Positive behaviour support

Behaviours which challenge always happen for a reason and might be the only way a person can communicate - it can arise for different reasons, which are personal to the individual.

Positive behaviour support (PBS) is a person-centred approach to supporting people who display or are at risk of displaying behaviours which challenge. 

It’s important that adult social care workers have the right skills and knowledge to use this approach and we have resources to help.

What is positive behaviour support?

Positive behaviour support (PBS) is a person-centred approach to people with a learning disability and/ or autistic people, who display or at risk of displaying behaviours which challenge. 

It involves understanding the reasons for the behaviour and considering the person as a whole - including their life history, physical health and emotional needs - to implement ways of supporting the person. 

It involves:

  • understanding the reasons for behaviours which challenge
  • assessing the broad social and physical context in which the behaviour occurs - including the person's life history, physical and mental health, and the impact of any traumatic life events
  • planning and implementing ways of supporting the person which enhance quality of life for both the person themselves and their carers.  

It focuses on creating physical and social environments that are supportive and capable of meeting people's needs, and teaching people new skills to replace the behaviours which challenge. 

Watch this short video from the Challenging Behaviour Foundation about what is PBS. 

 

How can we help? 

Our resources explain what skills and knowledge workers need to provide PBS, and how adult social care employers can find and deliver high quality training. 

Before you get started, read these FAQs from the Challenging Behaviour Foundation to find out more about how PBS can help you deliver high quality support. 

 

One part of PBS is to understand why the behaviour happens, how it's been learned and how it's maintained - this is called a functional assessment

Watch this video from the Challenging Behaviour Foundation about understanding behaviour and the importance of functional assessments. 

 

When you've found the reason, you should produce a PBS plan that includes ways of intervening when people are at risk of displaying behaviour that challenges, and includes teaching new skills. 

PBS plans should be co-produced and followed by everyone involved in supporting the person, including the person and their family. 

To put PBS into practice adult social care services need to:

  • have the right workplace values and ensure their staff match them

  • include individuals and their families in the process 

  • give adequate time to complete the process

  • provide staff training and good practice management

  • do on-going monitoring and evaluation.

Watch this video from the Challenging Behaviour Foundation about putting PBS into practice. 

 

The Centre for the Advancement of PBS at BILD has also created an animation that gives an overview of PBS and how PBS approaches work in practice when supporting an individual.

 

Positive behavioural support: a mini guide to arranging and paying for training, can help you find PBS training for your workforce.

It's explains:

  • what to look for in PBS training
  • how to find a suitable learning provider
  • how you can pay for training.

The PBS Academy has designed the Standards for Training for all those involved in the delivery, purchase or commissioning of PBS training. 

 

The UK PBS competence framework explains the things that you need to know and the things that you need to do when delivering best practice PBS to people with learning disabilities and/ or autistic people who display or at risk of displaying behaviours which challenge.

The PBS Academy has also developed Standards for Services which outlines the standards services should meet when delivering PBS. 

 

In conjunction with Imaginarium Seed and in support of the Winterbourne View Joint Improvement Programme, we produced four films to show some of the issues, difficulties and benefits of supporting adults with learning disabilities who can display behaviours which challenge in their communities.

 

 

 

When done properly PBS can have a big impact on the quality of life of individuals who display behaviours which challenge. Here are three case studies. 

  • J has autism and associated behaviours which challenge. Enfield Integrated Learning Disabilities Service (EILDS) supported him to move into his own purpose built flat and worked with staff from an independent care provider to put a positive behaviour plan in place. In this case study, EILDS explain what they did. Read it here.  

 

  • Eldertree Lodge support people who display behaviours which challenge. In 2017 they supported J who has a mild intellectual disability and emotionally unstable personality disorder. They developed a positive behaviour support (PBS) plan and as a result, her health and wellbeing has improved – the number of incidents of behaviour that challenges decreased and she’s more engaged in meaningful activities both in and out of the ward. In this case study, they explain how they did this. Read it here
  • Rebecca has a rare genetic condition which presents as a severe learning disability, autism, an eating disorder and mild self-harm. When Rebecca moved into a shared residential home from her family home, the number of incidents of behavior that challenge increased. This prompted her support team to introduce PBS and Rebecca moved into her own flat. Since then her wellbeing has improved and she is more active in her community. In this case study, her Mum explains how PBS has supported Rebecca and what her PBS plan includes. Read it here

  • Michael is 17 years old and for the past 9 months has lived at a supported living placement, with an adult education programme focused on building his life skills. Michael has complex needs including autism, a learning disability and oppositional defiance disorder, and displays behaviour that challenges services. Since moving into this placement, his support team has followed a person-centred PBS plan and his quality of life has improved. This case study explains how PBS has supported Michael and what the plan includes. Read it here

  • Gloucestershire County Council has implemented a county-wide approach to PBS. They set up a ‘Challenging behaviour working group’ to develop a Challenging Behaviour Strategy which outlines their strategic approach to supporting individuals with learning disabilities and/or autistic people who display behaviours which challenge - PBS is strongly featured in the strategy. Read the case study here

The PBS and autism training fund in 2016-17 was used to explore the use of 'personal workforce budgets' to train and develop the workforce to better support people with learning disabilities and/ or autistic people, who display or at risk of displaying behaviours which challenge. 

It was funded by the ‘positive and safe programme’ to contribute to the aims of the  Transforming Care programme.

A personal workforce budget is an amount of money allocated and spent specifically on developing the skills of the workforce that support an individual, including: 

  • developing ‘skills around the person’
  • interagency/ multi agency work at a person centred level
  • providing training in line with PBS competency framework or good autism practice
  • contributing to the discharge (or avoided likely admission) of one or more persons.

Download the evaluation report

Read these case studies to find out how organisations used the fund to improve outcomes for people with learning disabilities and/ or autistic people who display or are at risk of displaying behaviours which challenge. 

  • Read how  The Lifeways Group used the fund to train staff who support Keith, who has a learning disability, complex autism and related anxiety. They worked with staff to develop a positive behaviour support plan, communication skills and ways they could encourage Keith to engage more. As a result, Keith now leads a more fulfilled life, with reduced levels of anxiety and his behaviour patterns have changed. 

  • Read how  The Lifeways Group used the fund to train staff who support Jeremy, who has a severe learning disability, Downs Syndrome and Klinefelter syndrome. They used the fund to improve communication between Jeremy and staff, including developing a video of the Makaton signs that Jeremy uses. As a result, Jeremy accesses the community every day and the number of incidents of behaviour that challenges has decreased. 

  • Read how  Wirral Evolutions used the fund to train staff how to better support autistic people who display or are at risk of displaying behaviour which challenges. They trained over 100 staff on courses ranging from an 'introduction to positive behavioural support, to 'coaches training'.