Registration Form for Buddies

Buddies

Hartley House, 35 High Street, Chipping Sodbury, Bristol, BS37 6BA 5 Badminton Court, Station Road, Yate, Bristol, BS37 5HZ

Buddies is a Day Service for adults with conditions such as, but not limited to, a Learning Disability, Chromosomal Deletion Syndromes, Autism / Asperger's, Mental Health Diagnosis, Sensory Impairment, Acquired Brain Injury. We provide an environment where people can build new friendships and relationships, a fun and entertaining place to spend the day, where everyone who attends can feel safe, supported, and enjoy activities tailored to their needs. Our strap line is "Our Place, Our Space. Buddies is not so much an organisation, but the people who attend make our place, their place, Buddies.

Child Details Parental Responsibility Emergency Contacts Medical Info Other Consents Terms of Service

Applicant's first name: *

D.O.B: *

Gender: *

Male

Female

Applicant's surname: *

Home Address: *

18 Chatterton Road

Age:

Buddies preferred name: This may be your full name or a version / identification you have.

Responsible adult care worker / social worker: Name, telephone, team

Service users Gender preference for personal care: To protect the dignity of the S.U. and respect their needs and wishes, they may, or may not, prefer same sex staff to support them with personal care

Female if ever needed but no personal care requirements at this time

This is who I am and what is important to me: This should be a brief description of the type of person you are, the tings you like to do, the people that are important to you and your communication, medication, nuttrition needs (including chewing and swallowing), personal hygiene support requirements, safety in the community, triggers that will cause an emotional reaction (not just challenging behaviour but situations that might frighten or result in emotional upset). Please record your own view of what you need to get the most out of Buddies Day Service. This could include the level of support needed, best interventions, communiation support, what works well and what does not. *

Updated 16/07/2024
This is a review for Michael Perkins, who prefers to be known as Mikey. 
Mikey is 23 years old. Mikey has a diagnosis of Autism, Learning Difficulties and Epilepsy, and speech and language issues. Mikey's learning difficulties were diagnosed at the age of 2, and his Autism was diagnosed when he was 15 by a Paediatrician.

Mikey is described as a friendly and smiley young man who likes to be sociable. Mikey said his Family, iPad, hanging out with friends, his cat Blackie, and his neighbours dog are important to him. Mikey would like to get a job in the future – he fed back in his recent EHCP review, he is not sure now of interests - maybe in a café or apple store if he could. Mikey likes gaming - but not to get a job in gaming (as he has previously said). Though, he does like gaming - Mikey likes XBOX and Board Games. Mikey also likes his iPad, and enjoys listening to music, watching YouTube, watching Formula 1 and darts. Mikey currently goes swimming in the week, and Boxfit and Crossfit on weekends. Sarah advised that Mikey does not like to be bored. He likes to get out and be occupied. Mikey has a close relationship with all his family, and they enjoy spending time together. Mikey’s Father runs a group called “Nothing Special” which is for young people with additional needs.

Mikey previously had involvement from the Adult Community Learning Disability Health Service, (ALDHS, previously known as CLDT), via Occupational Therapist and Psychiatry – he was supported around food avoidance and nutrition. Mikey has not been diagnosed with ARFID (avoidant/ restrictive food intake disorder) but Sarah advised that this has been discussed and considered as something Mikey may have. Mikey has had continued involvement as and when support has been required via ALDHS – he has also had music therapy.

Service User's View: Please record your own view of what you need to get the most out of Buddies Day Service. This could include the level of support needed, best interventions, communiation support, what works well and what does not.

Updated 16/07/2024  -  Sarah Perkins - Mother

Sarah expressed Mikey is at an age where he likes to engage in further activities without the support of his Dad, and begin to build on his independence in doing so, especially when he is not in College. As stated, Sarah was in agreement that Mikey has really enjoyed going to his Day Provision. Sarah is also pleased with the new identified provisions within Mikey’s EHCP starting in September. Sarah has continued to note that outside of education, Mikey does not have opportunities to socialise independently, so she feels that the PA/Day Service and 1:1 support is really important. Sarah advised this is because Mikey needs things to stimulate him and do things – he needs to be out/active and social. Sarah and Jason advised that Mikey has really been building on his independence e.g. personal care and is trying hard.
Sarah had a Carer's assessment and one-off payment completed at the end of last year (December 2023).
Sarah is in agreement with this new plan, and feels this will be a good range of support for Mikey, as she is trying to ‘future proof’ as much as she can, so exploring CBS 1:1 to replicate what was there with a PA for Mikey to continue building on independence aware from them is positive, as well as the meaningful and consistent social links he has established at his Day Service.

13-06-2023
We want Mikey to continue to be happy and have a fun purposeful life. Mikey enjoys going to different activities and visiting different places. We would like to see Mikey become more independent - he is trying hard but still looks for others to do help him. He is pleased with himself when he does do something on his own. He is a sociable young man and we want him to continue to enjoy meeting friends which helps him so much with his communication skills. It is important for the future that Mikey has a range of things to interest and stimulate him. He expresses that he does not want to stay at home all day and do the same things over and over again. He enjoys going out and doing things - we just need to identify what those things might be.

We would like him to have a varied number of activities in the future and for him to be more independent from family - we hope when a PA is sorted this will start to improve.
We have had the initial social care assessment and are in the process of approval for funding for a PA. This will make independent trips / activities much easier for Mikey which will be brilliant for him.

Mikey wants to become more independent and very often mentions the fact he is 22 now. His selfcare is better and he is showering himself with Dad supporting. He does dress himself up to the things he finds hard like socks and shoes, zips and buttons. It is hard with shoes as he can do up a Velcro shoe but does not want to wear them as he wants a fashionable trainer. This improved independence has caused issues with getting out of the house on time as it runs to Mikey time, and he will not hurry and often claims he has come down at the right time.

We support Mikey to access activities which Jason runs via the Nothing Special group and recently this has included glass blowing, surfing, virtual reality, pub nights and crazy golf. We both feel he gets a lot out of these activities. Mikey has developed his voice and opinions over the last year and speaks about things much more than before. He has no concept however, that other people are speaking or have not finished their part of the conversation. He constantly speaks over people or turns up the volume on his ipad or game to drown others out. We are trying to help him understand other people wanting to speak as well. He likes to be the centre of everything. He is also so stubborn and if he does not think something should happen or is not happening then he will not deviate from his opinion. For example, if his weather app says it is not raining but it is he will not accept it even if he is outside and can see the rain.

Mikey has become more independent and will try to do more things. His interest in cooking at college has grown and he talks about that a lot. He has asked for a pasta maker for Xmas but he often shows no desire to do cooking at home. When he does though he enjoys it. Mikey's epilepsy is now much more under control and seizures are not as frequent as they were which is good. His overall health has improved. Mikey's weight has improved and he is eating much better but his eating habits are very up and down - sometimes good which is what I think he is at college but at home it is much hit and miss.

He also will not accept he has epilepsy at all. Mikey resists most suggestions to improve his level of independence.
His communication skills in a group situation are still poor - he speaks quietly, says random things when others are not listening and struggles if he is not with people who know him well. This does very much hamper his road to independence as if he cannot communicate clearly with people he does not know well then his progress is limited and he still relies heavily on family and friends to help him. At home he will say food is too hot and sit for up to an hour or more before food is at an OK temperature to eat. His reluctance to repeat foods continues and even with meal planning this is difficult. He has also been found to be low in vitamin D which is being addressed with a supplement.

He continues to struggle with muscular pain despite the increase in his physical activity in the last year. He is very controlling and restrictive. We still struggle if food has green in it and the repeating of foods during the week.

Avoidant/restrictive food intake disorder (ARFID) is previously known as feeding disorder or selective eating disorder. Someone with ARFID avoids eating certain foods, limits how much they eat, or does both. When a person develops ARFID, they are less worried about their body weight or shape and develop the eating disorder for other reasons, which include: a dislike of the smell, texture or taste of certain foods. feeling anxious following a negative experience with food, for example choking or sickness. previous fussiness with eating which develops into a more severe dislike of certain foods. a lack of interest in food and not feeling hungry. ARFID is more common in children with learning difficulties, attention deficit hyperactivity disorder (ADHD) and autism spectrum condition (ASC).

Updateed July 2024

Sarah Perkins - Mother

Mum - Sarah's views have been incorporated largely into the above conversation. Sarah expressed Mikey is at an age where he likes to engage in further activities without the support of his Dad, and begin to build on his independence in doing so, especially when he is not in College. As above Sarah was in agreement that Mikey has really enjoyed going to his Day Provision. Sarah is also pleased with the new identified provisions within Mikey’s EHCP starting in September.

Sarah has continued to note that outside of education, Mikey does not have opportunities to socialise independently, so she feels that the PA/Day Service and 1:1 support is really important. Sarah advised this is because Mikey needs things to stimulate him and do things – he needs to be out/active and social. Sarah and Jason advised that Mikey has really been building on his independence e.g. personal care and is trying hard. Sarah had a Carer's assessment and one-off payment completed at the end of last year (December 2023).

Sarah is in agreement with this new plan, and feels this will be a good range of support for Mikey, as she is trying to ‘future proof’ as much as she can, so exploring CBS 1:1 to replicate what was there with a PA for Mikey to continue building on independence aware from them is positive, as well as the meaningful and consistent social links he has established at his Day Service.

Carer's views: If this is a comissioned service, you may already have had your views recorded but it would be beneficial for Buddies to have this directly from you here.

Updated 16/07/2024
This is a review for Michael Perkins, who prefers to be known as Mikey. 
 I have gathered information for this review from his previous Assessment, as well as updated information from ongoing involvement and communication with both Mikey and his Mum, Sarah. At this time of review, Mikey has now finished his College placement, where he has attended since 2023. Mikey was attending 3 days a week, completing Foundation Studies, Futures Programme.
At an EHCP (Education Health Care Plan) review earlier this year, it was noted that Mikey was at the stage of phasing out of education/College. Mikey fed back he is now a 23 year old man, and he does not want to stay at college next year. Mikey expressed that he wants to do something else that is work based instead of classroom based. Mikey has now been supported by the Education Team to identify an enterprise based provision, 1 day a week, and is currently exploring a potential further day at another provision. This Conversation is therefore being completed, as we have reviewed and considered Mikey’s social care needs/goals alongside the new education provision from September 2024.

Mikey lives in the family home with his Mum, Dad, and younger sister, Lucy (18). Lucy is soon starting University so will be living away term time. Mikey’s Nan lives at the same address in an annexe attached to the house. As noted above, Mikey has just finished his year at SGS College Filton. Prior to this he was at The Chase, and he previously attended New Siblands School. 
Mikey previously had involvement from the Adult Community Learning Disability Health Service, (ALDHS, previously known as CLDT), via Occupational Therapist and Psychiatry – he was supported around food avoidance and nutrition. Mikey has not been diagnosed with ARFID (avoidant/ restrictive food intake disorder) but Sarah advised that this has been discussed and considered as something Mikey may have. Mikey has had continued involvement as and when support has been required via ALDHS – he has also had music therapy.
Mikey is under Neurology - Southmead for his Epilepsy. He has medication twice daily – this is Carmazapene, and Levetiracetam (an add-on therapy with other seizure medicines). Mikey also has emergency Buccal Midazolam, but they have never had to use this. Advice was sought from ALDHS as part of this review, to be clear on this, as Mikey has always had involvement from PA’s who the family have arranged training for, and we are now exploring Commissioned Services. Due to being prescribed Buccal Midazolam as a rescue medication for prolonged seizures, this would be a medical emergency they would recommend Mikey has to have someone with him who would be able to administer the medication if required. ALDHS have confirmed that the plan is applicable to cover travel as he could have a seizure while in transport. ALDHS advised it is common for support workers to be trained in Buccal Midazolam and drive cars so there does not need to be a second colleague. Sarah explained the history of Mikey’s seizures – they have mainly been in bed, he has only had one outside of the home. Prior to medication/management Mikey was having Seizures and/or absences daily, but now it may be 1 every 2 months. Mikey has a epilepsy alarm mattress. 

Mikey has undergone genetic tests due to his Kyphosis - an abnormality of the spine causing excessive curvature of the upper back. This causes pain and stiffness, but nothing was identified. Mikey has had 2 major spinal surgeries. He now has an open appointment with Orthopaedics. Noted Medication is correct as at time of assessment and could be subject to change. Sarah manages Mikey’s medication to ensure that he takes this. He takes liquid medication, however he does not have the dexterity to use a syringe so he is supported to take the medication too. Mikey also has paracetamol and ibuprofen. Mikey relies on others to identify when he is unwell and is supported appropriately by them to feel better. Mikey can tell someone that he is in pain – e.g. if he hurts himself. If a medical appointment is required, Sarah will ensure that these are made, and supports Mikey to attend and ensure that he is understood and his needs are expressed. Mikey has annual health checks, where he is supported by Sarah.

Mikey experiences anxiety, and Sarah has stressed the fact he experiences it daily. This appears to be attribute to his Autism. Reasons for heightened anxiety for Mikey may be; new situations, change, new people, if clothes not on properly or if he does not want to do something. 

Mikey wears glasses everyday due to being short sighted, his hearing is fine. Mikey has a good memory and specifically remembers dates and times well.

Mikey can talk and type to communicate with people. Mikey tends not to speak in full sentences and may be quiet when first meeting someone, as he can become anxious communicating with new people. Sarah advised that Mikey’s speech can be "garbled". Sarah advised therefore, that new people may not always understand what Mikey is saying and he will need to repeat himself. It was reported in his previous assessment, that even in instances where Mikey understands what is being said, he may look to a familiar face e.g. his Mum to repeat what is being said and/or to communicate via her. This is apparent during my involvement with Mikey - Sarah sometimes repeats questions asked and Mikey responded through her. However, during my work – at home visits, College visits, or via Teams/phone calls - Mikey has also verbally communicated and answered my questions directly. When communicating with Mikey, it is important that speech should be slow and clear, and sometimes, re-phrasing can help him understand better. Mikey has never used any communication aids such as pictures/photos and never wanted to use these or Makaton/visual aids. At this time, Mikey is happy for his Mum to be contacted on his behalf as the point of contact.

Mikey is in receipt of Universal Credit and PIP – Sarah is his Appointee. Mikey has his own bank account; however, his benefits are paid into Sarah’s account, and she transfers the money to Mikey. Mikey needs support to manage all aspects of his finances. Mikey has been supported with this by PA's - such as shopping and use of money at the tills.

At this time - Mikey is supported by both PA and Day Service to build on independent living skills away from the home – such as cooking/ baking/ planning/ shopping/ accessing the community/public transport. Aside from this, outside of College, most of Mikey’s social activities are managed via family, in particular with his Dad, Jason. Mikey enjoys going to Rhythm of the Night disco once a month on a Thursday. Mikey also enjoys going to a youth club in Filton - he now attends this independently but is supported going to and from the club by his family.

Mikey is supported in all aspects of running and maintaining his home environment, as this is managed by Parents. Mikey keeps his bedroom clean, but he does not spend much time in there. Mikey will take his plates and cutlery to the kitchen after a meal and does do other jobs around the house. Mikey is prompted when his clothes need washing/changing but his mum will do his washing. If Mikey was to be left at home by himself, he would not be able to manage. Mikey's Mum believes that Mikey is "unaware" of bills and house safety.

Mikey's mobility is varied when he is outdoors, especially on uneven surfaces. Mikey can struggle to walk long distances - this can take it out of him. When he is struggling, he can become slow and stiff when walking and when tired, he will start to drag his left leg due to having overly tight muscles. Mikey holds onto people for support when he is out, especially when it is busy or when crossing a road. Whilst Sarah believes he understands road safety, he does not go out unaccompanied as he would "freeze" if something unpredictable happened, as well as his Epilepsy and requiring support in an emergency.

Mikey needs support to manage food/nutrition. Mikey’s family support in this area by preparing meals, and supporting Mikey to cut his food up. However, as noted above, this is an area his PA's have also supported Mikey with in regards to building on independence. Mikey is able to cook some meals, such as an omelette. Mikey is able to drink out of all glasses as long as they are not too heavy. Mikey was previously underweight and has always had a lot of sensory difficulties and rigidity around food/diet – such as chewing too much, not repeating food/meals, and being particular about what food he will eat – he especially does not like green food, and is also fixated on not having the same food item more than once a week, or not having the same meal at home if he has already had it that week at school. Sarah advised Mikey has been supported with his fitness and to gain/maintain weight. Since this, she also noticed that his seizures have been less.

Mikey requires support to manage his personal care needs. His Dad predominantly provides the support with this, but Mikey has been supported to build on his independence in this area and this is going well. Mikey is supported with drying himself, shaving and brushing his teeth due to his lack of wrist movement. Mikey is able to use the toilet independently. Mikey enjoys having a bath, but usually showers as this is quicker. Mikey is able to dress himself with clothing such as jogging bottoms, and Sarah/Jason advised Mikey is really trying hard building on his independence, but requires support with belts, buttons, zips, laces and Velcro. Mikey does not understand weather appropriate clothing and would prefer to wear a t-shirt all year round. Mikey will say that he is hot even if he is too cold so that he can avoid wearing a fleece. Therefore, Mikey's family support him to be appropriately dressed for the weather. Mikey does not like the colour green in general and won’t wear green clothes.

Mikey has a particular routine he follows in the morning - get up, has a glass of water, medicine, breakfast, goes to the toilet, cleans his face, brushes his teeth, washed his hands, 2 sprays, then extra medicine, then get dressed, shoes and socks, coat. Encouraging Mikey to build on his independence does mean that it can take time to complete tasks, which can be difficult if there is time constraint (e.g. getting ready for a set time) as has to follow structured routine also.

Summary
In summary, Mikey continues to have identified care and support needs within most of the domains of The Care Act. At this time, a lot of his needs are met at home via family, or education provision, as well as existing social/day activity and his PA. Recently – it has been highlighted that finding a new PA has been difficult, but his family have managed to identify PA’s who can provide support during academic holidays. It was therefore previously agreed that PA support would remain in holidays, but Mikey’s identified Day Service Provision was to be in place weekly/ongoing. This been beneficial in working toward the same needs which previous weekly PA was focusing on - community/social opportunities, independence skills, meaningful activities. Mikey remains keen to go to this provision 1 x weekly, alongside his new Education Provisions. Mikey told me that he has friends there, and really enjoyed going and the activities that they do.

Therefore, Mikey now attends his social provision 1 x a week, and the Direct Payment support remains within the school holidays. For the purpose of this conversation/ updates – Day Service is now going to move to a commissioned service.

What support services are presently being accessed or provided: Please let us know of any services currently attended and any previous services. You may wish to add why these are not giving the full range of support and outcomes you would want or expect *

No previous placement, moved from college in summer.

Gender identification: When we use pronouns like “she” or “he” to identify a person without asking them what pronouns they use, we may be making an assumption about that person’s gender that differs from their gender identity. Some people express their gender in a non-binary way and use pronouns such as they/them or ze/hir/hirs. People who look to be one gender to you may identify as another gender.

No stated change from the general she, he, him, her etc.

Local authority assessment: Copy of the details recorded by carers in assessment of needs

Lisa

Lead professionals views: Copy of lead professionals statement

Sophie would benefit from attending more social groups to support building her confidence around others. 

Sophie is very able and i am sure would manage well in a supported living environment with core support overnight and an element of 1:1 hours.

Buddies day service to increase to 1 day a week as a commissioned service wef 1st Feb 2024 Sophie to be added to the supported living list so any suitable vacancies can be discussed with her.
UPDATE:
Sophie has visited Empowering Futures Farm and she she would like to attend one day a week (Fridays). This will be set up as a direct payment.

The farm will support Sophie with her confidence through craft, cooking, animal husbandry activities and socialising/working with other young people.

Social Worker conversation: Outcomes

Miss Sophie Mortiboys, who likes to be known as Sophie lives with her Mother (Sarah), Step-Father (Dave), Sister (Chloe) and Brother (Dan). Sophie likes animals and owns pets including dogs, fish and a hamster. In her spare time she enjoys shopping, walking, doing yoga, and going swimming.

On Monday's Sophie volunteers at the Children's Hospice charity shop in Yate and has recently got a part time job in a local pub kitchen for 4 hours on a Saturday evening.

Sophie has a diagnosis of Autism. She was diagnosed in 2016. Sophie explained she felt relieved to be diagnosed as it helped her to make sense of her behaviors. Sophie completed her GCSE's through home schooling. She did attend school initially, however she found it hard socially. Sophie struggles with heightened anxiety and is particularly anxious in social situations, she has tried talking therapies and medication for this however not found it helpful.

Sophie is independent in many aspects of her life. She is able to cook simple meals and is independent with all personal care. Sophie is able to leave the house independently and frequently walks to the shops in Yate or goes on long walks with her dog. Sophie will sometimes get the bus to Bristol to go shopping.

Sophie gets PIP and ESA. She manages her money herself by using her bank card and online banking.

Initial assessment of care needs based on local authority assessment:

Attends Pauls Place on Monday

Primary contact first name: *

Surname: *

Only enter your details here if you are either a parent or appointee responsible for funding: If not commissioned, invoices be sent to this person or Managed Account Provider (Penderel, WECIL, Paymentplus etc.) *

Address: *

108 Edgeworth
Yate

Contact number: *

Service users contact number: This is important in the event of a no show to check on the welfare of the service user

Email address: *

Service User Email address: General information relating to current activities and events are done via whatsapp.

Are there any other contact restrictions, times when you should not be contacted?:

Yes

Details of contact restrictions: We will only contact you during these times for general enquiries. In an emergency, we will call you immediately.

Deborah McCance

Secondary contact:

Surname:

Relationship:

Address:

88 badgeworth 
yate
bristol 
bs378yj

Contact number:

Work number:

Email address:

Is this a personal or professional relationship:

Guardianship/Appointee/Financial responsibility for the service user is with:

Primary contact

Secondary contact

Both (joint custody)

Other

Emergency contact is often the primary contact but where applicant is in a supported living service, the primary contact is often home manager or senior. Please add your details if you are the applicants parent or primary carer: In an emergency, paramedics will be contacted in the first instance. We will then endeavor to contact relevant people as listed here. *

Relationship:

Address:

108 Edgeworth
Yate

Mobile number:

Work number:

Emergency contact 2, if not parent/provider/appointee:

Relationship:

Address:

11 Minett Road, Ladden Garden Village, South Gloucestershire, BS37 7DX

Mobile number:

Work number:

Emergency contact 3, if not parent/provider/appointee:

Relationship:

Address:

26 Farley Close Little Stoke, Bristol, BS34 6HB

Mobile number:

Work Number:

I, hereby consent and grant permission to the following persons to collect the service user detailed here (Must be 18 years or over):

Joe Mitchell
Sophie Bell

GP Details:

Practice/Surgery address:

Courtside Surgery, Kennedy Way, Yate

Practice/Surgery phone Number:

Allergic reactions - Severity: *

Very high

High

Medium

Low

Allergies and/or medication', if any: Include name, dosage and frequency of medication

Physical or Medical conditions: Please bullet point name only in this section

Does the service user have any dietary requirements:

Yes

Please detail any special dietary requirements, medical, religious practice or ideological preference.:

Does the service user have any specific food and drink likes/dislikes:

doesn't like tuna tomatoes fish

Medication (Please list any medication the service user takes regularly and any drug interactions or food and drink to be avoided):

Omeprazole- 20mg daily 
Millinette contraceptive pill- 75mg daily 
Vitamin C 
Vitamin D

Additional information relating to diagnosed medical conditions: Buddies will record generic information from the NHS website of typical causes, traits and symptoms of your medical conditions for information purposes.

Addison's disease, also known as primary adrenal insufficiency or hypoadrenalism, is a rare disorder of the adrenal glands.
The adrenal glands are 2 small glands that sit on top of the kidneys. They produce 2 essential hormones: cortisol and aldosterone. The adrenal gland is damaged in Addison's disease, so it does not produce enough cortisol or aldosterone.

Symptoms of Addison's disease
Early-stage symptoms of Addison's disease are similar to other more common health conditions, such as clinical depression or flu. 
You may experience:
•	lack of energy or motivation (fatigue)
•	muscle weakness
•	low mood
•	loss of appetite and unintentional weight loss
•	increased thirst

Over time, these problems may become more severe and you may experience further symptoms, such as dizziness, fainting, cramps and exhaustion.
You may also develop small areas of darkened skin, or darkened lips or gums.
Although these symptoms are not always caused by Addison's disease, you should see a GP so they can be investigated.

Why it happens
Addison's disease is usually the result of a problem with the immune system, which causes it to attack the outer layer of the adrenal gland (the adrenal cortex), disrupting the production of the steroid hormones aldosterone and cortisol.

Treating Addison's disease
Addison's disease is treated with medicine to replace the missing hormones. You'll need to take it for the rest of your life.
With treatment, symptoms of Addison's disease can largely be controlled. Most people with the condition have a normal lifespan and are able to live an active life with few limitations. But many people with Addison's disease also find they must learn to manage bouts of fatigue, and there may be associated health conditions, such as diabetes or an underactive thyroid (hypothyroidism).

Adrenal crisis
People with Addison's disease must be constantly aware of the risk of a sudden worsening of symptoms, called an adrenal crisis.
This can happen when the levels of cortisol in your body fall significantly. An adrenal crisis is a medical emergency. If left untreated, it can be fatal.
If you or someone you know has Addison's disease and is experiencing severe symptoms, they will need a hydrocortisone injection immediately, either injected by themselves or by a person who is with them. Then call 999 for an ambulance, saying it's an "adrenal crisis" or "Addisonian crisis".



Crohn's disease is a lifelong condition where parts of the digestive system become inflamed.
It's one type of a condition called inflammatory bowel disease (IBD).

Symptoms of Crohn's disease
Crohn's disease affects people of all ages. The symptoms usually start in childhood or early adulthood.
The main symptoms are:
•	diarrhoea
•	stomach aches and cramps
•	blood in your poo
•	tiredness (fatigue)
•	weight loss

The symptoms may be constant or may come and go every few weeks or months. When they come back, it's called a flare-up.

Treatments for Crohn's disease
There's no cure for Crohn's disease, but treatment can help reduce or control your symptoms.
The main treatments are:
•	medicines to reduce inflammation in the digestive system – usually steroid tablets
•	medicines to stop the inflammation coming back – either tablets or injections
•	surgery to remove a small part of the digestive system – sometimes this may be a better treatment option than medicines

You'll usually have a team of health professionals helping you, possibly including a GP, a specialist nurse and specialist doctors.

Living with Crohn's disease
Living with Crohn's disease can be difficult at times. Unpredictable flare-ups and regular check-ups with your care team can disrupt school, work and your social life.
But if symptoms are well controlled, you can live a normal life with the condition.

Causes of Crohn's disease
The exact cause of Crohn's disease is unknown.
It's thought several things could play a role, including:
•	your genes – you're more likely to get it if a close family member has it
•	a problem with the immune system (the body's defence against infection) that causes it to attack the digestive system
•	smoking
•	a previous stomach bug
•	an abnormal balance of gut bacteria

There's no evidence to suggest a particular diet causes Crohn's disease.

Common symptoms
The main symptoms of Crohn's disease are:
•	diarrhoea – which may come on suddenly
•	stomach aches and cramps – most often in the lower-right part of your tummy
•	blood in your poo
•	tiredness (fatigue)
•	weight loss
You might not have all these symptoms.

Other symptoms
Some people with Crohn's disease also have:
•	a high temperature
•	feeling and being sick
•	joint pains
•	sore, red eyes
•	patches of painful, red and swollen skin – usually on the legs
•	mouth ulcers

Children with Crohn's disease may grow more slowly than usual.

There's currently no cure for Crohn's disease, but treatment can control or reduce the symptoms and help stop them coming back.
Medicines are the main treatments, but sometimes surgery may be needed.

Steroids
Most people with Crohn's disease need to take steroids (such as prednisolone) from time to time.
Steroid medicines:
•	can relieve symptoms by reducing inflammation in your digestive system – they usually start to work in a few days or weeks
•	are usually taken as tablets once a day – sometimes they're given as injections
•	may be needed for a couple of months – do not stop taking them without getting medical advice
•	can cause side effects like weight gain, indigestion, problems sleeping, an increased risk of infections and slower growth in children

Liquid diet
For children and young adults, a liquid diet (enteral nutrition) can also help reduce symptoms.
This involves having special drinks that contain all the nutrients you need, instead of your usual diet, for a few weeks.
It avoids the risk of slower growth that can happen with steroids.
Enteral nutrition has few side effects, but some people may feel sick or have diarrhoea or constipation while on the diet.

Immunosuppressants
Sometimes you might also need to take medicines called immunosuppressants to reduce the activity of your immune system.

Biological medicines
If other medicines are not helping, stronger medicines called biological medicines may be needed.
The biological medicines for Crohn's disease are adalimumab, infliximab, vedolizumab, ustekinumab and risankizumab.

Biological medicines:
•	can relieve symptoms if other medicines are not working
•	can be used as a long-term treatment to help stop symptoms coming back
•	are given by injection or a drip into a vein every 2 to 8 weeks
•	may be needed for several months or years
•	can cause side effects like increased risk of infections and a reaction to the medicine leading to itching, joint pain and a high temperature

Surgery
Your care team may recommend surgery if they think the benefits outweigh the risks or that medicines are unlikely to work.
Surgery can relieve your symptoms and help stop them coming back for a while, although they'll usually return eventually.
The main operation used is called a resection. This involves:
1.	Making small cuts in your tummy (keyhole surgery).
2.	Removing a small inflamed section of bowel.
3.	Stitching the healthy parts of bowel together.
It's usually done under general anaesthetic (while you're asleep).
You may be in hospital for about a week and it might take a few months to fully recover.
Sometimes you may need an ileostomy (where poo comes out into a bag attached to your tummy) for a few months to let your bowel recover before it's stitched back together.
You may need to take medicine after surgery to help prevent symptoms returning.

Please read our Terms & Conditions View T&C's

Any other instructions :

Early registration is recommended. Registrations will be considered in the order in which they are received. This form must be signed by the parent(s)/ guardian(s) with parental responsibility, guardianship, appointee ship, power of attorney; applying for admission of the service user and who it is assumed will be responsible for the fees. For more details, please visit our website: www.buddiesyate.org

Declaration :

I accept the terms and conditions of Buddies Adult Day Care Service

Yes No

Full Name of Parent/Carer:

Digital Signature

Debbie McCance

Date & time:

14, Mar 2022 12:13 pm

Child Details

Parental Responsibility

Emergency Contacts

Medical Info

Other Details

Consents

Terms of Service