Positive Behaviour Support (PBS) is a ‘person centred framework’ for providing long-term support to children and adults with learning disabilities, autism, or dementia, who have, or may be at the risk of displaying distressing behaviours. PBS helps adult social care professionals, including managers understand the reason for the behaviour so they can better meet people’s needs, enhance their quality of life, and reduce the likelihood that the behaviour will happen.
The bild have created a short introductory video about PBS. Watch it here.
There are 4 main reasons someone may start to present behaviour which challenges:
- Attention – could be positive or negative.
- Escape – they are trying to avoid something.
- Sensory stimulation – they like the feeling of the behaviour.
- Tangibles – they desire a social reaction.
Positive Behaviour Support framework
The framework is divided into three main areas, each of which details specific competencies that need to be achieved to deliver effective support. These are:
|Area||Reason for area|
|Creating high care and support environments||Aims to ensure organisations and those providing support operate from a person-centred support. Person-centred support ensures a high quality of life for all concerned, which includes assessing the risk factors for the development and maintenance of behaviour that challenges.|
|Functional, contextual, and skills-based assessment||Aims to ensure that the support outlined for each person is based on a thorough understanding of that person’s needs, preferences, abilities, communication style, the function for them of any behaviour that challenges and how this is maintained, and the context and resources in which and with such support may be given.|
|Developing and implementing a Behavioural Support Plan (BSP)||Aims to provide a detailed and personalised description of how best to support each person with developmental disabilities and their behaviours of concern.|
All the competencies listed are necessary for the person being supported. However, not all competencies will need to be demonstrated by every individual involved in the provision of care. While there are certain core competencies which will be applicable to everyone, there are also specialist competencies which will be the focus of experts within that area.
For this reason, the framework details three levels of competencies by function which can be identified in the diagram below.
HCC have advice, research and resources relating to Positive Behavioural Support for professionals, citizens and individuals, providers, families, and carers on their website.
Training should be certified by the Restraint Reduction Network
From April 2021, it is expected to see all services across Health and Social Care use training in restrictive practices that is certified as complying with the Restraint Reduction Network Standards. The standards apply to all training that has a restrictive intervention component and provides a benchmark for training in supporting people who are distressed in education, health and social care settings. The standards apply across child and adult services, and to all populations, including people using services with mental health conditions, those living with dementia, people with a learning disability and autistic people.
Due to the coronavirus pandemic, CQC acknowledge that the face-to-face training required to comply with these standards is not always possible. However, since April 2020 any training provider that wants to supply training should be certified by the Restraint Reduction Network. CQC expect providers of services to commission training accordingly.
CQC have published the final report in their review of restraint, seclusion and segregation.
This report describes what they found about the experiences of care for children, young people and adults who are subject to restrictive practices.
|CQC Guidelines for PBS||Brief description on PBS and the support for people with behaviours that challenge.||Click here|
|Find the Reasons for Challenging Behaviour: Part 2 info sheet||Information about what may lead to challenging behaviour and the different stages.||Click here|
|Positive Behaviour Support Planning: part 3 info sheet||Practical tool to support family carers to understand how to reduce the behaviour that challenges.||Click here|
|Positive and Proactive Care: Reducing the need for Restrictive Interventions||Guide prepared by the Department of Health focusing on PBS and restrictive interventions.||Click here|
|Physical Restraint||Information on physical restraint and when it is appropriate to use.||Click here|
|Glossary of Terms||A document that explains commonly used terms associated with PBS.||Click here|
|10 Things you can do to support a person with Difficult Behaviours||List of ideas for uncovering the real things that a person may need so that you can be more supportive with their challenging behaviour.||Click here|
|Support Worker Competence Checklist||A checklist for you to record and demonstrate your competence in delivering PBS.||Click here|
|PAL Guide for Activity Provision||A simple, effective tool enabling participation, person-centred care and well-being of people living with all stages of dementia||Click here|
|PAL Sensory Activity Level Guide||PAL asks users to develop a profile of a person’s interests and likes and dislikes and complete a simple checklist that reveals the level of ability of an individual.||Click here|
|PAL Checklist||The PAL instrument consists of a quick yet reliable checklist to complete for each individual resident. The checklist determines an ability level for each resident – Planned, Exploratory, Sensory or Reflex.||Click here|
|Positive and Proactive Support Plan||This plan should be implemented alongside a risk management plan.||Click here|
|Observational Checklist||Provides practical tools for those observing or inspecting services which provide PBS.||Click here|
|Behaviour Support Planning Audit Tools||Questionnaire to help evaluate where the service is now and prompt action planning.||Click here|
|Scatter Plot Assessment Tool||Tool to help discover patterns related to the behaviour and specific time periods.||Click here|
|Antecedent Behaviour Consequence (ABC Analysis Chart)||An ABC recording is a way of collecting information to help determine the function of a person’s behaviour.||Click here|