*The preview photo is AI-generated and does not represent the person featured in this case study.
Through Aimee Rossbottom’s perspective as the Assistant Registered Manager at Unique Community Services, we explore how positive risk-taking and human-centred support encouraged Jane to improve her overall wellbeing, regain her independence, and return to her home to live her passion and purpose.
Meeting Jane
Jane spent around 9 months in a hospital, surrounded by a high staffing ratio. Living within this environment brought many fundamental negative shifts, affecting her mental health and wellbeing. Time itself began to change shape, life milestones were put on pause, and relationships weakened under the weight of distance. Everyday freedoms, such as choosing meals, going for walks, deciding when to sleep, or participating in community life, became heavily restricted.
‘When we met Jane, we were there to create the most suitable plan to help her transition out of the hospital and back to her home environment. That way, she’d be able to build a more independent lifestyle and return to education.’ – Aimee Rossbottom, Unique Community Services’ Assistant Registered Manager
Hear Aimee share, in her own words, Jane’s journey of returning to life in the community.
Creating the Conditions for Discharge
At the very beginning, Jane was understandably reluctant to engage with anyone from the care team and was very wary of the care system. For a moment, it became a struggle, but then Aimee, working with the MDT, began building a foundation of trust with Jane to break down any walls of insecurity she had built from her experiences so far.
The first step was creating a phased support plan, being more present, taking the time to get to know each other, and letting Jane know they are here to support her to live the life she wants. Through reliability and an honest, holistic, and open approach, Jane began opening up to Aimee and the team. It was time for Jane’s personalised care plan to take place, creating a safe space for what was awaiting – a smooth transition from the hospital back to her home.
Transition Planning and Following Through with It
Jane started actively collaborating with Aimee and our multidisciplinary team and wanted to share more about herself, including her goals, aspirations, and interests. She felt heard and supported and was ready to actively participate in each segment of the process.
Wishes and hobbies: Jane expressed her love for spending quality time in nature, taking long walks in parks, and reading in the library.
Needs: She wanted her support staff positioned so she could access them when needed, while still feeling independent.
Interests: Jane’s greatest passion and purpose was getting back into education and volunteering in the near future.
After actively participating in her care plan (while Jane was still in the hospital), her wellbeing drastically improved, and the behaviours of concern significantly decreased. Implementing the right care plan meant that the environmental factors and interactions causing Jane distress and behaviours of concern could finally become a thing of the past, as we began to see her spark and smile emerge when surrounded by the right support.
Jane felt ready and prepared, and we began the discharge process, ensuring her transition home went smoothly and was well coordinated.
Positive Outcomes: Jane’s Support at Home Through Positive Risk-Taking
We started supporting Jane in her family home and focused on creating a supportive, nurturing environment where she could feel her most authentic self. We worked with Jane and her family to assess which adaptations and assistive technologies would best support her independence. Jane and her family were directly involved in the care planning, and our teams consistently consulted Jane about what she felt most comfortable with, from daily routines to support needs.
Positive Risk-Taking: Aimee encouraged Jane to take opportunities to try different things and think outside the box to take control of her mental health and thought processes. As Jane embraced positive risk-taking, she began to take control of her mental health. She reflected on past challenges and worked alongside her support team to develop strategies to overcome them.
One of Jane’s main goals was to go out for a walk in the local park without support staff within 24 hours. The MDT conducted a careful risk assessment and support planning, which reassures care professionals about the safety measures in place for positive risk-taking.
Positive Outcomes:
- No incidents of concern or episodes of concern.
- Jane creates her own rota and takes part in weekly reviews with her social worker and the commissioning team.
- Jane builds her own support with the care teams around what she believes would be most ideal for her.
- Returning to education after spending a significant period out of it, with aspirations of building a positive career.
- She set herself the goal of completing four GCSEs in five months and did it!
- Jane started volunteering alongside her studies.
One of the most significant milestones in her journey is taking regular walks in the local park, with the support team remaining 20 feet away to allow her to explore more.
As a team, we are incredibly lucky to be working with Jane and be part of her transformative journey.