In January 2023, Fosse Support Services received an urgent expression of interest from Derby City Council concerning a 17-year-old male, referred to as J. At the time, J was living in an unregulated children’s service under extreme distress and unsuitable conditions.
J had withdrawn from education six months prior due to escalating anxiety and significant safeguarding concerns, including reports of him receiving food through a window - a stark indicator of the breakdown in appropriate care.
Initial Assessment: A Crisis in Care
Upon meeting J for the first time to complete an assessment, it was evident that his current support provider was unable to meet his needs adequately. J was being supported by five staff members at all times. His behaviours of concern were frequent, often resulting in 5:1 restraints.
J's living conditions were poor; he lived in a three-bedroom mid-terrace house that had a strong smell of urine and faeces. The narrow stairs and regular use of restraints while moving between floors highlighted concerns for the safety of him and his staff team. As well as this J had no access to the kitchen or garden due risk assessments identifying these areas as high-risk. His community access was minimal, with only a one 10-minute park visit recorded in the past month, and his days were largely spent watching TV on the sofa with no meaningful engagement observed.
A Person Centred Pathway with Fosse Support Services
Recognising the urgency, we deployed two experienced team members to work alongside the existing provider while building a dedicated support team around J.
We collaborated with an Occupational Therapist to assess the type of property that would best support J’s safety and wellbeing. As a result, we secured a three-bedroom bungalow tailored to his needs. Our team met with the family of J and supported them to apply for housing benefit and to complete
housing application and new tenancy documentation.
With his environment addressed, we turned to his emotional and social wellbeing. Our team developed person-centred support plans, risk assessments, and a positive behaviour support (PBS) plan - all co-produced with J, his family, and his social worker.
Transition to Stability: A Turning Point
On April 3rd, 2023, J transitioned into full-time support with Fosse. The transformation that followed has been remarkable. Through careful review, J’s support was safely reduced from 5:1 to 2:1 between October 2023 and June 2024, with a corresponding drop in restraints - from eight in early 2024 to just one in 2025 - exceeding national reduction targets.
J now actively participates in a variety of community activities, where once he was isolated and disengaged, J is now supported to explore, enjoy, and engage with the world around him.
Impact: A Life Reclaimed
The positive impact of these changes is reflected in the feedback from J’s mother. During a recent phone call, she expressed her
relief, stating, “I visit J every Friday. I used to leave after my visit with a sense of dread; I don’t feel that way anymore.”
J’s journey is a powerful reminder of what is possible when person-centred care is genuinely prioritised. From a place of high risk and restriction, J has moved toward a life filled with connection, purpose, and care.