the lives of people with a learning disability and/or autism.

The Supporting Older People with Learning Disabilities Award – Jayne Jackson and the Apple House Team.

Let’s celebrate excellence in supporting older people with a learning disability or autism. The judges are looking for evidence from providers and individuals who are positive about older people, provide excellent person centred support, promoting independence, dignity and respect.

The Breaking Down Barriers Award – Apple House Team

We like it when we can see good access and easy read, as it helps to include all and encourages everyone to communicate more clearly and get around more easily. The award will celebrate an individual or organisation who have worked to make sure people get clear information and are able to contribute their views and experiences.

The People’s Award – ES who resides at Redcroft.

This award will presented to an individual or team of people with autism or a learning disability. We want to celebrate individuals or organisations who offer exceptional encouragement and support for individuals with learning disabilities and or autism in providing support services and or personal development and inclusion.

The Employer Award – Apple House Ltd

This award seeks to acknowledge and celebrate an exceptional employer who is committed to their employees delivering an excellent service to their customers, people with learning disabilities or people with autism and their families. Employers should be able to provide considerable acumen and entrepreneurial flair whilst at the same time having a sustained track record of delivering high quality care and managing change improvement.

The Great Autism Practice Award – Summerwood Team

The overriding goal of good autism practice is to enhance quality of life for individuals, families and supporters by making reasonable adjustments or providing support developing strategies to increase happiness and wellbeing in people with autism. This award will be presented to a team or individual who demonstrate evidence of good practice in their services and support to people with autism.

Joined by CQC and leading representatives of the sector, presentations and discussion will centre on what is already being achieved and what work can be done to take John’s Campaign’s ethos even further forward.

John’s Campaign was founded in 2014. Since then, overwhelming support has been shown from across the UK. Over 1000 wards, hospitals and other institutions have pledged their support. 58 MPs from across political parties signed an Early Day Motion in December 2014. Following this, the then PM, David Cameron, voiced support on the Andrew Marr show. A year later, NHS England officially endorsed the campaign, including it in their 2016/17 Commissioning for Quality and Innovation payment framework.

Apple House proudly adopted the core principles of John’s Campaign in 2017 and were commended for this by CQC as part of their inspection which led to a rating of our Hampshire care home, Summerwood, as ‘Outstanding,’ achieved by only 1% of care and nursing homes in the UK.

On Thursday we will be discussing how we greatly value the excellent inclusive relationships we work hard to establish and maintain with family and friends of people we support.  

Our team extends beyond ourselves in reaching out to the people outside our organization for their ideas, input and involvement.  We do this by whatever means are appropriate to the individual and can include social media, Skype, our Open-Door policy and regular face-to-face meetings.

— Jane Montrose, Managing Director, Apple House Care Homes.

Staff had an excellent understanding of people’s needs and worked with them to ensure they were consulted, listened to and valued. –CQC

Carly’s nomination was supported by family members of the individuals she supports and you can see from the newspaper article above just how highly valued Carly’s contribution is to their loved one’s care.

Jane Montrose, Managing Director of Apple House care homes, said, ‘Do we seem just a little bit proud of Carly? WE ARE BEYOND PROUD! For Carly, this is so deserved. She always goes above and beyond and so I am not surprised to learn of yet another occasion when Carly has prioritised the needs of those she supports and their families above her own personal obligations.  Carly is one hundred percent focused on each individual and her pro-active approach has been rightfully highlighted. Good luck Carly!’

Carly will be attending the awards ceremony and lunch this Thursday, 15th November, cheered on by Romaine Lawson, Director of Operations.

Daily Echo Editor Andy Martin said, ‘We are delighted to be hosting these very special awards for the second year. The dedication of all those involved in caring for others, whether they be professionally trained or informal or family carers is amazing and these awards are a tribute to them and all they do. Where on earth would we be without them? We heard some wonderful and inspiring stories in last year’s awards. I know it will be the same this year.’

🔊 Listen to this

CQC is the independent regulator of health and adult social care in England.  The inspection was unannounced and took place over two days on the 27^thFebruary and the 1^stMarch 2018.

Our teams have demonstrated their unfailing commitment to providing a high standard of care and support at Apple House.

We would like to share below some of the report’s findings and you can also view the full report HERE

Safe

We spoke with three people who lived at the home, all of whom were living full active lives. They all told us they were happy living at Apple House and were keen to be part of the inspection. No one had any concerns about safety and they made comments such as: “I am very happy here”, and, “This is a nice place to live”.

The registered manager had also taken steps to make sure people’s care was delivered as safely as possible as all aspects of people’s care had been risk assessed. The risk assessments showed that the service was not ‘risk adverse’, as people were supported to take calculated risks in meeting their objectives.

One person had been assessed as having memory problems; however, they were supported to maintain their preferred routine of going out in the evenings and arrangements were made to support them with this goal.

This person was also the in-house Fire and Health & Safety officer. They worked with staff and had their own picture format to work from. This helped them identify risks or hazards in the way that they could understand. They were supported by a member of staff and assisted with fire evacuations and monthly health and safety checks. The registered manager told us this has helped this person’s esteem by being valued and included in the safety of their own home.

The home had recently had an audit of their medicines’ management by their pharmacist.  The report showed good compliance with medicines guidelines.  The registered manager shared knowledge with their medication auditor as they did not know the risks to using paraffin emollients. They said they would feed the information, which was taken from NICE/ CQC and NHS guidance, back to their pharmacist team.

Effective

People were satisfied about how their care and support was managed at Apple House and fed back to us that their consent was always agreed before any changes to their routine. Health and social care professionals also commented positively about the support people received at the home.

The home had a small staff team who felt well supported by the registered manager as well as the directors of the company.

Records showed that staff had regular supervision meetings and annual appraisal meetings with the registered manager. In these meetings they reflected on their work, the people living at Apple House, as well as training and development needs.

People were mostly able to make decisions for themselves about various aspects of their care and support. The registered manager and staff were aware of the requirements of the Mental Capacity Act 2005 in relation to supporting people wherever possible to make their own decisions. People’s consent had been documented in relation to areas such as care and treatment, medication, sharing information with professionals and having photographs taken. People told us that their consent was always gained and that staff respected their decisions.

Where people lacked the mental capacity to make decisions about aspects of their care, staff were guided by the principles of the Mental Capacity Act 2005 to make decisions in the person’s best interest.

Care plans recorded that people had been involved and supported as far as possible in making any decisions. Best interest decisions had been made on the basis of the least restrictive intervention necessary. Staff had all had training in MCA.

Staff encouraged and supported people to eat healthily and to be involved in shopping, cooking and budgeting. For example, one person’s cookery folder showed how staff had worked with them. Real time photos had been used as visual prompts to help the person remember what actions were needed to complete the task.

Caring

People and health and care professionals all told of how supportive the staff were at Apple House.

We discussed equality, diversity and human rights with the registered manager. Staff had a good understanding about treating people as individuals and ensuring they were given choice and their preferences respected. Staff received training in diversity, equality and inclusion.

Staff we spoke with had very good understanding of people, how to support them and knew of their goals as detailed within care plans. Each person had a communication plan and staff knew how to communicate with each individual.

Staff were aware of people’s preferences and respected their choices. People’s records included information about their personal circumstances, likes and dislikes and how they wished to be supported. For example, care plans referred to people’s preferred routines and how they liked to spend their day.

Responsive

An advocacy worker who had been engaged to work with one person commented; “It is refreshing to meet such a dedicated staff who have such a strong bond with the residents. It is very clear that (person’s name) enjoys life at Apple House, and this is solely due to the professionalism and genuine warmth of the staff to the residents. Believe me, there are not many homes that I would endorse without a second thought.”

Each person had an up to date personal care plan. The plans detailed people’s needs and how they should be supported. The plans gave good information about the whole person; their health, social, spiritual and emotional needs and identified goals set with that person. The plans were up to date and shared with the people living at the home so that they were fully involved in planning what they wanted to achieve in the future. For example, the registered manager told us that staff at Apple House and family had worked with one person with a mental health condition to remain stable for the past 18 months. The professionals involved had agreed to sign a support plan the person had written with the help of staff. This person had also with support written their own support plan to lower their stress levels, demonstrating the service encouraged people to contribute to planning their care.

People were enthusiastic to share their experience of the home and were happy for this report to reflect the full lives that they were able to enjoy because of the support and assistance of the staff.

Each person had varied, differing interests and the staff had worked with people to ensure people individuality was respected.

Well-led

The home was well-led by the registered manager who had worked at the home for many years. The directors of the company also took an active part in supporting the registered manger and people living at the home. They visited the home at least once a month to support the registered manager and also to review the performance of the service.

The company was a finalist in the National Learning Disabilities and Autism Awards 2017 for Employer of the year and also for 2018. The award for 2018 was in relation to the ‘Breaking Down Barriers’, which celebrates and recognises an individual or organisation who has worked to make sure people get clear information and are able to contribute their views and experiences.

One of the directors had been awarded ‘Director of the Year’ and had also been a finalist for a lifetime achievement award with a local initiative recognising women’s achievement in business. The Managing Director and the Director of Operations gave a seminar presentation for Westminster briefing, one of Europe’s leading political information, public affairs and policy communication specialist. This service feeds into the House magazine, the weekly business publication for the houses of parliament.

The registered manager had sought feedback from staff members with questionnaires asking about their working life. This was in addition to the support, supervision and appraisal given to all staff. The registered manager gave feedback in an open letter to the team to motivate and inspire the team.

— CQC

We would like to extend our warm congratulations to Jayne Jackson, Registered Manager at Apple House care home, and her team, for their hard work and total dedication to the individuals they support. What an amazing CQC report and a very well deserved rating of Good!

— Romaine Lawson, Director of Operations, Apple House Care Homes.

🔊 Listen to this

Summerwood has been awarded the highest CQC rating of ‘Outstanding’ meaning it’s among the top 1% of care providers in the country!  We’d love you to be part of our dynamic team there so, if you are experienced in learning disability support and seek an employer who will value, train and reward you, please get in touch using our ‘Contact Us’ page on this blog or call John, registered manager of Summerwood on 01425 839687.

Due to promotion, we also have a full-time support worker position available at our Bournemouth care home, Redcroft, as well as two waking night shifts (Tue/Wed) available now! 

With top rates of pay, a £100 Golden Ticket, and career progression opportunities, why not get in touch today for an informal chat?  Please call 01202 428158 and speak to Sharron, registered manager of Redcroft or use the ‘Contact Us’ page on this blog.

We look forward to hearing from you.

About The Venus Awards…

“In 2009 I created the Venus Awards to applaud and reward working women who are so often starved of adequate recognition and workable life-balance.

My vision and mission for Venus is to actively influence a movement of change to a more equitable and inclusive society; not by forcing opinions but by mutual respect and inter-gender collaboration.” — Tara Howard, Founder.

Romaine says, “It’s been a great experience being part of the whole process for the Venus Awards. Not only did I meet such inspiring women during the the months leading up to the final who were also nominated, I was introduced to our fabulous sponsors and judges. If you know of someone that you would wish to nominate then I would highly recommend that you keep updated with the Venus website and put them forward when there are the nominations in your area.

I was delighted to achieve the Director of The Year award in 2017 for my area,  and now absolutely thrilled to be Director of The Year 2018 nationally!

🔊 Listen to this