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Who Let The Logs Out

July 9, 2012

I’ve made a decision. It’s a decision that will probably get me into trouble but I’m in a “what the fuck” mood.

I’ve written before that my life consists of recording every single aspect of Steven’s life for the professionals involved in his care package to scrutinise. Here is the current list of logs we have to keep:

1) Diet Log: Every single piece of food or drink that Steven consumes is recorded for the dietician.

2) START Incident Form: This is a very thorough document that goes into fine detail of any incident (or “near miss”) of Steven doing something untoward. This form goes to the psychologist and the positive behaviour team.

3) Daily Activities: This lists everything that Steven does during the day from having a bath; going to the gym; watching Daybreak etc.

4) Independence Logs: This is for the occupational therapist and covers anything that Steven does for himself and includes: applying deodorant; putting his clothes into the washing machine; packing his swimming gear into his bag.

5) Mood & Behaviour Logs: Another one for the psychologist – every mood change is carefully recorded and reasons why he might go from content to anxious considered.

6) Social Story Monitoring Chart: This is for the speech therapist and traces Steven’s reaction to the “Night Shift” story by recording his reaction at four stages during the course of the narrative.

7) Monthly Log Summary: Everyone gets a copy of this. It’s a monthly summary of any incidents of challenging behaviour.

 

I’m sure you’ll agree that’s an awful lot of recording. We don’t live in a house – we live in an observation chamber. It’s a life under a microscope. It’s a good job that Steven doesn’t understand irony because one of his favourite music videos is the Simply Red version of The Air That I Breathe (http://www.youtube.com/watch?v=hfbAKZTM3-A). That’s what our life feels like most of the time.

As I write this, Steven has been back at home for 542 days, which means that we have completed 542 daily logs. 542 times someone has written that Steven made his bed or had a glass of milk at 5pm. For the first four months, I religiously scanned these documents and sent them off to the professionals for their observations. And for the first four months, I didn’t get a single response, except for the suggestion that the forms be extended to include even more data. So, I stopped sending the daily reports and now, once a month, the support worker’s manager collects them and files them away somewhere.

I really like Steven’s dietician; she’s a warm-hearted, down to earth woman. She did initially analyse the daily diet logs and recommended nine changes to Steven’s daily intake. Not rocket science; just good sensible advice. I implemented all the suggestions and more, but unfortunately Steven’s weight gain has accelerated since the diet began. And that is the end of that input, although, I’m still asked to record everything he eats or drinks.

My guess is that the council use students on placement for their SALT and OT posts. We haven’t had an occupational therapist since before Christmas but up to that point, their emphasis had been almost compulsively focused on encouraging Steven’s independence. The big project of 2011 was pizza making and I got through a whole pack of printer paper recording the progress of that activity. The process of making a pizza was broken down to 28 stages and each stage had to be marked on a scale from 0-5, depending on Steven’s skill and commitment to the task. Since December, my independence logs probably disappear into a person centred void.

As I described in my previous blog post, my big problem is with the psychologist, who is clearly still in litigation mode rather than support mode. We meet every two months where she is ever critical of the lack of information contained in the START incident forms and instead puts her spin on our life with phrases like: “an escalation in aggressive behaviours”. She doesn’t mention the monthly summaries where the figures last month shot through the roof from 2 incidents in May to 3 incidents in June! She has been on our case since Summer 2010 and I don’t think I’m being unfair when I say that I cannot recall one single positive contribution she’s made in two years. But the recording forms are probably three times as long as they were two years ago.

Anyway, I’m ranting. What is my big decision?

Last week, we spent five days in Great Yarmouth. I did all the packing on Sunday night and when our support worker arrived on Monday, he put the big blue binder containing all the forms/logs into the suitcase. I took it straight out again. I wanted to experience five days out from under the microscope. And it was wonderful. One meltdown when I went to get the keys to the caravan and waited in a queue for 80 minutes and a mini meltdown when Steven realised that they didn’t have a ghost train at Pleasurewood Hills. Both meltdowns were contained and lasted about 20 minutes each; that’s 40 minutes out of the 7200 minutes we were away.

I’m not doing any more logs.

I will use the big blue binder to file the utility bills instead,

If someone asks me what Steven had for breakfast, I will rely on my memory rather than a log.

You can see from this narrative that the piles and piles of paperwork are not about analysis or professional intervention. It is simply recording for recording sake. When we were in court, Hillingdon made a big thing about me “under reporting incidents”. That was their only explanation for the enormous increase in incidents whilst Steven was in the positive behaviour unit. I was able to truthfully say that I had never once been asked for the logs in the 18 months that they had instructed me to keep them. Nobody had been interested.

Perhaps I expect too much. Perhaps I am wrong to assume that the exercise has any other purpose than recording an autistic man’s life. Perhaps I’ve mis-interpreted something as the king’s new clothes. And perhaps cosmetic intervention is the best that can be offered.

One thing that I’m sure of is that if I had been working with one of my clients for two years and they couldn’t think of one valuable intervention I’d made, I’d be deeply ashamed.

Like Mick Hucknall broke free from his observation bubble at the end of the Simply Red video, so I want to release myself from a life of claustrophobic scrutiny. It would be really nice for Steven and I to watch an episode of Mr Bean without the event being recorded on a log. It would be even nicer for Steven to have a meltdown and not feel that recording it will be used against him in the future.

So, apart from a chocolate Yuletide one, the Uxbridge house will now be a log free zone.

 

CRAZY POSTSCRIPT:

I wrote this blog during a gap at work this morning. I’ve had the idea of stopping the logs since we were away last Thursday but haven’t mentioned it to anyone.

I got home today just after 1pm and Steven was out with his support workers. Because it usually holds such a prominent place on the dining room table, I immediately noticed that the massive blue binder was missing.

This is what happened. Probably at exactly the same time that I was writing this blog, Steven was getting very agitated about me going out this evening and threw the folder out of the living room window. We live in a first flor flat, so it landed in the hedge below. There was just the one support worker on duty at the time, so he couldn’t go out and retrieve it and by the time the second support worker arrived, the whole thing had gone missing from the hedge. A few pages of daily logs were stuck in the leaves but everything else was gone. No risk assessments. No incident reports. No behaviour management plans. No record that Steven has had bananas, grapes and satsumas 542 times for breakfast.

Now, you tell me – who in social services is going to believe that story!

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From → Social Care

12 Comments
  1. Audrey I'Keefe permalink

    As always Mark very good blog and tells it as it is…….respect……;-)

  2. blackvandyke permalink

    Good for you! It’s unreal to expect you to spend so much time on paperwork that obviously contributes so little to you and Steven’s lives. Perhaps the next step is sacking that psychologist! (Can you do that? I bet they won’t like it, but can they force you to keep seeing her?)

    I would at least consider continuing to record Steven’s diet as continued weight gain is pretty concerning and could lead to a whole host of other problems – but there are almost certainly better and more convenient ways to do it. I need to log my intake too but I use a commercial tool for it – there are lots of these around, they’re quite similar, always free, always carry some advertising. The one I use is SparkPeople. You set up an account for Steven, read their advice on how to make good use of the page, and go from there. I do my logs on my mobile or on the computer.

  3. abby-lee widger permalink

    Oh Mark, I adore you, Steven and your blogs. Totally pricelss. I hope the support worker filled in their own incident log about the folder for verification of your story (you know I am serious) xx

  4. This is pure Monty Python.

    I sent an email this morning to all the professionals, informing them about the ring binder and my decision not to do any more logs. I compromised and said that I would still do START recording forms at any time we get a rare incident. But the daily logs,stating that Steven had a banana for breakfast etc etc would be stopping.

    I got a reply back expressing deep concern that Steven was able to throw a binder over a balcony and that it could have caused serious injury to a passer by.

    So, this massive folder that includes dozens of risk assessments and behaviour management plans has now become an instrument of risk itself.

    I am so tempted to write the following response: “I share your deep concern and the incident has made me realise that we have commited a serious lapse. Despite having over 100 risk assessments, we do not have a risk assessment to cover the risk assessment folder. If someone could get on to it, I can then attach as an appendix, the behaviour management plan about the risk assessment and behaviour management folder to the risk assessment and behaviour management plan folder. Kind Regards”.

  5. I think the ring binder should be in a secure location that can only be accessed by nominated persons and qualified professionals. There should be a booking out form for anyone wishing to use the folder which must be signed and dated when the folder is booked out and also when booked in again.
    There shall be no more that 20 pages in the folder at any one time so that the mass of the working folder ‘the folder’ will be insufficient to cause injury at normal throwing speeds. All other pages shall be in the ‘archive’ folder which is also in the secure location but is not accessible on a day-to-day basis.
    The folder shall be of a soft construction with no sharp corners and will preferably be covered with a soft foam jacket to prevent injury. Securing of the folder to the secure location is also required to prevent total removal from the secure location. This may be achieved by a bungee cable of no more than three (3) meteres in length and must be securely fixed at each end.
    The secure location shall be locked at night and any incidents recorded on the ‘temporary incident form’ which shall be inlcuded in the folder the following morning. There shall be no more that three nominated keyholders for the secure location and the names of the nominated keyholders shall be recorded on the front page in the folder.
    For suitable folders please refer to MIL-STD-1453-23-4A part D section 21 ‘Folders for demanding environments’

    I hope this helps. 8-}

    • You’ve just passed your interview to be a key member of Hillingdon’s Positive Behaviour Team

      • It’s OK I’m feeling better now, think I will pass on the job offer!
        I’m with you about the folder issue. You may have seen the book ‘F*** Diets’ well I think you should write your own, ‘F*** Folders’, it could be a best seller.

  6. Lena permalink

    Why are they trying to institutionalise your home life? These instruments were primarily designed for collaboration and delivery of targeted care and services by disparate professionals on shift work and in different departments/agencies. Hey ho!

  7. Well that man!!!! And well done Steven – out of the window was the most appropriate way for the damned blue file to leave your lives – if Hillingdon don’t like it let them lump it (whatever that weird phrase means!) – what they going to do about it !!!!!!!!!!!!!!!!!!!

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