Discipline/punishment in the care setting

Firstly, I think it's really worrying that you work in a setting like that and have had no training in autism. Makes me wonder how many others haven't either.

Secondly, I believe you are right. If she doesn't have that level of understanding, then a consequence like that is not going to help. It sounds like a very impulsive behaviour. It would also be better if they were teaching and encouraging her to use kind hands rather than telling her no hitting. But any consequences that are used should be immediate and in level with her understanding. By the sounds of her level of understanding I'd say they should be pretty short consequences such as no iPad for 10 minutes, rather than no iPad for the rest of the day.

As far as the iPad goes, I can see not letting her just have it all day but her watching TV instead doesn't make sense if it's about screen time so again I think you are right. I don't think her being on it solidly from 2 to when it does sounds great either. Personally I would say it was much better if she had a schedule for the day where for example she does an activity, does a task you need her to do such as go to the toilet and has the iPad for a while. So she can have her iPad time periodically throughout the day rather than in one long stretch. Screen time is a heavily debated topic. Some think it needs to be regulated as it can be over stimulating etc, others see it as a regulation tool in itself and think it should just be allowed. I lean towards the I think it should be regulated side.

This is all just my opinion, others may have a different perspective.

Expecto_Patronum said:

I think it's really worrying that you work in a setting like that and have had no training in autism. Makes me wonder how many others haven't eithe

My elderly mother has multiple carers visit her every day at home to help her with assorted medical and mobility needs and none of them had much knowledge about autism.

These are provided by the NHS who outsource the service to a 3rd party and this company sponsor most of their employees as young women on work visas from Pakistan (based on the 20 or so who have been in attendance over the lst 2 years).

They do receive training in the UK but this is primarily in helping them communicate more effectively, on the rules and laws they must follow and on practical advice on helping elderly patients.

There is no interest in training them in the needs of the 1-2% of the elderly population who are autistic as statistically we are not significant enough to merit it.

From my discussions with the staff and their supervisors this seems the crux of the matter.

For me that just sits in the category of not good enough. People shouldn't be written off as not mattering because they are in a small percentage of the population. Very sad.

To my knowledge (I only know a few care homes so this is far from comprehensive) they are paid by the patients, their estates / family or (for the lower cost ones) by the NHS / benefits service.

The ones I have looked at in detail are primarily paid for by the patients until their cash reserves run out then they are downgraded to ones that fit the budget of the benefits system.

There is an assessment process to review what assets the patient has and only once these drop below a certain level do the benefits start to get paid.

It has some subtleties too detailed to go into here but essentially while you have cash, you pay the bulk and only when you are poor will the state help out in a significant way, and even then it on their terms.

This has been for the Scottish system and I don't know if England follows the same process.

The care homes take money from patient and/or benefits and supply the staff, support and accommodation.

It is run as a business as there are just too many for the NHS to manage - over 300k people are in care homes in the UK and with the NHS struggling to cope with supplying healthcare to the masses, these special needs are an overhead they don't want to deal with so they are largely outsourced.

With the population aging so fast there will be many more in care in the near future as family support groups are becoming rarer and people are more commonly divorced so don't have a partner for support.

So the problem will only get bigger - not appealing for the NHS to try to take on.

So who pays the care homes? If they're making a profit, why can't the government run them & make a profit?

Iain said:

I'll do a bit of digging to see just how much training is involved here (not just for autism) to see what both the staff and the companies are faced with.

Re learning disabilities and autism, “The Oliver McGowan Mandatory Training is the standardised training that was developed for this purpose and is the government's preferred and recommended training for health and social care staff.”  

The Oliver McGowan Mandatory Training on Learning Disability and Autism

Iain said:

I'll do a bit of digging to see just how much training is involved here (not just for autism) to see what both the staff and the companies are faced with.

Re learning disabilities and autism, “The Oliver McGowan Mandatory Training is the standardised training that was developed for this purpose and is the government's preferred and recommended training for health and social care staff.”  

The Oliver McGowan Mandatory Training on Learning Disability and Autism