Individual Placement Contract

Description

The person is a young adult with a diagnosis of autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), anorexia nervosa, and complex developmental trauma. The person has been an inpatient for over three years and has been subject to long-term segregation for more than two years due to the level of assessed risk and complexity of needs. The person turned 18 in July 2025. Lot 1: The person is a young adult with a diagnosis of autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), anorexia nervosa, and complex developmental trauma. The person has been an inpatient for over three years and has been subject to long-term segregation for more than two years due to the level of assessed risk and complexity of needs. The person turned 18 in July 2025. The person has been clinically assessed and accepted by Ellern Mede Hospital in Sheffield, a specialist provider with expertise in managing complex eating disorders alongside autism, neurodevelopmental conditions, and significant trauma histories. The person continues to present with significant risks, which are currently managed through enhanced nursing observations at a 5:1 ratio (3:1 constant observations with additional staff on rotation), alongside care in a highly controlled environment free from potential risk items. A gradual and carefully managed approach to peer interaction and external exposure is required due to the person's vulnerability and risk profile. Due to the ongoing requirement for nasogastric (NG) feeding under restraint, combined with serious mental health risks including high suicide risk, the person requires treatment within a specialist adult mental health inpatient setting with the appropriate clinical expertise, staffing levels, and governance arrangements to safely manage these needs. The person remains detained under Section 3 of the Mental Health Act and therefore requires ongoing treatment within a hospital setting. The complexity of the person's presentation, including the interaction between anorexia nervosa, autism, ADHD, OCD, and trauma, necessitates intensive multidisciplinary team (MDT) input that cannot be safely or effectively delivered in a non-specialist or community setting at this time. The clinical team at Ellern Mede Hospital recommend that continued inpatient admission remains clinically necessary, and that Ellern Mede is an appropriate placement to meet the person's complex clinical needs. Funding approval is therefore essential to enable transfer to this specialist setting and to prevent further deterioration in the person's mental and physical health, reduce ongoing risk, and support recovery