Case Study

Background

ASH has been living at The Cottage for three years, where he enjoys the independence of his own flat, supported by two consistent staff members who know him well. Maintaining his independence, wellbeing, and happiness has always been central to his care.

Acorns works in close partnership with relatives and met with ASH’s sister to co-produce a clear action plan. This allows progress to be regularly reviewed while focusing on enhancing his access to the community and supporting his overall health and wellbeing

Person-Centred Approach

ASH has remained at the centre of all planning and decision-making. His wishes, preferences, and routines have been carefully considered alongside the views of his family and professionals.

Key elements of the approach included:

• Regular communication with his sister and multidisciplinary professionals
• Ongoing review of an agreed action plan
• Respecting ASH’s independence while ensuring his safety
• Creative problem-solving to maintain meaningful activities

Actions Taken

Health Management

Health appointments were carefully and proactively coordinated with hospital and community teams to ensure everything ran as smoothly as possible for ASH. All appointments were attended successfully with no missed visits, and positive scan results have provided reassurance for both his family and the staff team.

For one particular procedure, a high level of joint working took place involving the CEO, home manager, and two staff members. Careful planning ensured ASH arrived at the hospital at the right time, in line with his sedation schedule, helping to reduce waiting times and avoid unnecessary distress. The team worked closely with hospital staff throughout, making sure everything was done in a calm, coordinated, and person-centred way, always with ASH’s best interests at heart.

During the appointment, staff and family stayed close by to offer reassurance, comfort, and familiar support. Additional staff were present to help with communication, provide gentle distraction, and ensure ASH remained calm, safe, and supported throughout the process. This teamwork helped make what could have been a stressful experience much more manageable for him.

After the procedure, ASH was supported with care and kindness as he recovered. He enjoyed a McDonald’s meal on the way home, which brought him comfort and familiarity. He was then supported back to his home where staff and managers ensured he was settled, relaxed, and comfortable, with his wellbeing carefully monitored.

Compliment received from ASH’s sister

I have just left Ashley. I am so proud of him he coped so well. He was in a great mood when I left his placement. He was reading the backs of every item of food in his flat and telling everyone he loves them so much!

I also just wanted to say thank you to each and every one of you for organising this and getting Ashley what he needs so we know how to help him going forward. It was seamless today. It was completely stress free and everyone who encountered Ashley at the hospital were transparent with me and understood his needs.

Also Ashley’s support workers Olamide and Aaron and Lisa and Cass were phenomenal today, Ashley is incredibly lucky to have such a kind, proactive and creative staff team today who work together so seamlessly. I could really see how they genuinely care for Ashley today, not just as support workers but as human beings. I know Ashley is in good hands so really thank you.

Safe Community Access

Following discussions with his sister and health professionals, a car harness was introduced to support safe travel, enabling ASH to continue accessing the community.

Maintaining Meaningful Activities

ASH particularly enjoys shopping. When accessing the community became more complex, the team developed a creative solution:

• An on-site “Tesco shop-style” experience was created
• This was supported head office staff who had Community connections to help achieve ASH having his own Tesco shop

Health Balanced Diet

We have taken time to listen carefully to ASH’s sister in relation to his diet and nutritional needs and worked together to create a balanced and supportive rotating meal plan. This includes a clear menu planner with healthy snack options, designed to promote both wellbeing and enjoyment.

The team has embraced a fresh, home-cooked approach, preparing meals from scratch so that ASH can enjoy a varied, nutritious diet each day. This has helped ensure mealtimes are not only healthier but also familiar, enjoyable, and tailored to his preferences.

The menu plans are reviewed and adapted, taking into account family feedback and ASH’s needs, ensuring his diet continues to support his health, happiness, and quality of life.

Outcomes

The impact of this work has been positive for ASH:

• Improved Health and Wellbeing
  • All health needs are proactively managed
  • Positive clinical outcomes and reassurance for family
  • ASH is enjoyed a nutritious diet
• Maintained Independence
  • ASH continues to live in his own flat
  • Supported in a way that promotes choice and control
• Increased Safety
  • Safe travel enabled through appropriate travel equipment
  • Risk managed without restricting quality of life
• Meaningful Engagement
  • Continued access to a preferred activity (shopping)
  • Creative alternatives ensured enjoyment and stimulation
• Stronger Family Relationships
  • Family feel listened to and involved and have compliments Acorn – see compliments tracker
• Enhanced Quality of Life
  • ASH remains happy, engaged, and supported – see video and photos
  • His preferences remain central to daily living

PBS UK input

The staff team has undertaken training with PBS UK and, as a result, developed PERMA goals for ASH. These goals are focused on increasing his independence skills and supporting positive achievement in everyday activities.

One key goal has been successfully supporting ASH to make a cup of tea independently, one of his favourite drinks, with the appropriate level of support from his dedicated team. This has helped promote his confidence, sense of achievement, and daily living skills in a meaningful and enjoyable way.

Further compliments received from ASH’s sister

He’s so funny isn’t he. I think setting up his own Tesco was the best idea anyone’s had! It’s meeting whatever need he has to go the shop and it seems it’s more about looking through things and having choice. Thanks again for never giving up on him and always finding creative ways to manage his behaviour.

I’m grateful for all of your support and also that I have been able to repair the lack of trust I’ve had in professionals and care agencies because you have all been so proactive, honest and transparent so thank you.

Conclusion

What we have achieved together with ASH reflects a warm, person-centred, and genuinely collaborative approach that has led to consistently positive and meaningful outcomes. ASH continues to live happily and independently in his own flat, supported in a way that promotes his safety, wellbeing, confidence, and dignity. His health needs are proactively managed through strong partnership working with health professionals, resulting in reassuring outcomes and peace of mind for both ASH and his family.

ASH enjoys a balanced, home-cooked and nutritious diet that is tailored to his preferences, helping to support both his health and everyday enjoyment. His independence continues to grow through gentle encouragement and meaningful skill-building, including achievements in daily living such as making his own cup of tea, which he takes pride in.

When community access has been more challenging, the team has responded creatively and flexibly to ensure ASH can still enjoy familiar and meaningful activities in a safe and enjoyable way. These thoughtful adaptations have helped maintain engagement, choice, and a sense of normality in his daily life.

Family involvement has remained central throughout, with strong communication and partnership working ensuring ASH remains at the heart of all decisions. Positive feedback and compliments from family and professionals reflect the dedication, consistency, and care shown by the team, and the positive difference this has made to ASH’s life.

Overall, the outcomes achieved together have been very positive, supporting ASH to live a full, happy, and meaningful life, with his independence, wellbeing, and happiness always at the centre of his support.