‘The doctors said I would be a “cabbage”, unable to walk or talk’
At 19 Jonathan Beebee confounded doctors by making a full recovery after a violent attack. His escape from a life of dependency has driven him to improve community care using positive behaviour support
A small, almost invisible scar on Jonathan Beebee’s head marks the spot where a series of violent blows nearly killed him.
Inside the Birmingham council block where he lived, he was attacked so viciously that his assailant would later be charged with attempted murder.
Slammed against a door, struck with an ashtray, beaten and punched, Mr Beebee just managed to raise the alarm before he collapsed.
At hospital doctors told his devastated parents that their 19-year-old son was going to die.
‘The doctors said I would be a “cabbage”,’ says Mr Beebee, from his modest office overlooking an industrial stretch of land by Southampton’s docks.
‘They said I wouldn’t be able to walk or talk and my parents would need to feed me and change my nappies.’
The attack left him with a blood clot in his brain, broken ribs, collapsed lungs and a fractured hand. He was in an induced coma for six days before confounding the grim predictions and regaining consciousness.
When he woke up, Mr Beebee could not move or speak. Suddenly dependent on others, the communication skills he had taken for granted eluded him.
He remembers lying in his hospital bed, trying to let his mother know that he needed the toilet. He says: ‘I couldn’t get the words out, so they gave me a pen and I managed to scribble the word “shit”.’
Months of intensive therapy followed as he started his slow recovery. ‘I was doing exercises five times a day. I was determined to walk again,’ Mr Beebee says.
‘All the time I was thinking that if I had become the “cabbage” the doctors predicted, who would have looked after me and what support would I have?’
Before the assault, he says, his job at an 80-bed nursing home as a care assistant felt like being on a production line.
During his rehabilitation, while living with his parents on the Isle of Wight, he spotted an advert about learning disability nursing. He says the idea of working in this field ‘resonated’.
His narrow escape from dependency made him keen to help people with high needs. So just 11 months after the attack in 1999, he began nursing studies at the University of Southampton.
Fast forward to 2010, and now having amassed experience of working with people who have challenging behaviour and learning disabilities, he embarked on a master’s degree in applied behaviour analysis.
‘This is the science that underpins positive behaviour support (PBS),’ Mr BeeBee says.
‘It is the study of human behaviour; the rules of life. All behaviour occurs for a reason – we just have to figure out what that reason is.’
This idea is at the heart of PBS4, his not-for-profit social enterprise, which provides personalised PBS for people with high needs and challenging behaviour.
PBS4 takes referrals from local authorities, clinical commissioning groups and those receiving personal budgets.
After only a year, PBS4 is supporting five people with learning disabilities and employs 43 staff.
Mr Beebee is also working with a housing association in Rochdale on a joint project to provide housing and care for people with learning disabilities.
The quest to help people with high needs to live as independently as possible in a positive environment is the driving force behind PBS4. Its aim is to provide compassionate, person-centred care.
The thought of what might have been has shaped his career, and a series of arresting artworks on the PBS4 walls remind people of this.
One is based on an image from the BBC Panorama programme exposing the abuse at Winterbourne View care home which showed a patient lying helpless under a chair while their ‘carer’ sat on it.
The picture depicts an artist’s mannequin trapped under a chair with a pile of banknotes on the seat and warns of what happens when organisations prioritise money over care.
‘We are not doing this to make fat cats richer,’ he remarks, adding that his own early experience as a patient in the system has informed his path.
‘Seeing the abuse at Winterbourne View made me wonder how anyone could treat another human being like that. That could have been me. I could have been the person being sat on.’
‘I then thought about what I could do about it. I wanted to show people how to do it right.’
Care in the community
Mr Beebee worries that the plans to close 50% of learning disability hospitals and move care into the community will not solve current service problems.
‘The focus on closing hospitals does not look at why people are getting admitted in the first place.’
He fears the closures will lead to people moving on to prisons and mental health hospitals if adequate support does not materialise.
As a member of the steering committee for the RCN learning disability nursing forum, he adds: ‘Whenever I see someone who is dependent on their carer, I ask: would that care be good enough for me?
‘Too often services are not good enough, so I strive to champion, advocate and support those with high needs who may not be able to speak up for themselves.’
‘We provide highly competent social care for people in the community,’ Mr Beebee adds confidently.
‘Ultimately it will make going into hospital redundant.’
Key concepts of positive behaviour support
Positive behaviour support is underpinned by applied behaviour analysis
Everything we do is behaviour
All behaviour happens for a reason; the challenge is to uncover what that behaviour achieves for that person
We build better behaviours to meet the function of any challenging behaviour. As long as these are easier for the person, challenging behaviour becomes redundant
Interventions are multi-elemental, so we need to think of various strategies to reduce behaviours that challenge us
Case study: accentuate the positive
Jane was living in residential care with an intensive support team before receiving PBS4 support.
She has an inoperable brain tumour, which gives her epilepsy and autistic traits.
She has displayed severe challenging behaviour and has been aggressive to carers.
PBS4 director Jonathan Beebee says Jane’s care team was burnt out. Most left because of the almost daily incidents.
New staff heard horror stories about injuries sustained by staff on her team and fears grew about working with her.
‘They were petrified,’ Mr Beebee recalls. ‘So the first thing we did was start to tell positive stories about Jane.’
With her family’s permission, PBS4 videoed Jane at the park playing football, singing songs and telling stories, and made the video part of staff inductions.
The team then looked at the reasons for her behaviour and realised it was the result of anxiety, fear and lack of control.
Staff learned to look for signs of anxiety and help Jane calm down and feel safe, by singing her songs, holding her hand and speaking to her in a friendly tone.
Videos were made to give her coping strategies for everyday situations.
As Mr Beebee explains, one strategy on its own would not have been enough. ‘We are now supporting Jane in her own home with a team of eight dedicated to her, whom she regards as friends.’
In the past Jane did not leave the home; now she goes out to a local restaurant and the park.
‘Incidents are now rare,’ says Mr Beebee. ‘But when they do happen, we manage them in a positive, proactive way using strategies for crisis intervention and prevention.’
He explains that if Jane becomes aggressive, staff will let her chase them around until she calms down.
‘She burns off adrenaline and then realises she’s not really upset, that they are friends, and then she starts crying.’
About the author
Stephanie Jones-Berry is assistant editor, RCNi
Find out more