Organisations get together to discuss how Positive Behaviour Support could change people’s lives


A festival to foster a wider awareness of the principles of Positive Behaviour Support (PBS) took place in idyllic surroundings in Surrey earlier this year.

National social care provider Dimensions collaborated with several service providers and organisations to hold the festival: CMG, PBS4, Choice Care Group, Avenues, Surrey Positive Behaviour Support Network and Surrey County Council.

Guests were enticed into a spacious environment adorned with reams of bunting, pompoms, flags, CDs, umbrellas and ribbons. In the late summer sunshine the environment met people’s sensory needs and was appreciated by all.

The festival looked at the challenges of implementing PBS nationally, locally, organisationally or as an individual. A lot of big questions start to emerge – How do we enable change? How do we design safe quality services? How do we improve quality of life? How do we work together? How do we embed change in practice?

PBS is a framework to help understand a person’s behaviour, and then use that knowledge to improve the person’s quality of life and decrease behaviours that challenge.

It has a solid evidence base. Over the last decade it has become increasingly recognised as the social care sector’s preferred approach to supporting adults and children with learning disabilities and autism.

The nature/nurture debate

A session on the nature of behaviours that challenge and Applied Behaviour Analysis was presented by Nick Barratt, Head of Behaviour Support at Dimensions.  He examined theories of the nature/nurture debate, our understandings of communication and the purpose and function of behaviour in enabling social interaction.

He used a simple example of how contexts of behaviour and communication link directly to outcomes.  For example, if someone feels unwell and is asked to do an activity such as washing up, an activity which is not meaningful or a priority for them, they are labelled ‘challenging’ if they react negatively.

Active support

A session led by Sarah Keane and Pippa Woodford  of the Avenues Trust used group discussion and role play to teach and develop awareness of the impact and benefits of active support and person centred approaches on the lives of individuals with varying disabilities, cognitive impairment and behaviours that challenge.

The unannounced role play left the audience in silence as staff undressed a member of the audience showing little respect, dignity or communication.

Their performance created an intense learning experience and awareness of how such treatment would trigger challenging behaviours – from abuse and withdrawal to physical aggression.

Incorporating standards

Louise Denne and Alison Branch from the PBS Academy spoke about the PBS Competence Framework and standards identified for service providers and teams. People of varying backgrounds, including professionals and providers, worked together looking at the standards and relating them to how their organisations were functioning and how they could incorporate them into the support of individuals with behaviours that challenge.

Triggers of challenging behaviour

The connection between sensory needs and behaviours seen to be challenging was discussed by Surrey and Borders Community Living Disability Team. They examined the wider influences and triggers to challenging behaviour and how it is often a response to a situation or sensation that the individual finds difficult to understand.

They linked the benefits of using PBS to identify the needs and triggers to a person’s behaviour, ensuring knowledge of the person is embedded in the plan. This enables the support, environment, activities, and communication to be managed to give pleasure and engender a state of calm and relaxation, whilst managing and minimising recognised triggers. It is essential that professionals and carers work with families to help the individual engage in meaningful activities.

Overuse of medication

Jonathan Beebee, Chief Enablement Officer and Nurse Consultant with PBS4, led an inclusive group discussion on the widespread use of medication to manage challenging behaviours, often with individuals with no diagnosed mental health issue.

He stressed the importance of monitoring and reviewing the use of medication ensuring it is essential, side effects are managed and the use regularly reviewed. His message was that medication is not the answer to managing behaviours that challenge and should be used cautiously as part of a robust PBS plan – an ethos echoed in NHS England’s STOMP (STopping Over-Medication of People with learning disabilities) campaign.

Creative curiosity

Finally, the importance of curiosity in the workplace was discussed by Lynsey Way, PBS Strategy Lead with the Care Management Group (CMG). The session encouraged creativity in attendees and enabled them to think for themselves.

The group identified obstacles that would inhibit curiosity, such as increasing regulations, staff set in their ways, fear of being criticised or failure.

Lynsey offered advice for managers on ways to encourage curiosity in their teams, develop a culture where staff felt able to make suggestions, question practices and ideas, and make mistakes.

The festival showed us that PBS is not an intervention sought only when a problem arises – instead it is a means to ensure individuals are supported in line with their needs, with staff understanding the importance of person-centred approaches, individual development and learning – in short, supporting people with learning disabilities and autism to have the best life possible.

Report by Sam Croniken