A Warm Welcome From the PBS Lead
Carra-lynn Lindsay听
鈥淚 am extremely proud to lead the 51视频 Foundation in developing their Positive Behaviour Support Approach. This means that we can ensure all of our services are equipped to support everyone in a way that best suits them and ensures we promote high quality support and quality of life for everyone. 听
PBS is based on working with the individual and their support network to understand why someone is distressed, the impact their environment has on them and the best ways to keep them safe and happy.听听
It is a quality of life framework that helps to make sure we can get the right support in place to build skills and improve quality of life.听听
This support should be delivered using the Tier Support Framework to ensure the right support is delivered at the right time for each individual.听
When a person receives PBS, it is unlikely to come from just one individual, one professional group or one service. Families, carers, professionals, service providers and commissioners need to work together and each play their part in supporting that person.听
Please feel free to email me at any time with any enquiries at c.lindsay@percyhedley.org.uk听听
PBS Explainer Video
Watch the following video where PBS (Positive Behaviour Support) is explained by Cara-Lynn. She also interviews a student, Ruby, about how PBS has helped her.
You can learn more about PBS in the sections below too.
What is Positive Behaviour Support?
At PHF we aim to deliver a PBS approach. This means we enable staff and families to:
- Understand the needs and behaviour of students, who (may) present with behaviours of concern and remain dependent on others to meet fundamental needs
- To work together, in order to promote a meaningful quality of life, for both the person and those who care for them.
It is our goal to support every person in PHF to feel safe, happy and part of the community. We strive to achieve this by valuing student voice; supporting readiness for learning; promoting choice and improving quality of life in a meaningful way for each individual we support.
These ensure that each person is supported in a way that uses the 4 key principles of PBS: Promoting Quality of Life; Values Led; Understanding Behaviour and meeting needs; Making systems work for the individual.
PBS Tier Support Framework
PHF are committed to embedding the PBS Framework across their services to enable everyone who we support to have good quality of life. This support should be delivered using the Tier Support Framework to ensure the right support is delivered at the right time for each individual.
Universal support should consist of service wide training, development of support plans, and development of capable environment using MDT and PBS coaches.
Targeted support should consist of PBS practitioners providing evidence based, qualified support, brief functional assessments where required, assessment and strategy development and review with support from PBS coaches and MDT to implement, plus Universal (Tier 1) support.
Specialist support should consist of PBS practitioners working alongside external services (NHS) to provide timely, function based interventions and assessments, plus Universal (Tier 1) and Targeted (Tier 2).
Core Elements of PBS
Values
- Person-centered Foundation
- A person-centred approach with a focus of improving quality of life for the person and those around them is an integral part of PBS.
- Constructional Approaches & Self-determination
- PBS is about Ensuring the right support is provided at the right time to support the person to engage in life in ways that are right for them PBS strives to ensure people are supported to learn and build on new skills that allow them to express themselves and make choices.
- Partnership
- A PBS approach is about learning from and listening to the key people who support and care for the person as well as the person themselves- these people are seen as the experts as they have lived-in firsthand experience.
- Elimination Of Aversive, Restrictive And Abusive Practices
- PBS is about working to get rid of aversive, restrictive, and abusive practices that have a damaging effect on a person鈥檚 quality of life emotional wellbeing, relationships, and mental health which can often lead to trauma.
Theories
- Evidence base
- PBS is about using behavioural approaches to support a person to learn new skills, meaningfully engage in activities, enjoy new experiences, and communicate their wants and needs in a safe way.
It is about providing a supportive environment which enables the person to experience a good quality of life and reduce the need for behaviour which concern.
- PBS is about using behavioural approaches to support a person to learn new skills, meaningfully engage in activities, enjoy new experiences, and communicate their wants and needs in a safe way.
- Multi-professional Approaches
- PBS Is not a stand-alone framework, it promotes multi-collaborative working from a range of other evidence-based approaches and therapies e.g., Occupational Therapy, Speech and Language Therapy to deliver a PBS approach.
- Function of Behaviour
- All behaviour, including challenging behaviour happens for a reason – understanding what this is (practitioners call it the function of the behaviour) can suggest how to make sure the person has access to the things they need in other ways (e.g. by changing the environment, teaching them new skills etc.)
Processes
- Data driven
- PBS bases decisions on data gathered about a person’s skills, behaviour, and needs.
- Bespoke Assessment
- A functional assessment (a range of procedures) helps to identify the reasons (function) for a person’s behaviour and is used to create a clear and structured plan of action.
- Proactive Support
- A PBS plan will include proactive strategies to prevent challenging behaviour from happening, strategies to teach new skills to make the challenging behaviour less likely and reactive strategies that minimise restriction if it does occur.
- Implementation, Monitoring + Evaluation
- Once strategies outlined in a PBS plan are implemented, they need to be monitored to ensure that they are being implemented in the right way and that they are effective in improving a person鈥檚 quality of life and reducing behaviours of concern.
- High Quality Care and Support Environments
- PBS highlights how important the physical and social environment is in enabling someone to live a good meaningful life. – this is what we call a capable environment.
Working to Reduce Restrictive Practice
What is Restrictive Practice?
Restrictive practice is making someone do something they don鈥檛 want to do or stopping someone doing something they want to do.
Any restriction needs to be appropriate, proportionate to the level of risk, and in the person鈥檚 best interest.
What are we doing to Reduce Restrictive Practice?
At The 51视频 Foundation, we champion the Restraint Reduction Networks听Six Core Strategies听to eliminate the unnecessary use of restraint and prevent toxic cultures. Combined with a greater understanding of the Human Rights Act 1998, embedding these strategies across services will enable person-centred care and support and promote a positive culture.
51视频 is working towards an ongoing programme of Quality Assurance and Training. Key areas of development have been identified and a training programme of听Positive Behaviour听Support (PBS)听is being developed of training for all staff working directly with the people we support. The PBS framework seeks to improve quality of life and support staff to meet the individual needs of the people we support.
The training given to staff helps to reduce the need for restrictions by supporting people to meet their needs without displaying behaviours of concern. We are ensuring that our Positive Behaviour Support (PBS) and Restrictive Practice policies reflect current best practice guidelines from the Restraint Reduction Network (RRN) and Government papers and that our practice reflects these.
Who is responsible for Reducing Restrictive Practices?
Everyone in 51视频 is responsible for working together to reduce the use of restrictions. Depending on the role of a staff member this may look very different, whether it is using the least restrictive option when working with a Person we Support within any situation, or reviewing service wide practices, to ensuring training, quality assurances and structures of support are in place.
Core Strategies of Reducing Restrictive Practice
Leadership
Visible Leadership
- Identify a responsible person in each area of service
- Clear and Consistent Procedures for logging and reviewing restrictions and Debriefs
Data and Performance Management
Data reviews
- Develop foundation wide reporting system
- Define clear reporting measures and timescales
Learning and Workforce Development
Training Structure
- Review current training in place
- Develop and roll out PBS training programme for all staff
Personalised Support and Prevention
Debriefs and individual risk assessments
- Ensure clear processes are in place for debriefing
- Individual risk assessments reflect skill building plans and preventative strategies
Involving People with Lived Experience
Accessible Involvement
- Scope potential ways to gather voices of people with lived experience
- Development of accessible resources
Continuous Improvement and Reflection
Training Structure
- Set up Steering Group to ensure consistency
- Develop systematic process for reviewing incidents with identifiable actions to prevent re-occurrence