Children’s Services Case Study
Case Study Title:
Care package for child with Autism
Completed By:
Peter Porkolab
Completed Date:
November 2010
Inspection Framework: Reference to which of the key elements / judgements /
criteria does this case study cover?

Quality of provision taking into account service responsiveness; quality of
assessment and direct work with children and families; quality of case planning,
reviews and recording Child is safe

Safeguarding outcomes for children and young people – children and young people
are safe and feel safe
What was done and why?
Diagnosed with Autism at the age of 2, the individual has been self harming since the age
of 8 and this has escalated over time, it has worsened considerably since 2007. He has
developed ways of hitting his face with his shoulder, scratching himself and head butting
objects. In the past when parents or carers have tried to restrain him from hurting himself
he has bitten and hit them. There have been incidences of attempts to grab people by
their clothes, scratch, grab hair and head butt. When he is agitated he displays early
warning signs eg. pacing and making loud angry vocal sounds. These types of
behaviours usually take place when the individual is in pain or hungry. However, there are
a number of times when his behaviour is unpredictable and there seems to be no triggers.
He has marked mood swings, from being aware, calm and interactive to being distressed
and displaying self injurious behaviours. The change in behaviour can be quite rapid and
can escalate very quickly.
It was decided that a helmet was needed to protect his head from harm. He wears splints
at night to prevent him from hitting himself with his hands or knees. He can walk but
sometimes refuses to and drops to the floor so a wheelchair is used. His sleep pattern is
disturbed on a nightly basis and he needs to sleep in a padded bedroom in order to
prevent injury to his head. In addition he is doubly incontinent and wears pads all the time
as he is unable to indicate when he needs to be changed.
An inpatient assessment was carried out at Brooklands Hospital in July 2008; it
recommended that the individual be placed permanently in a residential placement. It
concluded that he needed to be placed somewhere which provides a structured
environment that encourages physical and sensory activities such as sensory rooms and
soft play rooms. He needs carers who are experienced in working with children and
young people with severe learning disabilities and Autism. He requires two carers at all
times who can implement clear daily routines and boundaries so that the individual can
understand what is expected of him.
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The assessment noted that he does well in a single environment, without too many
transitions. This ideally indicated a residential placement which included schooling and
would mean the individual would only need to manage the transition between the
residential placement and his home environment during holidays and weekends.
Due to caring needs placed on the parents, they were finding it increasingly difficult to
dedicate time to their daughter. They felt that they were missing out on their daughter
growing up. The mother’s mental health was becoming increasingly in jeopardy as her
depression was worsening. The family were not confident they would be able to continue
to meet their son’s needs under such immense strain.
Following further discussion with partners in health and education it was concluded that it
would not be in the individual’s best interests if he was placed in a residential placement.
The parents stated that they wanted to remain a strong family unit and believed they
could do so with support.
Multi agency assessments were carried out and a support package was put in place.The
current care package ensures that two-to-one support is provided at home and at the
short term placement where he goes every weekend.
What difference has it made for children, young people and their families, how do
we know?
This care package has made significant improvements in the life of the individual and his
family. The support package has prevented the breakdown of the parents in their caring
role and ensured that the individual remains in the care of his parents and part of his
family.
With the support of the two carers at home and at the placement the individual can be
easily prevented from self-harm and his safety can be ensured. The short term placement
enables him to participate in fun, interesting and safe activities. It also ensures that he is
accessing physical and sensory activities. He appears to enjoy the activities and the time
spent at his short term placement and his self care skills has developed. For example, he
has started to use a cup instead of using a sport bottle to drink.
The support package also provides a break from caring for the parents. These breaks
gives the parents time to spend with their other child and as a couple. The mothers
mental health has started to improve since the support is provided
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