Tag Archives: autism

Accessing health and social care for people with learning disabilities: sense, commitment and passion in the Lords

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A one hour debate in the Lords on Thursday blew some dusty old cobwebs away with blistering contributions from members. The film can be watched here and transcription here. It’s well worth making a brew and having a watch or a read. Personal experiences underpinned the debate with respectful and sensitive acknowledgement of the deaths of Patsy, Myles, David Lodge, Connor and many other people with learning disabilities.

Lord Paul Scriven was the force behind organising the debate and set the tone, stating the current situation is simply not acceptable. “Saying that tweaks will be made to a fundamentally broken system is an acceptance of the status quo that killed Connor a decade ago, and it is the same status quo that killed my nephew.” He referenced social murder arguing “state-sanctioned erasure whereby those very institutions aware of the risks to life choose to maintain the status quo rather than dismantle it”. Carefully dismantling current interventions that are often used to suggests a job is being done well, he listed the safeguards and reasonable adjustments Myles was supposed to have which failed. At Myles’ inquest, the coroner “found a culture stuck in another era where clinicians had only a superficial grasp of regulations and communication was unsafe”.

Why has the machinery of oversight failed so spectacularly, asked Lord S, as he described the CQC as a regulator of process and the Leder review a toothless archive of tragedy. I felt like punching the air as processes, interventions and programmes were punctured with intense sense and clarity. The government is acting in “a startling vacuum of oversight”. We are propping up what is a death making system. “We need a systematic reform of the implementation, accountability and regulatory framework that moves beyond paper policy and puts the actual safety and survival of human beings at the very heart of the system.”

Baroness Ramsey described the woeful health experiences of her sister Patsy while Baroness Hollins focused on the death of David Lodge which was again dense with failings. Digital flags, and patchy annual health checks were discussed with sadness as Baroness Hollins has been a central figure for decades, as a medic and a parent, involved in myriad initiatives while little has changed. “The question is no longer what needs to be done to ensure the safety of people with learning disabilities in health and social care settings, but why is it not being done?”

There is zero accountability.

Subsequent speakers raised the lack of accountability, the presence of interventions with no ‘heft’. As Lord Addington said “it is great having a flag, but what do we do when we see it?” There is some irony that the focus is on ‘flags’ while social murder happens in full view.

Hearing these words spoken in Parliament was refreshing. There was an energy set by Lord Scriven’s refusal to allow white noise to cloud the area, to allow empty words – annual health checks/digital flags/mandatory training/annual death review – to fill space. Human rights breaches are documented, evidenced and seemingly unstoppable. In the room yesterday, broadcast and laid on record, were determined, evidence-based, passionate words. As Lord S beautifully reminded us, Myles is “a citizen, with an inalienable right to safe care and an equal right to long life”.

He is indeedy. Thank you.

Adventures in Zagreb

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In Zagreb with self advocate Beth Richards to talk at the fourth annual Mental Health and Autism conference organised by a small group of reluctant activists/autistic mothers.

We ate štrukli, wandered around the Festival of Lights before the conference was opened by Zagreb mayor, Tomislav Tomašević.

The day was intense. I talked about social murder, flourishing lives and the Laughing Boy production. Beth offered insights into her involvement in various projects. The Lost in the System panel, including Kristina Karlović, Jelena Čupković-Premuš, Ljilja Ivanković, Marko Buljevac and Raphael Bene, talked sense while listening to lengthy impassioned/desperate contributions from parent attendees. Niamh Mellerick offered an unusually plotted request for recognition that well meaning actions in childhood can have long term impacts for autistic children. Matea Begić Alić finished up, talking about her research into autistic people’s lives and support.

Today Beth and I ran a coproduction course at the University of Zagreb for a team of researchers pioneering different ways of doing research in Croatia. A lively and engaging conversation with the sweetest cabbage for lunch.

Contrasts, similarities and moments. Shared atrocity stories, sadness, disbelief and anger spilled into the conference and course. There’s a long way to go to change practices in Croatia though in many ways we’re not much better in the UK. Eighty odd years after the establishment of parent led groups like Mencap, the four organisers worked in the background during the conference. No limelight seeking, egos, photo opps or desire for acknowledgement. They simply want things to be better.

Laminating the dead

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These posts are coming a bit quicker right now. Sign of grim times still. There was an All Party Parliamentary Group (APPG) on Learning Disability meeting yesterday. Barbara Keeley MP tweeted after the meeting clearly laying out the continuing failure to get people out of ATUs. The meeting involved a mother talking about her son’s ongoing inpatient treatment then a load of blather. Helen Whately, Care Minister, was present and again, seemingly excelled in mediocrity.

I don’t know why, nearly 10 years on from Winterbourne View these meetings need to involve the live retelling of atrocity stories. We’ve heard so many now it’s become almost voyeuristic, generating faux horror from a bunch of dusty parliamentarians many of whom couldn’t give a flying fuck outside of that space. It can also be parasitic and draining emotional labour for the storytellers and others present.

The way in which these meetings are organised sustains a narrative of disposable humans and bleak lives while taking time from what should be a clear, focused and strategic discussion on, er, action. It always seems to be the same parents in attendance too. The same small group of cherry picked bods.

This morning on twitter the discussion continued with John Lish dismissing APPGs as a meaningless industry. Five seconds of googling found that it is our old chum Mencrap which organises these meetings. Bit of a giveaway really in calling it ‘Our APPG’ on the website.

Holy macaroni. I tumbled straight back to an underground cafe near the Houses of Parliament where, months after Connor died Rich and I were invited to a meeting at the House of Commons by Mencrap. Not the learning disability APPG I’m now wondering? Surely not… In that dim space, we met other bereaved families and I was given an A4 laminated photo of Connor. Eh?

An hour later, ‘important’ people spoke at the meeting while families sat silently around the edge of the room. Five minutes before the end of the meeting, we were told to stand and hold up our laminated dead.

Seven years on and Mencrap is still laminating the dead. Still following the same revolting template of presenting bereaved or devastated parents to a room of pomp and performance. Nothing has changed. John is right. This is an industry. And further evidence that nothing will change while Mencrap retains the power the organisation has to effectively maintain the status quo in its own self interest.

The Unit. Day 68

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“And LB, make sure you say ‘Hello’ before you ask grandma for your bus magazine. Ok?”

“Yes.”

…

“Hello LB.”
“Hello.”
“How are you?”
“Hello.”
“Did you enjoy the bus museum?”
“Hello.”
“Would you like a drink?”
Where’s my bus magazine?”

Home movies and translation

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As a prelude to two days annual leave, I started to ‘sort out’ stuff yesterday afternoon. A painful experience. Partly because it highlighted my (our?) hoarding tendencies groan, but also because it made visible the way in which our lives were disrupted/interrupted/put on hold a few months ago. This interruption – still no effective words for this – was apparent through opened but discarded post and other overlooked detritus.

Shudder.

Anyway, one positive to the sort out was finding home movies that had been missing for several years. They’d fallen down the side of the desk where I’m sitting typing this (the darker reaches of sides and behinds that are only explored when annual leave beckons).

I took time out of sorting to graze this footage. Sob. Where.did.the.years.go???

Various things jumped out, including a trim version of Rich *cough cough* and the total cuteness of the kids. And LB’s quirkiness and humour shines. In one scene, he’s jumping up and down with excitement during an Easter egg hunt, completely missing any eggs even when gently guided towards them repeatedly by Rich. In another, he’s sitting eating his tea with Rosie and Tom, wearing a cycle helmet, his ELC police tunic and a pair of googles. Hilarious. Why was this version of him absent from every ‘official’ report/discussion over the years?  Looking back, we were completely derailed by a system which delivered so little. I can remember LB and Rosie being filmed by a paediatrician at an assessment centre as tots. She wanted to capture his “non-interaction” and “own world” stuff on film for teaching. Makes me cringe now but in the early days of crash landing into ‘special needs-land’, you invest so much hope in these professionals making your child ‘better’, you do pretty much anything they suggest/ask. Hunter-gatherer diet….? Er, let’s not go there.

Framing ‘learning disability/autism’ as a negative, needing treatment, repair or containment [yes, I know. The irony] rather than engaging with LB (and other dudes like him) as individuals, means that support is pretty much useless. And as I keep saying, support that don’t support, ain’t support.

So what advice would I give my fifteen year ago self?

The dude’s different, and he’s always gonna be. Get over it and get on with enjoying what he brings to the party. Oh, and don’t get too hung up on all those meetings with health and social care professionals. They ain’t as important as you think. Really.

‘Busy behaviour’ in the ‘Land of the Golden M’; The sequel

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ryan5-195Bit of groundhog day this weekend. My PhD (started about 10 years ago now) focused on going out in public places with learning disabled children and McDonald’s featured consistently in the interviews with mothers. Or the ‘Land of the Golden M’ (as it was then) as one mum called it.

Children’s ‘busy behaviour’ was tolerated, the food arrived quickly, it was always identical (very important to a lot of kids who were on the autism spectrum) and sprinkled with that magic dust that makes it pretty taste-tastic for kids.

Regular readers will know that now LB is offered choices in a fairly blunt way, it can be difficult to encourage him to do things. Last weekend he said no to going out with us, so this weekend, we decided to fall back on the old favourite and offered breakfast at Mooky D’s. An instant “yes”.

Wow. Changes afoot in the Oxford branch; self service machines and a new queuing system. Even better for the less than patient. It was fast and we had a laugh.

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LB was in great spirits and, once he’d noshed every bit of his food and drunk his milkshake, chatted about scrapyards and tyre disposal. Perfect.
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The Unit: The beginning

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I’ve just been reading old posts in preparation for a meeting with the learning disability service manager this morning and realise there was a jump from Charlie’s Angel’s taking LB to town on that Tuesday morning to him being sectioned that night.

Just briefly, to fill in that gap;

The trip to town on the bus went ok but LB became agitated after his Subway sandwich and they came back quite early. I was at work later that day when a mate rang and told me about a mental health/learning disability treatment unit she’d been told about, very locally, that should admit LB on an informal basis because he was a danger to himself or others. She gave me the number to ring to set the process in place. And a second number to ring to follow up, if he wasn’t admitted within an hour or so.

Sitting on the bus home, holding the scrap of paper with the two numbers scribbled on it was indescribably awful. As was the rest of the day. And the days that followed.

Funny really, looking back. These numbers obviously gave us access to tap into a tried and tested process. After a very short space of time, we had a consultant sitting at the kitchen table. Bizarre really as we had been shouting for help with zip all effect up to that point. But hey ho, until you know what you really need to know, you don’t really know anything in the weird world of learning disability support.

The consultant talked with LB first on his own, and then went though a load of questions with us. There were some tensities, shall we say. Rich nearly exploded when he suggested organising outreach workers to come in each day to check on LB instead of admitting him. Things had got beyond outreach in a big way. And we had little confidence in whether ‘outreach’ would materialise. Eventually, after nearly two hours, and a call to his line manager, it was agreed that LB should be admitted.

The consultant left saying he would call when ‘the bed’ was ready. Tom had his judo grading. Rich dropped him off and told him to walk round the corner to his grandparents after and wait for us to collect him. I got together some pyjamas, clean clothes, wash stuff and sat with LB who seemed quite excited. He loves the whole hospital/institution thing; uniforms, wards, processes, order.

We got the call and set off for the unit.

“Where are we going?” said LB as we turned away from the local hospital. We explained it was a different hospital and then, five minutes later, arrived at a neat two storey building on the site of the learning disability team. Right by the psychiatrist’s office. ‘Five minutes from home’, you say? Next to the psychiatrist’s office??? Yep. Knowledge eh? It’s a vicious beast when you don’t have it.

There was a  brief blip and slight tensities as we weren’t expected and waited at the door trying to establish our credentials.  Rich asked, again through gritted teeth; “You get a lot of people turning up randomly to try and get their children admitted, do you?”

We waited in the living room while the official approval to admit LB was received and then unpacked his bits in his new room. We left pretty much straight away and went to pick up Tom. He got his blue belt.

Charlie’s Angels

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At 8.45am today I was sitting with the phone ringing through the list of day services and respite from the social services. We were desperate for some help. Got to number three (No. 1 only took referrals through the county council and No. 2 sounded very dubious and said to ring back in a couple of hours when a manager might be there). The phone rang. It was Vicki, LB’s teacher. “We’re coming over to see you right now, me, Tina and Sue. We can have a chat and then Tina and Sue will take LB travel training.” Eh? Wha???

Twenty minutes later they were sitting in the kitchen, giving Chunky Stan fuss and organising a new school timetable for LB that didn’t involve him going into school at all (but them going out of their way to collect him and drop him off). Their focus was LB, and our family.

Sue and Tina went off with LB to catch the bus to town. Vicki turned to us saying it had all been a bit last minute; she’d told me on the phone they were going to come over before she’d checked with the head teacher if it was ok to leave school. They felt they just had to do it.

This is what support looks like.

And thank you beautiful ladies.

Definitely not laughing boy

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LB is upstairs, muttering and smacking his legs, shouting out and watching scrap metal videos on youtube. We had a burst of sunshine this afternoon when he came down for a piece of coffee cake and chuckled about how good it was. Funny how tiny snatches of what was can be so powerful. I went up to see him a short while later but he was talking a bizarre type of gibberish and looked at me with hatred. He muttered about how Sara had been killed.  “Ok, matey, I’ll be downstairs if you need anything”, I said,” [fake] cheerfully.

We are occupying this strange, exhausting, stressful space at the moment. He’s threatened Rich but remains OK with Tom and Owen. We have the medication to knock him out if necessary, though where the line is drawn between deciding he needs medicating before it’s too late to get him to take it isn’t clear.  We are piecing together strategies; not say no to him outright, prepare him carefully for any expectation he will do something, listening constantly for any shift in tone or intensity, mentioning any past special interest (Mighty Boosh, Irish lorries, cross channel ferries) to try to snap him, even fleetingly, into the coffee cake mood.

Today I chased up social care. Yes, despite the set of exchanges on Friday afternoon with the learning disability team, I had to contact them. The duty Care Manager seemed active and concerned which is great. He put me in touch with someone from Southern Health Outreach (based at Saxon House, the building with the snooker table). I rang them and have an appointment for April 3rd. Seventeen long days away. The psychiatrist rang straight after. She suggested we meet or have a telephone consultation soon. Er, right now would be good, I said. She found her notes, listened to me (without really listening) and suggested doubling his anti-depressant. We are meeting her in a week to see if this has helped. The psychologist was already booked in to meet us on Thursday. That is no support our support right now.

I’m writing these miserable posts because I think that we shouldn’t (not we as in our family but we as in every family with a dude like LB) be in this position. It screams to me that support and services are woefully inadequate and structured in a way that ultimately cause harm rather than good. LB’s following in almost identical footprints to a classmate, a situation I never dreamed of six months ago.

Now I ain’t a psychologist, or a psychiatrist, but I think LB probably wanted a mate, a girlfriend and a slightly different structure to his life. And now he’s retreating into some hideous fantasy type world that has got trouble written all over it. Doubling anti-depressants and organising late in the day, middle aged carers isn’t going to do an awful lot. But hopefully I’m wrong.

Comic relief day. No.

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LB punched one of his teaching assistants* in the face this morning.

Horror.

I rang the emergency number on his Care Manager’s ‘out of office’ email and was told someone would ring back. The guy called back ten minutes later and suggested a referral to the learning disability team nurse who specialised in challenging behaviour.

“Ok, how long will that take?”
“Well I’ll put the referral through next week and she’ll get in touch when she gets it. I’m not sure how soon she’ll be able to come and see him though.”
“Eh?? Have you listened to what I’ve said?????” 
“Er, sorry?”
“What are we supposed to do in the meantime, if he turns on someone else?????”
“Well, I could make it an urgent referral I suppose… Ok. I’ll put it through as urgent then. And there is a psychiatrist too. I don’t know if….”
“She.discharged.him.last.week.”
“Well I could try ringing her this afternoon.”

Thirty minutes later he rang back.

The psychiatrist had gone home, he’d spoken to the duty psychiatrist; we have to go to the GP and ask him to ‘escalate’ LB to the psychiatrist.

I’m putting it out there now, the support and services for young learning disabled people in Oxfordshire is worst than crap-shite. Unacceptable. Please feel free to pass this link on to anyone in health and social care. Or anyone really. Things HAVE to change. And not just for LB.

*Sue, who has gone about as far beyond the call of duty as you can with LB, including getting in contact with mermaids around the world and sitting around in a stinking, freezing cold workshop every Wednesday, while LB does mechanic training.