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Ruils - Working Together for Independent Living
Case study 1
S. was in abusive marriage, she was a victim of domestic violence. She has three children, a girl of 17 who wants to go to University to study law and two young boys aged 4 and 10 who have significant SEN – severe autism, non-verbal with challenging behaviour. We gave S. lots of support through our workshops – she had no friends or family because her community had ostracized her when she left her husband to seek refuge in Richmond. We have supported her with housing, benefits advice, ASD anxiety management; we took her to see her local MP for advice, we referred her to specialist support workers and advocated for ongoing support. We paid for a trained childminder to look after the youngest child when she went to court so that her daughter did not miss any more schooling. She told me that she has really loved coming to our workshops and coffee mornings - she exchanged numbers with another parent, she feels less alone and she loves the home made cakes. She said that all the doors were closed and ‘I opened your door and you have opened all these doors’.
Case study 2
The family were struggling to cope with the challenging behaviour of both children, but particularly the eldest who has recently been diagnosed with Attachment Disorder. She is aggressive, violent and very emotional. The youngest is also showing signs of the condition which can be very common in adopted children. Dad has had to give up work to be a full-time carer – he regularly has to go to school to collect the older girl who needs a high level of care throughout the day and evening. There are days when the older girl refuses to go to school so someone always has to be at home. She cannot manage without support for homework and needs one to one supervision. She asks for a bath every day and needs someone to be with her to keep her safe and make sure it goes smoothly. She needs help with tying her shoe laces – she has poor fine motor skills, possibly because of Hypermobility problems.
She is very volatile and becomes angry very easily. She is often aggressive and violent. This has a huge impact on her sister who can be found hiding in corners and she copies her sister’s behaviour. Recently the youngest has started to make high pitched squeals which sends the older child into a meltdown. The younger child also makes repetitive noises in response, possibly to block out the noise. She is scared of her sister’s meltdowns. She also becomes angry, upset, disobedient and withdrawn.
Mum is the only breadwinner and her income fluctuates. She is self-employed but cannot do a full day’s work because of the demands on the family. Money is very short. During the holidays she can only work one day a week.
Over the 12 weeks we have worked with them we have made a Family Fund application for a family computer, we have found local funding for a games console, we helped to get the older child Disability Living Allowance and the father to get Carer’s Allowance. An application to The Extra Mile charity has resulted in them getting school shoes and a suitcase. We have secured funding for swimming lessons and Merlin Passes for the family to be able to have days out together. We have also secured a grant for a computer and some counselling for the parent.
'Thank you so, so much for all your wonderful help, it's making such a difference for us already'.
Case study 3
Single parent E. came to us at her wits end. Her daughter G. (14 at the time) was at risk of permanent exclusion from school because she was unable to control her impulsive behaviours. In the last three years she had more than 300 behaviour reports, more than 150 in this academic year alone, including disruption, rudeness, alleged assault, alleged theft, being disorganised, not having the right equipment, calling out inappropriately, persistently talking in class, calling out during a test, bullying and intimidation, not following instructions, lying and being confrontational. She had been excluded internally and externally from school. With our support we helped to have her assessed at Springfield Hospital where they diagnosed her with ADHD and Conduct Disorder. We supported E. to get her daughter an EHCP plan in place with full-time support. The child psychiatrist recommended medication to manage her impulsive behaviours. We also found a specialist in ADHD to give mum strategies to cope better with the daughter’s behaviour. She eventually managed to gain 6 GCSE’s and is now studying for her A levels.
We supported mum to go to local specialist support groups where she has ongoing advice; she started meditation classes partially funded through us, and she is much healthier both physically and mentally, and able to work again. “I am very, very happy with all your help. I know you can’t solve everything but I really appreciate all your help. Every time I called you there was someone to help me, to listen to what I was going through. This was very different to other services. I am always recommending you to other parents.”
Case Studies from HFAC Monitoring Form, December 2017
MAN&BOY Project - Building self-esteem in Men & boys
Case Study - Steve 34, uncle to James 11.
James is an only child and has been raised by his mother since an early age when contact with his father ceased. His schoolteacher observed that James was unusually shy and really lacking in confidence and was concerned for his social and emotional development. After hearing about MAN&BOY the school contacted James’s mother and suggested finding an adult male within the family who could take part in the project. Steve said, “My sister asked if I'd go with him and be his 'role model' and I was more than happy to do it. It was a good excuse to spend time with him”.
Steve and James came along to an Adventure Weekend Camp. The camp provided a variety of outdoor activities designed to build trust and confidence through working together. The aim was to have fun whilst supporting the family to strengthen their relationships in an atmosphere of praise and encouragement. Steve said, "Neither of us knew what we were walking into, we were a little apprehensive but we couldn't have received a more friendly welcome. The organisers immediately put you at ease. I learned that being a role model is a massive responsibility and it has made me want to be the best I can be, which hopefully James will see and be inspired by”.
After completing the camp, Steve and James attended the ‘follow-on’ Relationship Building Course. This ran over 6 consecutive weeks and combined a climbing activity alongside relationship skills training. The first half of each session was based around a relationship topic such as communication, boundaries and saying sorry and the second half provided an opportunity for them to learn a practical skill together, (climbing) helping them to build trust and confidence.
The course aims to build memories and stimulate positive changes in men and boys. Steve said, "The climbing course really helped James grow in confidence and he blossomed on the camping trip. It was amazing to see the transformation. You get out of relationships what you put in and I'm unbelievably proud of James and how he's developed, to see him just becoming himself”.
After seeing the difference the project made to James, Steve decided to volunteer with MAN&BOY. Steve said, ‘The course really boosted my confidence and showed me that I have skills and abilities to contribute’. Steve has now gone on to complete an NVQ in Goods Delivery Driving and also taken nationally recognised exams in communication and numeracy. Steve said “I now want to push myself in all aspects of my life, to set the best example for my nephew James and the son my wife is expecting in the near future”.
For further information visit: www.manandboy.org or email email@example.com
Mary has long-term complex physical & medical conditions that affect her mobility. She is on a combination of strong pain relief medicines, which exacerbate her mental health issues. Mary has a long history of clinical depression, substance misuse and has been diagnosed with bipolar disorder.
Mary has been known to the service since August 2014 and was initially seeking support as she was previously homeless and under the care of CMHT. She was referred for debt advice in April 2015.
Mary has required intensive support whilst unpicking the various debts that had built up over the previous years. The debts were an unfortunate consequence of a severe episode of mental ill health that had led Mary to lose control of her finances. She had experienced temporary bouts of homelessness and had sofa-surfed and lived at various temporary addresses over the years. When she came to us, Mary was constantly receiving phone calls, text messages and letters from bailiffs. She felt harassed and increasingly distressed about creditor demands and was at a loss as to what to do.
Over a period of 10 months, despite numerous meeting cancellations due to Mary’s ill health, her financial situation was finally resolved. Richmond AID has arranged for 4 debts to the value of £496.00 to be written off, and further 2 debts totalling £3,945 are on hold pending a discretionary write off. Mary was awarded a one-off grant of £300 so she could buy furniture for her new one bed social housing flat. Mary is now managing on a sustainable monthly budget.
She is engaged in the community and carries out peer support work at SPEAR. She has also received a recent diagnosis of emotional instability and is currently engaged in an intensive 18-month therapy program under the Richmond Personality Disorder Intensive Treatment Team.
Aisha was referred to our agency via RHP as an eviction notice was pending due to rent arrears of £1,986. There was also an outstanding Council Tax bill for £1,408 and an overpayment of Housing Benefit for £1,400. The debts had been referred to bailiffs. Aisha is not only a full-time carer for her disabled husband, but also offers care and support to her mother and her father who suffered a serious debilitating stroke last year.
Aisha and her husband had lost their Housing Benefit entitlement in June 2015 as Aisha’s husband had received a lump sum cash payment of £21k from his pension provider. This was over the Housing Benefit Office’s savings limit of 16k. Claimants are allowed to have up to £16k in savings without completely losing their Housing Benefit, but anything beyond this figure causes immediate termination of benefits. Aisha had used the pension lump sum to pay off some of their debts and to contribute towards the cost and share of a static holiday home for her husband and her parents who had not had a holiday for 11 years.
Once the benefits were stopped and Aisha realised she was supposed to inform DWP about the pension award and seek agreement to clear previous debts, she supplied the information and evidence required. However, she was informed she was not entitled to Housing Benefit as she had assets of £21k. This matter went to appeal but was declined and an order for repossession due to arrears was authorised.
Aisha had used all the rest of their savings to cover daily living expenses and was unable to meet the rent / Council Tax demands. The couple’s health was deteriorating by the stress caused by this situation and there did not appear to be any recognition that their savings were a decreasing asset. Aisha and her vulnerable disabled husband were at risk of being made homeless, which would have caused Richmond Council additional costs in housing them temporarily and could have led to potential additional social care costs should Aisha have lost her capacity to carry on caring for her parents.
Richmond AID challenged the appeal decision and the Housing Benefit Office agreed to review the case. As a result of Richmond AID’s intervention, the decision was overturned and the couple’s Housing Benefit was fully reinstated and backdated to July 2015. The eviction process was also stopped. Aisha and her husband are now secure in their home and Aisha is able to continue providing care for her husband and her parents.
Ms F is 33 and suffered a spinal stroke 18 months ago. She is now paralysed from the neck down. She was in hospital for over a year and as she needed an adapted flat she was rehoused when discharged from hospital. She was initially referred to the Richmond AID Money Advice service for money and debt advice but it soon became clear that she was also socially isolated. As a result, she was referred to our Information Navigator, which led to a home visit. A referral was then made to a befriending service and to her neighbourhood care groups. She has also been offered help should she wish to increase her independence by applying for a motorised wheelchair/scooter. She has been advised how she could utilise the mobility component of her PIP to acquire the wheelchair/scooter and support will be available should she decide to pursue this option.
Richmond AID was successful in applying for a grant to support her with her electricity costs, which are higher than average due to the modifications in her home.
(Case Studies from HFAC Monitoring Form April 2016)
Richmond Carers Centre
CASE STUDY 1
Mrs M cared for her mum of 93 who lived alone in her own home with support arranged through LBRuT Adult and Community Services. Mrs M contacted RCC in November 2013 via the Support Line as she was experiencing difficulties with the care agency who were providing daily assistance with getting her mum up and ready in the morning. Mrs M had liaised with the appropriate team within LBRuT to raise her concerns but the situation had remain unchanged so was feeling frustrated and angry as it was impacting on her mum’s wellbeing. Mrs M was provided with support to prepare for a network meeting with ACS and the care agency. Additional information was provided to Mrs M regarding community services – SPADE and Age UK House Keeping Service to enable Mrs M to take a trip away. Mrs M subsequently dropped in to RCC in Jan 2014 to talk about concerns she had regarding the care her mum was receiving in Teddington Memorial Hospital after having a fall at home and an operation to repair a fractured arm at Kingston Hospital. Support was provided to determine what action to take and it was agreed for an RCC Support Worker to contact the relevant Social Work Team on behalf of Mrs M to raise the concerns. The concerns were followed up immediately however sadly Mrs M’s mum’s health deteriorated further resulting in re-admission to an acute hospital where she passed away. Mrs M had continued to receive emotional support throughout this difficult time and subsequently requested advice about how to raise the concerns she had about the care experienced by her mum. Assistance was provided to prepare 2 complaints letters, access to an advocacy service and respond to the final complaint outcome. Ongoing emotional support was provided by both telephone and email. Mrs M is still experiencing considerable distress at the loss of her mum, the emotional turmoil due to the experience her mum had at the end of her life and progressing through the complaints process. She is awaiting our Counselling Service and continues to receive our Complementary Therapy service. Further emotional support will be provided for up to 6 months and consideration as to whether ongoing contact with RCC through a possible ‘Friends of RCC’ service for former carers.
CASE STUDY 2
MR is a woman aged 56 who was referred to RCC in June 2014 by the Alzheimer Society. Initial contact with MR was to provide one to one telephone emotional support. She and her husband have been caring for her mother (who lives with them) for many years but over the last year or so her mother’s dementia had deteriorated which often resulted in aggressive outbursts towards MR. The impact and stress of caring led to MR being signed off sick from her full time job for 6 months. During this time she was attending the Richmond Wellbeing Service and engaged successfully in CBT as she was experiencing high levels of anxiety and depression thus becoming increasingly socially isolated. During a visit to RCC, MR advised she was awaiting assessment for her mother and she too was due to receive a carers assessment from Social Services.
RCC helped MR navigate support at Social Services by explaining the processes and procedures. By providing MR with advice and information regarding her rights she said she felt more confident to ask for the appropriate support to enable her to continue in her caring role. Over a period of three months, MR attended RCC for a number of one to one sessions with an Adult Carer Support Worker. This enabled her to talk through her caring role and reflect on the strategies and techniques she had learnt during her CBT counselling through the Wellbeing Service.
In January 2015 MR had negotiated a phased return to work and was also advised on her rights for flexible working. She was also helped to understand the purpose and support available at her workplace through Occupational Health. Since February 2015 MR has returned to full time work as her mother has been awarded a personal budget to assist her with social care and activities of daily living. MR and her husband were also assisted in applying for the Carers Break Payment. More recently MR has now engaged in counselling here at RCC. She has also been able to call “as and when” if she is needing further information or advice.
(Case Studies from HFAC Monitoring Form June 2015)
Home-Start Richmond upon Thames
Case Study A
The family (single parent with 1 adult child and two aged 8 and 2) were referred to Home-Start by the Family Support Team due to Mother being diagnosed with a serious illness, family debts, issues with maintaining their new home and a history of serious domestic abuse both physical and emotional. The Mother could not be left on her own with the children due to illness and needed support going out with the younger children.
Home-Start provided a volunteer who offered emotional support to Mother (talking and listening), respite to the eldest child (main carer), support to allow both younger children to attend school and nursery plus suggestions to improve their routine.
The eldest child has now moved back into home to become a full time carer, the middle child has improved her school attendance and the youngest has started nursery. The Mother has gained more confidence and now has a routine in place to get children up and to school/nursery in the morning. The Mother is now more accepting of her own health situation and the support received, becoming less distrustful.
Case Study B
Family (Mother and partner, 3 children aged 13, 10 and 3) were referred in November 2013 by the school nurse due to the stresses of financial difficulties, sibling rivalry, and Mum’s depression.
Home-Start provided volunteer support to offer friendship, practical help to call the debt line, signposting to CAB, Children’s Centre and nursery registration, encouragement to join the library and attend playgroups as well as active listening regarding Mother’s depression and encouragement to discuss with GP.
Now Mother reports feeling better. She is taking medication, has engaged with local play groups and has taken steps to sort out financial problems. She has asked the volunteer to help her to manage her debts and letters have been written to seven creditors to explain situation. Mother feels more confident about resuming work and will be job-seeking once her youngest begins nursery. Mother is trying to encourage more family time together and they are going to the park at weekends. Signposting to Children’s Centre First Aid course has also been successful.
SPEAR Recovery Programme Case Study:
Ashley (not his real name) moved into Penny Wade House after sleeping rough in Richmond. He has a long history of violent offending. He also felt depressed and suicidal and heard voices when he drank heavily. He hadn’t had stable housing for over 6 years.
Soon after moving in he started to feel better and started to take his psychiatric medication on a consistent basis. He stopped drinking and didn’t re-offend during his hostel stay. Ashley became a popular participant in hostel social and skills development activities, he undertook a volunteering role locally, and attended a local gym regularly.
Ashley recently moved out of the hostel into independent accommodation and continues to work towards employment aspirations.
Case Study from a Volunteer Befriender:
I trained as a Befriender for SPEAR in September 2012, and was matched in November with a female client, who had just got into a new tenancy, but was finding life really tough. She found it difficult to get out of her newfound four walls, and with no structure in her life days were never-ending, and she dreaded the weekends and having no-one to talk to.
We met once a week in different locations, and she had the opportunity to talk about her weekly challenges in a totally non-professional way. As my client’s confidence started to grow, we got into more of a routine and set new goals to find groups for her to join. We often went together for the first time, but once through the door, she was able to assess for herself if she felt comfortable to stay.
My client has now moved on from SPEAR. It took a while to develop a trusting relationship, and one which was not dependent. I learnt so much about how fragile life can be, and how much human contact can help promote self-esteem, motivation and hope. It was a very rewarding volunteering experience for me.
Katherine, Volunteer Befriender
(Case Studies relating to funding given by HFAC - January 2013 – December 2013)
Crossroads Care Richmond and Kingston Upon Thames
Case Study - Saturday Club, M
M has been attending our Saturday club since 2011 aged 8. He was referred to us by social services where the family was under a child protection plan. M has a diagnosis of ADHD, Mild Learning Disabilities and Cornelia de Lange Syndrome. He had delayed speech and language skills, especially in his expressive language and forming coherent sentences.
Due to his high levels of need, he was initially allocated a 1:1 care support worker at the club. Not only did he need support to help manage his behaviour, but also continence issues meant he required a member of staff to support him with his personal care needs.
Throughout his time at the club his behaviour has been temperamental, where at times it became extremely challenging, mainly due to changes within his family circumstance.
We introduced two permanent weekly activities at the club, Karate and Football coaching. At first, it was very difficult to encourage M to take part in the activities and when he did participate, he became very challenging towards the other children. We continued to support M throughout both the Karate and Football sessions.
The Karate sessions were going very well for the children at the club and with funding we were able to purchase the Karate suits and provide help towards the license and grading fees for those who required financial assistance.
M began to enjoy the sessions, especially the Karate. We purchased his suit which gave him a great sense of pride and ownership. Over the past year, staff have reported a significant change in M’s behaviour since participating in the Karate. His listening skills have improved immensely and his respect for his peers greatly increased. He has successfully graded and passed his blue and red belt. Recently he graded for his purple/ white stripe belt where the Karate instructor reported “he performed extremely well, even when he made a mistake or two, he rectified it and moved on without any stress”.
This is a great testament to how far he has come from when he first started at the club. M is now respected and valued amongst his peers at the Saturday club and continues to make great progress.
Case Study - A Parent's Perspective
“My son has been attending the Saturday Club since he was 8 years old. He has just had his 18th birthday and now sadly he will have to leave. The Club has been a lifeline for us and my son has gained so much self-esteem and self-confidence during his time at the Club and I know he will undoubtedly miss attending. However, he is now going onto bigger and greater things. Volunteering within the community and being elected as a champion for young people with learning disabilities within Richmond & Kingston. One of the biggest concerns for him was if he would still be able to continue with the Karate once he leaves in December. Thankfully Tony has agreed to continue his training at the Busen Centre in January where he can continue to attain his next level belt and eventually achieve his ‘black belt’.”
- 90% of families have reported an increase in feeling supported, and more rested following a break – in relation to well-being and stress.
Case Study - Core Respite Services
Mr J is 91 years old and has been caring for his wife of 89 years old for over 10 years.
Mrs J has vascular dementia and over the last year has developed a number of health problems, including Transient Ischaemic Attacks and Ulcerative Colitis. Her mobility has also significantly deteriorated, due to Achilles Tendonitis, and following many falls, is now unable to walk and entirely dependent upon her husband for all her health needs.
Mr J does not leave Mrs J on her own because of her health problems and also because she becomes very anxious if Mr J is out of her sight. Mr J is very keen to continue to care for his wife at home.
Mr J, although caring for his wife 24 hours a day, has his own serious health problems, including an ulcerated ankle, which has needed constant medical attention over the last year; he also has of history of developing pneumonia.
This year, we were able to take this couple off our waiting list, and provide a regular weekly visit from a Crossroads Care Support Worker on a Friday morning. Mr J uses this time to attend doctor, nurse or hospital appointments, do essential bank or building society visits and also his weekend shopping. If Mr J is unwell the Care Support Worker will do shopping and run errands for him.
Mr J says he really benefits from the Care Support Worker’s visits, especially as they both have been unwell in recent months. Mr J say that Mrs J also benefits from the Care Support Worker’s visit as he says his wife “enjoys chatting to H” and having the company and support of the regular Crossroads Care Support Worker. The respite breaks, funded by Hampton Fuel Allotment Charity, work well for them both, as they do not have any family support and are very isolated. Mr J is very satisfied with the Crossroads visits and has only one request, that is to receive more hours from Crossroads!
- 100% of service users felt positively about the Crossroads service they received and the reliability and care received from the allocated care support workers.
- 85% reporting that their caring role has had a significant impact on their personal interest hobbies and pastimes.
“A brilliant caring service – if only more funds would be more available to provide Crossroads with the ability to do what they do best – care for carers – so they can care for the people they love.” Older Carer
(Case Studies from Cross Roads Care Richmond Upon Thames Monitoring & Evaluation Report, December 2017)
Integrated Neurological Services (INS)
The grant from HFAC made it possible for INS to recruit its first Speech and Language Therapists to meet the needs of Richmond residents whose neurological condition has affected their ability to communicate effectively, particularly people who have had a stroke or those with Parkinson's Disease (PD). INS therapists aim to help those with difficulties to maximise their communication skills and to participate in meaningful interactions with others in their daily lives.
This year several new group programmes have been greatly appreciated by the participants. For example, some participants in a recent 6-week programme for people with PD told us:
“This is the most enjoyable course I’ve ever been on; I’ve been sorry when each session has ended.”
“The sessions were real morale boosters.”
“My friends say I’m easier to understand.”
Participants in a group for people who have had a stroke said:
“It was good to share understanding, experiences, stress”,
“Made it easier for me to communicate in a group”
And their partners told us:
“Her speech has come on in leaps and bounds since doing the course”
“This was a real boost to her confidence”
“INS has been our life saver”
Integrated Neurological Services
11 February 2013
Clarendon School Family Group
Clarendon School Family Group launched in September 2010, with the generous support of Hampton Fuel Allotment Charity and Richmond Parish Lands Charity. Clarendon a school for children with moderate learning disabilities, commissioned The School & Family Works (“SFW”) to run the multi-family therapy group to support families with multiple disadvantages.
A Family Group is a community of up to eight families who meet weekly. The meetings, which take place on school premises during school time, last for approximately two and a half hours and are co-facilitated by a therapist from SFW and the Deputy Head.
It’s quite a struggle to bring up a child with learning difficulties, especially if you are facing additional pressures. It’s easy to feel frustrated, isolated, incompetent and powerless. Family Group works because, as trust develops, parents are able to explore the complex difficulties they face, resourced by each other, by relevant theory, and held in a genuine collaborative partnership with the school and the therapsit. The model promotes competence and confidence in parents, transforming outcomes for vulnerable children.
What does success look like for the children? By the time they ‘graduate’ Family Group children are able to engage cognitively and socially at school and make full use of other opportunities provided, supported by their parents in alliance with appropriate services. That’s as good as it gets!
QUOTES FROM PARENTS
'It’s great to meet with people who get it. You feel you are not the only one. ..'
'Family group has really helped me meet people at the school'
'I love coming - it’s for me as well as my son'
'I can't wait for group I've had a really tough week'
QUOTES FROM CHILDREN
' like to get up on family group day'
'I like being able to talk about how you feel'
'I was going to ... (not follow target) then I thought of family group and it stopped me'
'You can say what you think in (the) group and people listen'