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How positive behaviour support can deliver life-changing outcomes Mark Henry, head of behavioural support and mental health at Exemplar Health Care, discusses how bespoke interventions can enable people who display behaviours of concern to thrive, and shares the stories of three service users who have been supported by its specialist team to achieve this
Where people have complex health conditions, this can result in behaviours which can make safely caring for them a challenge. While many people who display behaviours of concern are able to live in ‘mainstream’ residential homes or supported living, others thrive in care homes that specialise in care for people with these complex behaviours. Behaviours of concern can have a range of causes, often involving damage to the brain or a mental health condition. People can experience such behaviours due to: • dementia • a brain injury, such as from trauma, or medical insult to the brain such as a tumour, haemorrhage or infection • a disability the person was born with, or genetic conditions • stroke. At Exemplar Health Care, the people we support usually display behaviours which have made it difficult for them to interact with others safely or effectively, such as physical or verbal aggression or offensive language. Many of them have been deemed to have behaviours that are considered ‘too complex’ for mainstream nursing and care services.
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Our community-based homes and OneCare services provide person-centred care and rehabilitation that focuses on maximising independence, building everyday living skills and empowering people to live their best lives. Through our specialist care, many people are able to find new coping strategies and learn skills to manage their feelings. Our approach to behaviour support focuses on how we can prevent the need for restrictive practices and reduce the frequency and intensity of behaviours of concern, so that people can live a fulfilling life and integrate with society without their behaviour restricting what they can do. Our trained teams work with individuals to understand the reasons for their behaviour, to learn the skills to manage their own behaviour, to identify, remove and reduce any trigger factors and implement strategies to reduce the frequency, duration and impact of incidents of behaviours of concern. We look at psychological methods of distraction and diversion before other methods are considered. Our care homes have high staffing levels which enable us to work at people’s own pace and build trust. Our homes also have in-house
Activities and Life Skills Teams that support people to take part in everyday activities that are meaningful to them, which helps to reduce feelings of frustration for people who display behaviours of concern. All of our care and nursing colleagues complete our Exemplar Positive Behaviour Support (EPBS) training which has been certificated by the British Institute for Learning Disabilities Association of Certified Trainers (Bild ACT). This confirms that the learning meets the Restraint Reduction Network (RRN) Training Standards 2019. The certificated EPBS training includes up to five days of learning – two of which cover PBS theory, psychological support, self-protection skills and break away techniques, and up to three days of level two training which covers restrictive practices. The training provides colleagues with the skills and knowledge to protect people’s fundamental human rights and promote person-centred, best interest and therapeutic approaches to supporting people when they’re distressed. We also have a central team of Mental Health and Behaviour Support Specialists who support our colleagues and service users who display behaviours of concern, including crisis or rapid intervention when a person’s behaviour is escalating. The team is made up of Behaviour Support Specialists who take the time to observe the individual, understand the reasons for their behaviour and suggest strategies to reduce distress or discomfort which might be causing the behaviour. Through dedicated, bespoke support, our team - working closely with our service users - are able to deliver outcomes that truly change lives.
