Package of Care for individual with Complex Care Needs

The client is a 64 year old man with diabetes who has lost one leg due to this condition. He has reduced capacity due to alcohol misuse. He has a forensic history and continues to present with behaviours that challenge. He is subject to a guardianship order, with WLC holding welfare and financial guardianship.

A package of care and support is being provided in an individual tenancy in West Lothian. The package of care is provided by two member of staff 24 hours a day, 7 days a week.

Cognitive capacity: This is reduced due to alcohol related brain damage and there is no suggestion or likelihood of recovery. Although he has been sober for a number of years, there is a high likelihood of gradual decline through diabetes and a higher than average possibility of developing a vascular dementia

Potential changes in level of need: There is currently a relatively settled period with very few causes for concerns requiring ASP. Aggressive outburst appear to be confined to staff. The client is very demanding of staff. The client remains very sexualised and can be inappropriate in his behaviour towards staff or with members of the public. The client has a history of absconding from his designated accommodation. A tracker is on his wheelchair which staff can use to find him via the app on the staff phone should he abscond.

Physical needs: The clients bloods are monitored using a Libra monitor on his arm. Staff are required to respond appropriately e.g. sweet and gels when low.

General Risks: The risk of the client lashing out and/or sexually assaulting staff remain high. This is only liable to reduce when he becomes so heavily impaired that he does not have the physical ability to assault, or the motivation to do so.

Smoking: Staff have observed that his agitation and aggression increase when he does not get as much tobacco as satisfies him, which had led to his tobacco being increased. While this is bad for his health and diabetes, there is an agreement between the provider and HSCP that the reduced risk of violence to workers justifies smoking.