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This weeks blog comes from Julian Fennell, Deputy Director of Adult Services, who perfectly outlines how Autism East Midlands enabled a safe return to day services following a lengthy break.

Getting it right from the start

Throughout lockdown, Autism East Midlands maintained contact with those we support in a way that met individual preference and as safely as able. For some we generated activity packs and delivered them to homes, for others we tapped into special interests and skills and helped organise and facilitate online activities, quizzes and themed events.

We also recognised that families were also adapting to change and were equally happy if those preferences were for us to remain in the background and be available to provide support and guidance as and when required.

Our aim of course was to maintain contact, be ready for a safe resumption of service and offer the support that individuals and their families needed most during such uncertain times.

What has been refreshing on this unfamiliar journey is that we have all developed some new skills too, particularly as one of our greatest challenges was learning together how to use zoom or teams and connect remotely.

Preparing to Resume day services

As we watched the news, listened to politicians and medical experts, we were working in the background to develop a resumption of day services. Most autistic adults will not recall such a lengthy period outside of routine since they attended school and were subject to ‘summer holidays’. Therefore we wanted to ensure that a transition back to services was as successful as we could enable for both them and their families / carers.

Our plans across our day services return focussed on areas such as the continuation of regular handwashing, structuring of environments to create ‘bubbles’ with those we support and peers they are familiar, implementing and adherence to social distancing and the changes we need to apply to react to the continued closure of venues our day service users find so popular – such as bowling, swimming, gym and trampoline venues.

Changes in the environment, structure and routine

Since rules on bubbles and the amount of people who can congregate for certain activities is constantly being reviewed, it has been impossible to provide services to all of our day service users simultaneously and in the way they have been accustomed. Each of our day services have spent considerable time splitting their building in to ‘quadrants’ to enable safe and agreed interaction and contact.

Our Hamilton day service in the heart of Nottingham has split their building over three floors. Those we support have been consulted on timetables and elect an ‘am’ or ‘pm’ slot, (the day service hours have been extended to ensure that individuals receive their full commissioned support) arrive at the service at set times, have a new and welcoming thermal imaging camera to support picking up on one of the key symptoms of the virus, have ‘named’ rooms that they will have safe access to, have consulted and revised programs of activity and will leave in a way that reduces the amount of unnecessary contact with large groups.

All of our services have applied the above principle and additional measures to make services for those returning as safe as able, those include as mentioned thermal imaging camera’s to test temperatures and support attendance, but also deploying staff in such a way that there is a structured program to ensuring that the day services are clean. A robust cleaning procedure has been implemented across each service and those we support understand our requirement to undertake these current measures.

Prior to resumption of services, we consulted with those we support and those who may advocate on their behalf by explaining the changes that they would see on return. For some we facilitated initial visits prior to a planned timetable of return, for others we used visual story boards to help explain what would be:

the same and what would be different

This proved very beneficial in helping those we support understand the changes and ease any transitional anxieties when services resumed.

Implementing social distancing

For those we support, we have seen variation in understanding in relation to social distancing. This of course is common in society at the moment and we recognise that many of those we support have been actively shielding throughout the key lockdown period. Therefore returning to day services is new and exciting and people are meeting up once more with their peers whom they have not seen in a long while.

At Autism East Midlands we applied a similar approach to schools and created accessible signage for services in order to support social distancing as well as setting those new rules that were the same (as they are happening in society in shops, pubs, social venues) and what would be different(such as only having access to one ‘quadrant’ of a day service, or having a packed lunch as opposed a hot cooked meal) and unfamiliar to what is ordinary in someone’s routine.

To support this further, each day service has developed and uses varying word and visual formats to encourage social distancing. Further complemented by agreed changes to timetables, dedicated rooms for ‘bubbles’ of service users and reduced the amount of ‘traffic’ in services in order to make this as easy as able.

Our day service in Worksop has altered the use of an external fixed building to create 1:1 space for an individual who finds it difficult to comply and adhere to recommended safe distancing. The space created means that he can attend his day service and has a newly created timetable that is meeting his current outcomes, but is also developing the opportunity for new ones.