Welcome to the brand new Voyage Care podcast! In this season, we’ll be focusing on how our services deliver person-centred care to the people we support. For episode two, we’re hearing from Raj, our Specialism Implementer and Stacey, Service Manager at Redcliffe House. Redcliffe House is one of our residential care homes that specialises in autism. They’ll be discussing the importance of understanding and accepting autism, all while delivering exceptional person-centred care.

Supporting autistic individuals

Visit our Autism support page to read more about how we support autistic people and our partnership with the National Autistic Society.

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Read the transcript of the podcast below.

Raj:

Today, I’m talking to Stacey Fritchley, who’s the manager of Redcliffe House in Mansfield, Nottinghamshire. Redcliffe House is an autism specialist service and has been accredited by the National Autistic Society since 2011. Knowledge about autism and consistent practices have made Redcliffe House attain outstanding for responsive in the past and still maintain good in all areas of the CQC inspections. Redcliffe House understands that every autistic individual is unique and have practices which are very consistent and have done a lot of work in conjunction with the National Autistic Society to generate autism awareness among the nearby community, and work closely with local autism practices.

Stacey believes providing awareness about autism is not for a week or a day in the year, but it should be every day. Stacey is very passionate about autism and autistic people, hence we chose to talk to Stacey today. So Stacey, welcome to the Voyage Care podcast and today we will be talking about the importance of autism awareness, accepting autism and appreciating autism. So Stacey, if you could explain to us your journey into autism and how you joined the journey of supporting autistic people, please.

Stacey:

So, when I was younger, I used to do health and social care as a qualification. I always wanted to get into the care sector. I never realized the autism would be something that I would enjoy supporting autistic individuals because that wasn’t something that I was made aware of at the time when I was doing my GCSEs. So I aimed to go into something more familiar, such as elderly care, but when the opportunity to come to Redcliffe House at the age of 18 became available as an apprentice, it was something that I really wanted to do and really wanted to challenge myself with it. So that’s how I got into autism and supporting autistic individuals and I’ve been here since.

Raj:

So you started as an apprentice, then you worked your way up to a support worker and now you’re a manager of Redcliffe House.

Stacey:

Yes.

Raj:

That’s great, okay. So you explained about your journey. So can you just briefly explain the barriers you felt initially as an individual, as a person, as a young person after GCSE and a person supporting autistic people in our service?

Stacey:

So initially, because I didn’t have any experience or very little knowledge of supporting autistic individuals and all of the things that entail effectively supporting them, I was very nervous, a little bit naive going into it, that it would be quite straightforward, very easy, but it was very difficult in fact, at first, and it taught me a lot of time. I had to do a lot of observation of other support workers and the people that happened to be there at the time to ensure that I was providing effective support to the individuals that we have here. It was very difficult at first, but I think over time I gained a lot of confidence and it’s about understanding the routines of the people we support, how to effectively communicate with them and just developing positive rapport with each individual as individuals.

Raj:

Great, that’s great. So observing other people, other staff, working here and making yourself understand people’s required needs, then how did you make sure that the awareness about autism, as you mentioned earlier, is different than what you thought about supporting people in elderly homes and everything. So how did you make sure you are aware what autism means? How did you come into that concept of what autism is and how did you break into these things?

Stacey:

So when I began working at Redcliffe House and supporting autistic individuals, we went through various different autism awareness trainings. I went through lots of observations in terms of people watching me and how I interact and then also how I watched them and how they interacted with autistic individuals. So we did a lot of talking to one another, basically just thinking of ideas on how best to support people, especially autistic individuals. So, that’s how I gained a lot of knowledge about autism initially.

Raj:

So the awareness about autism has changed your approach to support people. Do you think that the approaches was very consistent with the support plans and everything, because obviously you have to follow support plan, support guidelines and everything. So was it in all line with what you were doing?

Stacey:

Yes, yeah. I think it’s very vital regardless on who you’re supporting that you follow the support guidelines, they’re all in place for a reason, but I think it’s also worth noting that autistic individuals, specifically in terms of routine and such, and their sensory needs and such as that, it is absolutely vital that you do follow those support guidelines. So, when I originally began at Redcliffe House and I was getting to know the individuals, it was vital that we followed all the support guidelines. Even when things might change or vary a little bit from the support guideline, maybe a change in their behavior or a change in need, it’s necessary to look into that and see how best we can support them in those changes as well.

Raj:

When there is a change of behaviors happening in an autistic person, so as we support autistic people, changes are inevitable. You can see changes everyday, which can be different to what we have planned. So if there is a change in behavior, if there are behaviors which is not according to support plan happened, so how do you make sure the staff are aware and how do you work on it so that staff understand? Do you do debriefing? Do you do role plays? How do you do these things?

Stacey:

So when there is a change in maybe a behavior or need for a person we support, that’s a little bit out of usual character, we re-enact it and we try to look at the situation as a whole, what could potentially have caused that change? Maybe it was an external factor, maybe it was a sensory issue at the time, or maybe it could just be something that they are going through as an individual. It’s very difficult to get inside of a autistic individual’s mind, to fully understand and comprehend what their thoughts and the way that they perceive the world are, so it’s a matter of reenacting the whole situation and trying to really think outside of the box on what could potentially affect them. I think having a good understanding of that individual and the person that they are, that’s how you better do that. So the staff team can come together and we can all think about ideas and debrief on the situation to try and help the individual further with their needs.

Raj:

Staff understand autistic people and we try to understand what autistic people think about the staff members and get to a balance point and support people. Is that right, what you’re talking about?

Stacey:

Yeah, yeah.

Raj:

Explain us more about how important it is to make sure understanding autism that we manage the day-to-day changes within the service. Say for example, there are changes of faces in staff member, so you plan a day and the staff member doesn’t turn up, or you have visits from external people, or workers turning up. So how do you make sure autistic people understand? We manage them in a way we don’t have a lot of unexpected behaviors, how do you do those things please?

Stacey:

So I think in terms of … It’s all dependent on the autistic individuals that you support, and it all depends on how what they require, what support they require in all these changes in day-to-day lives, and in their day-to-day lives and routines and around them. So for example, in our service, we have pictures on our activity boards, so that way they can see who exactly is on shift at that time. We don’t change over shift patterns during the day. We just have one long shift, so that way the people we support know that once that person is there, they are there, that is their staff member for that day. I think that’s very important for the people that we support, because they need to know that that is a consistent part of their life and they get to know those faces and understand that familiarity with them.

Stacey:

In terms of one of the people that I support as well, he’s autistic, and he is also partially sighted. So he can become into your personal space-

Raj:

Personal space, yeah.

Stacey:

He’ll come into your personal space just to see who you are, but this can be perceived as a little bit … maybe if you don’t understand his needs, or if you don’t know the individual, it can be quite intimidating for someone to come into your personal space. But in actuality, he’s just doing it just to see you, to see who you are, because he doesn’t know who you are without getting into your personal space to physically see you. That’s a very difficult thing for him because he’s autistic. He needs to be able to do that and we have to accept that as staff members, that this is necessary for him.

Raj:

Staff understand the sensory sensation so well. Even though the receptors, the eyes receive information, and they do not transfer to the brain and he cannot comprehend who the person is. So to make it more aware, he come closer to have a better vision and staff understand these things. So do you make sure this is explained to the external people visiting as well?

Stacey:

So when we have visitors or external professionals come Redcliffe House, we provide them this information sheet. On this information sheet, it has a little bit of an explanation of each of the autistic individuals that we support on there and what to expect when they enter Redcliffe House. So for example, it will state on there that there is an individual that may come and intrude on your personal space and that there may be another individual out in the garden playing with stones and making a high pitch noise and this is a norm for them. This is important for them to do this. It will explain that, and it helps the visitor or the external professional coming to Redcliffe House, accept that these individuals are autistic, that we do have to accept these initial behaviors, these initial needs, and adapt to their needs.

Raj:

So you make sure that what our staff understand, the consistency is passed on the visitors and external professionals as well, so that the people’s meaningful needs are not deferred in any way and we have a meaningful practice throughout.

Stacey:

Yeah and I think it also provides a consistent approach for everybody involved in these autistic individuals’ lives.

Raj:

What we’re establishing here is we make the people aware about autism. We also make sure that they accept autism as well, which is a great thing you do here, which is really great. So if we have to take people out to hospitals or GP appointments, we have to transfer all this information to external professionals as well. So I’m sure you have heard about Oliver McGowan issue, where an autistic person went hospital and he sadly have dead because people didn’t understand his autism and they treated different way. So what sort of things do you actually have when you or the staff take with them when they support people to hospitals or GP visits?

Stacey:

So we have health action plans, which the person that is supporting them will take it with them and the doctor, the GP, the dentist, whoever it happens to be, will be able to see exactly what needs that person has, as well as the medical history and so on and so forth. But in terms of more specifically for the autistic individuals that we support, we have things such as autism profiles and sensory profiles that we can also take with us, so that way they have a better understanding of how to treat the autistic individual that we support. They have a better understanding of their needs and what is necessary in order to effectively treat them and make them better.

Raj:

Well, that’s good to hear because it’s good to know that we follow the latest government guidelines and make sure the people who go to GP services and hospitals are supported very well, and the people who actually see autistic people have the relevant information, which is great. Right, so let’s imagine you got a vacancy and you got a new referral. So can you take us through the journey of how do you make sure an autistic person is [inaudible 00:14:59] those things?

Stacey:

So we carry out an initial autism assessment, as well as a care needs assessment. This is just to ensure that we can provide the necessary support that that individual will need should they transition to Redcliffe? So we talk to various social workers and other professionals that are involved in that person’s life. This again is just to establish if that person would be suitable and compatible with the other autistic individuals that we have here. Then we would go on to complete things such as autism support plans, autism profiles, sensory profiles. Then if we feel that this is a potential and we could potentially accept this individual at Redcliffe House, we’d want to make the transition as smooth as possible. So we’d complete things such as micro type transitions. We try to implement whatever we possibly can in place of that individual’s needs to help them transition smoothly, bring in things from their old place, into the new place, to Redcliffe House, so that way they feel more at ease, more comfortable. They’ve got their own belongings with them. They’ve got something familiar to help them settle in a little bit better.

Raj:

Oh, that’s good. So you do a proper transition so that people are aware of where they’re coming and they don’t have any surprises and they can gel in very well. We have the awareness, we have the acceptance and we appreciate autism, which is great. So we are trying to get this word across the community, so that there is more appreciation about autism. So as a manager, have you had to come across any grief to support an autistic individual, which it very important and it is very difficult situation to do manage grief.

Stacey:

Yeah. So I think it’s important to understand that in terms of autism, we perceive grief as someone that we might have lost somebody close to us, but in terms of an autistic individual, their grief could also sustain from a lack of routine or just even not being able to compete or take part in things that they would ordinarily do, a loss of maybe a toy or a sensory object that’s so important to them. Anything of any vital importance to them, if they’re no longer able to do that, could be considered a form of grief for them because they feel such a strong emotion for that loss.

Stacey:

So I think most autistic individuals do go through that, that I support, if they are unable to do their own routines as they usually would, but we have had occasions where we’ve had to support an autistic individual with the loss of a parent. This was done through social stories and just staff trying to understand the individual and trying to help and support them the best they could using the simplistic information, using their preferred method of communication, using the social stories, using pictures personal to them, so that they know that that person is always there, they can see them, because sometimes having that visual perception of that person helps, rather than just verbally telling them that they’re still in your heart and stuff like that. Sometimes you need to visually see that person.

Stacey:

So we put all of this together to help this individual, this autistic individual. It did help, but in terms of grief, I mean, this could go on forever and staff accept that we just need to continuously keep supporting him in this area if ever he does display any signs of grief or maybe upset over the issue.

Raj:

So people understand and when I say people, the staff understand, that delayed reactions can happen and people can be upset sometimes, grief.

Stacey:

Yeah, yeah.

Raj:

That’s good. So in terms of training and making update with the autistic practices. So when you interact with your staff members, do you actually talk more about the interoceptions, like the internal feelings when people cannot express a feeling of hunger, thirst, and everything? If somebody is not doing anything, more terminologies, like autistic inertia, so the person can sit idle without doing anything, unless somebody prompts. Normally services might just let them watch TV continuously because it’s easy for them. So is our staff at Redcliffe House aware that the person requires prompt because of autistic inertia so that they change the actions and activities they are doing?

Stacey:

Yes. So we do discuss all of those types of things because it’s necessary for each individual that we support. So each autistic individual that we support, it could vary from person to person on who we’re discussing at the time. As I said before, we tend to discuss these ideas and these areas, especially if there appears to be a change in behavior or need. We specifically talk about it a lot in staff meetings and things, because it’s necessary that everybody has this understanding of autism and how the autistic individual might perceive things or might feel at the time and how external factors can also influence them. So it’s just as much part of ensuring that they are effectively meeting needs and communicating well. It’s a basic understanding of having that, of that individual.

Raj:

Not many services understand these type of new things because interoception is a new area, which autistic practices are being developed now, which is great. So to create awareness and acceptance within the community, do you actually do anything with the community, like the new Autism Awareness Week, as you told me earlier, that autism is not just for a week or a day, it should be every day. So do you do anything to make sure that the community around Redcliffe House and in and around Mansfield are aware about autism? Have you done any charity works or have you done any fundraising?

Stacey:

Yeah, so every year we take part in the Autism Awareness Week and we raise funds for the National Autistic Society. We’ve done this for many years and we most recently did a 30 mile accumulated walk.

Raj:

Oh good, great.

Stacey:

All of the autistic individuals that we support got involved, even if they weren’t able to walk a long period of time, they just walked around the garden and it all added up.

Raj:

Wow, great, that’s great.

Stacey:

And we made a tally and a chart and put it on the wall. A lot of the autistic individuals really enjoyed putting their miles on the wall and tallying it up with staff support. It was just a sense of achievement for them and they were so pleased that they’d hit the target and we raised a lot of money for the Autistic Society. We do this every year, whether it be a walk or a carwash, we’re always raising funds and we’re always getting the word out there and spreading the word, and spreading autism awareness around.

Raj:

So, how important do you think is we use the right terminologies like addressing people as autistic person, rather than just seeing them as person with autism?

Stacey:

I think it’s very important because it’s all about accepting that individual as they are. I think it’s important that people don’t see it as a person with autism and more that autism is them as a person. I think if we can understand that, that would help and we could further accept them for as the individuals that they are. In terms of accepting them, we can then support them accordingly. I think that is one of the first steps to understanding, so that simple little bit of terminology is vital in understanding autistic individual.

Raj:

Great, that’s great. So we don’t address them as people with autism, we don’t label them. We just call them autistic individual, that’s their identity. So it was nice talking to you, Stacey. So, it’s good to know that the practices which we follow here are high standards and hope we continue to do this in the future. So thank you for your time, it’s such a nice feeling talking to you.

Stacey:

Thanks Raj.

Raj:

Thank you very much.

If you’d like to learn more about our exceptional person-centered care, please visit our website, http://www.voyagecare.com. Stay tuned for another episode of our podcast next week.

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• autism
• person-centred care
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• Redcliffe House
• season 1