Steven had been going to Flex gym for several years and had a one to one circuit session with his personal trainer, Adam. They had a great relationship.
Steven had a self created set routine each week that he always followed. Upon arrival at the gym, he would chat to the wheel clamper and stroke his beard, go and get changed, then point at name all the gym members on the gallery wall. Adam would arrive and they would do 15 minutes on the rowing machine, a circuit of all the weights, a game of football and a fast game of catch. It worked like a dream the vast majority of weeks.
The SALT had examined this routine and decided that one potential problem with it was that Steven may get agitated if someone was using one of the machines he was due to use and his sequence around the machines would be broken. It was a fair point, although I couldn't remember an example of when it had caused a problem.
Anyway, one day she turned up (with the assistant manager of the Unit and a student care worker) right in the middle of Steven doing his naming the members part of his routine. The SALT had produced a symbol card, with pictures of each of the equipment in the gym. Her plan was that before Steven used a piece of equipment, he put up the symbol for that exercise and then remove it before moving on to do his next set.
Steven became very agitated because his normal routine was in tatters. Over 20 times, he pleaded - "want Sally to go" but she stayed put, determined to introduce her programme. Adam arrived and stood by helplessly in what, was after all, his arena. Eventually the inevitable happened - Steven was screaming and hit me across the chest. The SALT and the assistant manager left at that point. Adam said that they had succeeded in what they set out to achieve.
A week later I saw the logging of that incident. It was classified as "Intolerable high risk" as it was in a public place and a member of the public could have been at risk from Steven's aggression.
More risk assessments needed.