Example of a Positive Behaviour Support plan

Positive Behaviour Support (PBS) is a person-centred framework used to understand and support an individual to manage behaviours that challenge. The framework is mostly used with those living with a learning disability and/or autism.

When I joined social care, you could make a referral to the crisis team and someone would come out within weeks to support you to put into place strategies (often a PBS plan) to improve the quality of life for the person requiring support. Unfortunately, with cuts to budgets (and mental health in particular), it is harder to get the support required and I often see learning disability managers looking for support and guidance around managing behaviours that challenge.

In this blog, I am going to explain how to set up a PBS plan for a new user and look at how you can use PBS to improve the quality of someone’s life. Alongside Log my Care, we have also designed a Positive Behaviour Support plan template so you can action the framework in your organisation.

Benefits of Positive Behaviour Support plans

Positive Behaviour Support plans focus on understanding the reasons behind challenging behaviours and it is important to remember that these behaviours often occur due to an unmet need or communication difficulties. Some of the benefits of using a PBS plan include:

• Helps you identify patterns or triggers of behaviours.
• Aids strategies to be implemented that focus on positive reinforcement than punishment (which sadly still happens in a lot of learning disability services).
• Ensures support is based on the individuals needs and preferences.
• Increases the persons dignity.
• Promotes independence through coping strategies, confidence and independence.

How to set up a Positive Behaviour Support plan

The key to a great Positive Behaviour Support plan is knowing the person so you can truly personalise it to meet their needs. The PBS plan will want to capture three key things:

1. A brief description/overview of the person including things that are important to them, communication (including aids), likes/dislikes, health, mental health, mobility (including aids), any diagnosis, relationships and phobias. This is the part that allows staff to truly understand the person they are supporting.  
2. How the individual likes to communicate, what aids do they need, the level of their understanding and what support they need etc.
3. The individual’s functional skills - what skills do they have, do they need support to complete them and if so, what support do they need etc. Functional skills include communication, decision making, safety awareness, self-care, leisure and recreation interests and vocational skills.

In order to capture the above the you need to ensure that the person and their support network (next of kin, healthcare professionals, power of attorneys etc) and anyone else the individual wants involved feeds into the Positive Behaviour Support plan to truly capture the individual. Many learning disabilities will allocate a key worker to the individual requiring support, and their input from my experience is crucial to this process.

It is important to note that this tool should be used alongside referrals to healthcare professionals such as the behaviour therapy team as they will be able to do further in depth work with the individual such as a full holistic assessment and evidence based strategies that they are trained in.

Once you have the above three key pieces of information, you then need to establish with the individual and their representatives the following:

• How do they show you that they are happy/calm?
• What can the organisation do to support the person to remain happy/calm?
• Slow triggers that cause the individual to become unsettled (non-happy/calm) and any known antecedents/triggers before I display behaviour.
• What they individual looks like/sound like when they are beginning to become less happy/calm?
• What you can do to support them?
• What does it look like when the individual's behaviour is deescalating?
• A detailed list of the behaviours that are exhibited, what they look like, how these impact on their environment, access to the community, quality of life, risks etc.
• Why the individual may display these behaviours. It is important that this is not guess work and that behaviour charts and records are consulted to establish known causes if the individual is unable or does not wish to tell you.
• How the individual wants to be supported to make them feel safe and comfortable. This information will form the post incident section.

Reviewing the Positive Behaviour Support plan

There are a couple of key components to reviewing the effectiveness of a PBS plan which is firstly ensuring that staff are consistency applying the proactive and strategies from the plan, de-escalating behaviours and triggers before they escalate and reporting on any changes to the individual that could affect the plan. Staff should be using proactive strategies such as teaching new skills, modifying the environment to prevent challenging behaviours.

The second is to ensure that the PBS plan is reviewed on a regular basis or when there are any changes. You want the document to be a live one, that is reflective of the individual and their needs. Over time, and with support from a behaviour specialist/therapy team you and your team should be able to implement positive reinforcement to encourage good behaviour and teach new skills.

Final thoughts

Positive Behaviour Support has been proven to be an effective way of improving the quality of life and reducing behaviours in people with autism and learning disabilities. This blog gives you the tools to implement a PBS plan for the people you support, however it is important to make a referral to a behaviour therapist so that they can undertake a more thorough functional assessment of the individual.