What advice could you give me for a service user who refuses to use the toilet and urinates etc. in his room and in wardrobes? There is no medical reason for this and it appears its a behavioural issue which has been long-standing. The home has given me 4 weeks notice to move the service user as they are unable to manage and are under investigation by the CQC.

Answered by Sheila Scott

Dear Sharon,

I am unclear where you fit in to this very large challenge:

• Are you a registered manager?
• Are you a social worker?
• Who do you work for?

If the responsibility is yours then in the first instance you should contact the person who made the arrangements for this person to live in the home or the GP or the hospital consultant responsible for the person’s medical care.

You must see what they recommend should be done for this person.

If they are unable to help then you could contact the Challenging Behaviour Foundation to see what they would recommend.

http://www.challengingbehaviour.org.uk/

You might also like to look at the Social Care Institute for Excellence (SCIE) website which also issues guidance and advice about how to deal with Challenging Behaviour. In the short term you have the difficulty that the home has given notice and unless you are able to negotiate some time to seriously address the issues then you need to be looking for a home to take him as quickly as possible and you should be looking for a home that is prepared to work with the service user and other parties to try to turn around the issues that the service user is currently presenting.

Wherever the service user lives in the future there needs to be a plan in place setting out how these challenges are to be dealt with.

Best wishes.

Sheila