Step-by-step PBS implementation

Getting the foundations right: What are the key components of a successful PBS plan?

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A successful Positive Behaviour Support (PBS) plan starts with strong foundations. If you get these components right, you'll set your team and the individuals in your care up for greater outcomes. With PBS, it's essential to ensure that everyone— from the individual receiving your care to your care team and wider stakeholders— is on board with what it takes to drive a successful PBS initiative.

In this chapter, we'll dive into the individual components of a PBS plan and how to get them right.

First, get the intentions right

Before creating a PBS plan for an individual in your care, it’s crucial to ensure you’re doing this with the right intentions. The intention of a PBS plan should be values-driven and centred around improving quality of life, inclusion, participation, and enablement.

The core purpose of a PBS plan is to enhance the individual's well-being. This means not just focusing on reducing distressed behaviours but promoting a holistic approach that fosters personal growth and happiness. Unfortunately, too often, PBS plans are created with the primary goal of reducing incidents or managing behaviour. While these are important outcomes, they shouldn't be the sole focus.

By building the PBS plan around a positive and motivational intention, you’re more likely to see success. When the priority focuses on improving someone's quality of life, community involvement, and personal growth, their distressed behaviours naturally decrease because they feel more supported, understood, and valued.

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So, what are the core components of a successful PBS plan?  
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1. Understanding  

2. Communication  

3. Engagement  

4. Incident management  

5. Recovery  

6. Consistency  

Understanding: assess the individual’s needs

A great PBS plan starts and ends with the individual it seeks to benefit. They should be involved from the very beginning. An initial assessment is a crucial step in getting to know the individual, understanding their unique needs, preferences, and strengths, and determining the best way to communicate with them.

To tailor a PBS plan effectively, you need to deeply understand the individual. This involves identifying not just their struggles and difficulties but first and foremost, their strengths and potential. PBS is fundamentally a strength-based approach. Recognising and building on the individual’s strengths can provide powerful motivation and pathways for positive change.

Key areas to assess:

• Communication: Understanding how the individual communicates is key. This includes both their preferred communication methods and their ability to understand others. Some individuals may use verbal communication, while others may rely on non-verbal cues, assistive technologies, or alternative communication methods. The goal is to find the most effective way to engage and connect with them.

• Strengths and weaknesses: A comprehensive assessment should also identify the individual’s challenges and strengths. This includes recognising any triggers for distress or challenging behaviour and understanding the individual's capabilities, interests, and aspirations. By focusing on strengths, you can build a PBS plan that empowers the individual and promotes positive behaviours through encouragement and support.

• Goals: Working towards a goal can be a great motivation and provide a lot of fulfilment to an individual’s life. Using the SMART (Specific, Measurable, Actionable, Relevant, Time-bound) framework — which we explored in our last e-book Goal setting for service users) — work with the service user to understand any goals they would like to work toward and how they can support their PBS plan.  

• Interests: Spending more time doing the things that interest us most is important for our wellbeing. It is important to understand what the individual’s interests are so you can work together to increase the frequency that they’re partaking in activities that they enjoy. The Subjective Quality of Life Tool is a great resource to use here. You can download it through the link below.  

Communication: the cornerstone of effective support

Communication can make or break a PBS plan and so it’s critical to understand the individual’s communication preferences. It’s not just about talking to the individual but also about listening, observing, and responding to their needs in a way that they can understand and appreciate.

Why communication matters

Communication is the primary means through which we understand the needs, desires, and emotions of the individual in our care. Without effective communication, it’s nearly impossible to create a PBS plan that truly meets their needs.

Strategies for effective communication:

• Tailoring communication methods: Every individual has a preferred way of communicating. It might be through words, gestures, pictures, or technology. Understanding and respecting these preferences ensures that the individual feels heard and understood. In Chapter 2, we discuss some great tools that can be used here.

• Active listening: Active listening involves not just hearing the words spoken by the individual but also understanding the emotions and intentions behind those words. This requires patience, empathy, and attentiveness.

• Consistency in communication: Ensure that all team members are consistent in their communication with the individual. Mixed messages can create confusion and anxiety, leading to an increase in challenging behaviours.

A good and robust communication plan that is tailored to the individual's needs and preferences is critical to making a PBS plan a success.

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Engagement: encourage active participation in PBS

Engagement is about more than just keeping someone occupied. It’s about creating opportunities for the individual to be actively involved in their environment and daily life, fostering a sense of agency and self-worth.

Encouraging positive engagement

Engagement is a powerful tool in PBS. When individuals are meaningfully engaged, they are less likely to exhibit challenging behaviours. Engagement can take many forms, from participating in household chores to being involved in community activities or pursuing hobbies and interests.

Promoting agency: Hotel Model vs Active Model of care

One of the critical aspects of engagement is giving the individual a sense of control over their own life. This means moving away from a "hotel model" of care, where everything is done for the individual, to a more active model where the individual is actively involved in decisions and activities.

Active support involves:

1. Reflecting on what's important: Considering what the individual values and what they need to live the life they want.  

2. Providing graduated levels of help: Offering assistance that ranges from simple verbal reminders to physical guidance, depending on the individual's needs.

3. Using positive interactions: Providing supportive interactions that use positive reinforcement to encourage participation in activities.

Creating a capable environment

A capable environment is one where the individual feels safe, supported, and able to participate. This environment should be predictable and structured, with clear routines and expectations that reduce anxiety and promote confidence. It’s important that this is client-led, and that they are empowered to set the pace, routines, and anything else that impacts their environment.  

Management of incidents: proactive and reactive strategies

While the primary focus of a PBS plan is to create a positive, supportive environment that prevents incidents, it’s also important to acknowledge that incidents can happen and to have strategies in place to manage them effectively.

Proactive strategies

Proactive strategies are essential in preventing incidents before they arise, and an effective PBS plan should dedicate around 80% of its focus to these strategies. Since every individual is unique, proactive strategies must be highly personalised, tailored to each person's specific needs and strengths. These strategies should include motivational tools, such as encouraging participation in activities that the individual finds fulfilling, addressing their environmental and communication needs, and creating clear plans to help them achieve their personal goals. It's crucial to remember that PBS is a strength-based framework, so the emphasis should always be on leveraging and building the individual's strengths and fostering their sense of agency over their environment.  

Reactive strategies and the traffic light system

Reactive strategies come into play when an incident does occur. The goal is to manage the situation in a way that minimises harm and reduces the likelihood of recurrence. This might involve using de-escalation techniques, providing space for the individual to calm down, or removing triggers from the environment.

At Log my Care, we use a traffic light system in our PBS plans feature. Using a traffic light system, you can split your reactive strategies into “amber” and “red”. Amber can be used for softer touch actions like removing throwable actions from the environment. Red can be used for when things are escalating into ‘crisis’ territory.  

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Minimising restrictions

Restriction, whether medical, mechanical, or physical, should always be a last resort, and should only be used when the safety of the individual or of others is at risk. Instead, the care team might step back and allow the individual some space after ensuring all hazards have been removed from the environment, or use calm, reassuring communication to help de-escalate the situation. These communication strategies should be clearly outlined in the individual’s support plan.  

Recovery: rebuilding trust and emotional safety

After an incident, it’s essential to focus on recovery. Recovery is about more than just returning to baseline; it’s about repairing any damage to relationships and ensuring that the individual feels safe, supported, and understood.

Addressing stigma and guilt

Incidents can sometimes leave individuals feeling ashamed or guilty. It’s important to address these feelings directly, offering reassurance and understanding. The focus should be on moving forward positively, rather than dwelling on what went wrong.

Repairing relationships

After an incident, the relationship between the individual and their caregivers can be strained. Engaging in enjoyable activities together, having open and honest conversations, and showing consistent support can help rebuild trust.

Emphasising emotional safety

Emotional safety is a critical component of recovery. The individual needs to feel that they are in an environment where they are respected, valued, and safe from judgement or harm. This means creating a supportive atmosphere where the individual can express their feelings and work through their emotions in a healthy way.

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Consistency: the key to a stable environment

Consistency is the glue that holds a PBS plan together. It ensures that the individual knows what to expect, which can significantly reduce anxiety and challenging behaviours.

Consistent approaches across the team

All care team members must be on the same page when implementing the PBS plan. This means regular communication, shared understanding of the individual’s needs and preferences, and a unified approach to care.

Predictability and structure

A predictable environment is a safe environment. Individuals thrive when they know what to expect, which is why routines and clear boundaries are so important. This predictability doesn’t mean rigidity, but rather a structured approach that allows for flexibility when needed. This could look like having a timetable of activities available for the day but still allow the individual choice as to whether to participate in them.  

Creating a capable environment

A capable environment is one that consistently supports the individual’s needs, promotes their strengths, and helps them navigate challenges. It’s an environment where the individual feels empowered, understood, and capable of achieving their goals.  

A successful PBS plan is built on strong foundations, where the focus is on enhancing the individual’s quality of life, understanding and addressing their unique needs, and fostering a supportive and consistent environment. By getting these components right, you’re not just managing behaviour; you’re empowering individuals to live fulfilling, meaningful lives. This holistic approach, grounded in respect, empathy, and positive intentions, is what truly makes a PBS plan successful.

In Chapter 2, outline some of the key tools and strategies available to support you in creating successful Positive Behaviour Support plans.

Creating a robust Positive Behaviour Support (PBS) plan requires the use of various tools and strategies that are tailored to the individual’s needs and circumstances. This chapter explores the essential tools and approaches that can help in building an effective PBS plan, ensuring it is both comprehensive and adaptable to the individual’s evolving needs.

Identifying and understanding behaviour

Understanding the motivations behind an individual’s behaviour is crucial for developing a successful PBS plan. By identifying the reasons for certain behaviours, you can create strategies that support positive change and reduce the occurrence of challenging behaviours.

Motivation Assessment Scale

The Motivation Assessment Scale (MAS) is a tool used to understand the underlying motivations behind specific behaviours. Ideally, this assessment should involve the service user and their carer whenever possible, as their input can provide valuable insights into their behaviour. By identifying whether behaviours are driven by sensory needs, escape from tasks, or other motivations, you can tailor interventions more effectively.

Trial and error

Sometimes, the most effective way to understand what works best for a service user is through trial and error. Introducing various activities and observing the service user’s reactions can provide key insights into their preferences and triggers. By recording observations on engagement levels and preferences, you can identify which activities promote positive behaviours and which may need to be adjusted or avoided.

ABC chart (Antecedent, Behaviour, Consequence)

The ABC Chart is a well-established tool for analysing behaviours by systematically recording what happens before (antecedent), during (behaviour), and after (consequence) a behavioural event. This chart helps to identify triggers and patterns in specific behaviours you want to observe, providing a clear picture of the factors influencing the individual’s actions. Through consistent use of the ABC Chart, carers can develop more targeted strategies to manage and support positive behaviour.  You can download our ABC chart template below.

Environmental considerations

The environment plays a significant role in influencing behaviour. So much so, that Chapter 3 is dedicated entirely to environment. By carefully observing and adjusting environmental factors, you can create a setting that supports positive behaviour and reduces the likelihood of incidents.

Observe and record environmental factors

Environmental factors such as lighting, noise levels, and crowding can have a profound impact on behaviour. For instance, harsh lighting or loud noises might trigger anxiety or agitation in some individuals. By observing and recording these factors, you can identify which environmental elements are conducive to positive behaviour and which may need to be modified. Simple changes, like reducing noise levels or adjusting lighting, can make a significant difference in creating a supportive environment.

Local authorities

Engaging with local authorities and other community resources can enhance the effectiveness of a PBS plan. Local authorities often have access to tools and services designed to support individuals in maintaining independence and improving their quality of life.

Reablement providers

Reablement providers are particularly focused on helping individuals remain as independent as possible. These services offer tools and strategies to support people in developing the skills they need to live independently. By collaborating with reablement providers, you can incorporate these tools into the PBS plan, enhancing the individual’s capability and autonomy.

Collaborating with carers

Your day-to-day carers are often the most familiar with the individual’s daily routines, preferences, and challenges. Their involvement is essential in creating a PBS plan that is realistic and effective.

Valuable insights from carers

Carers provide invaluable insights into the service user’s life. They often have a deep understanding of the individual’s likes, dislikes, and triggers, which can be crucial when developing a PBS plan. It’s important to engage carers in the planning process, ensuring their observations and experiences are reflected in the strategies you create.

Supporting carers

Supporting and managing carers is equally important. Carers need guidance on how to interact with the service user in ways consistent with the PBS plan. Providing training and resources can help carers feel more confident and capable in their roles, which in turn supports the overall success of the PBS plan. We'll go into this more in Chapter 5.

Skill development

By now, you should know that PBS plans are so much more than a behaviour management tool. PBS plans are also about helping individuals develop new skills that enhance their independence and quality of life.

Using PBS plans and ABA techniques

PBS plans can be used in conjunction with adapted Applied Behaviour Analysis (ABA) techniques to introduce and develop new skills. For example, you might begin teaching an individual how to cook by starting with simple tasks, such as washing vegetables, and gradually building up to more complex tasks, like following a recipe. This step-by-step approach allows the individual to build confidence and competence, reinforcing positive behaviours through skill acquisition.

Example of skill stacking:

Professional involvement

The involvement of professionals, such as social workers, clinical teams, and local authorities, can provide additional support and expertise that enhance the effectiveness of a PBS plan.

Engaging with professionals

Professionals bring a wealth of knowledge and resources to the table. Collaborating with social workers, psychologists, occupational therapists, and other specialists can provide a more comprehensive understanding of the service user’s needs. These professionals can offer assessments, recommend interventions, and provide ongoing support to ensure the PBS plan is effective and responsive to the individual’s needs.

Data collection and evaluation

Ongoing data collection and evaluation are critical components of a successful PBS plan. By continuously monitoring the effectiveness of the plan, you can make informed adjustments that improve outcomes.

Using the Motivation Assessment Scale and ABC Chart

Tools like the Motivation Assessment Scale and ABC Chart are not just for initial assessments; they should be used throughout the implementation of the PBS plan. Regularly collecting data on behaviours, triggers, and outcomes allows for ongoing evaluation of the plan’s effectiveness. This data-driven approach ensures that the plan remains responsive to the individual’s needs and can be adjusted as necessary.

Communication tools

Effective communication is essential for the success of a PBS plan, especially when working with individuals who have difficulties with verbal communication.

Talking Mats and Makaton

Talking Mats and Makaton are communication tools that can facilitate interactions with individuals who struggle with verbal communication. Talking Mats use visual symbols to help individuals express their thoughts and preferences, while Makaton combines speech with signs and symbols to support communication. These tools can be particularly effective in helping service users communicate their needs and feelings, reducing frustration and improving the effectiveness of the PBS plan.

Gestures and visual aids

In addition to formal communication tools, using gestures and visual aids can enhance understanding. Physical objects, pictures, and gestures can be used to convey instructions or preferences, making communication clearer and more accessible for the service user.

Activity planning

Carefully planned activities can help reduce anxiety and promote positive behaviours, especially for individuals who thrive on routine and predictability.

Social Stories

Social Stories are particularly effective for individuals with autism. These short narratives describe what to expect in various situations, helping to reduce anxiety by making the unfamiliar familiar. For example, a Social Story might describe what will happen during a visit to the dentist, helping the individual prepare for and cope with the experience. Incorporating Social Stories into the PBS plan can help the service user navigate challenging situations with greater confidence.  

Predictable environments and routines

Ensuring that the service user’s environment and routine are predictable and clear is key to reducing anxiety and promoting positive behaviours. This might involve setting up daily routines, using visual schedules, or creating calm and structured spaces that support the individual’s need for consistency.

Building an effective PBS plan requires a combination of the right tools, strategies, and collaboration. By understanding the individual’s behaviour, tailoring environmental factors, engaging carers, developing skills, and involving professionals, you can create a comprehensive and effective PBS plan. Consistent data collection, clear communication, and careful activity planning ensure that the plan remains responsive and effective, ultimately leading to improved outcomes for the service user.

Care management software

Care management software such as Log my Care is a powerful tool for capturing and storing information around an individual’s PBS plan. Log my Care's PBS plan feature supports the effective management of Positive Behaviour Support (PBS) plans by enabling teams to focus on proactive strategies, personalised care, and continuous adaptation. The system’s traffic light scoring for risk assessments allows for quick identification of escalating behaviours, while its collaborative tools ensure that plans are tailored to the individual’s needs and goals.

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In the next chapter, we’ll look at how exactly you can implement and track your goals using a digital care system.

Creating an environment where Positive Behaviour Support (PBS) can thrive is essential for the success of any PBS plan. The environment plays a significant role in influencing behaviour, reducing anxiety, and promoting independence. In this chapter, we will explore the key aspects of creating a supportive and effective environment that enables PBS to flourish.

Predictability

A predictable environment is crucial in managing anxiety and fostering a sense of security for the service user. When individuals know what to expect, they are less likely to feel overwhelmed or anxious, which in turn reduces the likelihood of challenging behaviours. This predictability is particularly important for those who struggle with changes in routine or unexpected events. By providing structure and consistency, you create a foundation that supports positive behaviour and well-being, helping individuals feel safe and in control.

Implement a clear and accessible timetable

One of the most effective ways to ensure predictability is by implementing a clear and accessible timetable for the service user. This timetable should include scheduled activities, daily routines, and information about staff members.

• Scheduled activities: Clearly outline the day’s activities, from morning routines to evening wind-downs. This schedule should be visually accessible, using pictures or symbols, if necessary, to ensure the service user can easily understand and follow it.

• Staff rotas: Including staff rotas in the timetable can help the service user feel more comfortable with the people around them. Use photos and brief descriptions of staff members, including their interests, to help the service user feel familiar with and connected to the team. For example, if a staff member enjoys painting and the service user is interested in art, this shared interest can be a point of connection.

Matching interests

Building strong, positive relationships between staff and the service user is a key component of a successful PBS environment. One effective way to foster these relationships is by aligning staff and service user interests.

Why matching interests matters

When staff members share or show interest in the same hobbies or activities as the service user, it creates a natural bond that can enhance trust and communication. This connection can lead to a more supportive and engaging environment, where the service user feels understood and valued.

Example - Connecting through shared interests

For instance, if a service user is passionate about yoga, a staff member could take the time to learn about the different postures, practice yoga together, or even venture out into the community to try a yoga class together. This shared interest can create a positive and enjoyable interaction, making the service user feel more comfortable and engaged.  

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Familiarisation with the environment

Introducing a service user to a new environment can be challenging, especially if they have difficulty with change or new experiences. A gradual and thoughtful approach to familiarisation can ease this transition and help the service user feel more at ease.

Gradual introduction to the environment

Rather than immediately immersing the service user in a new space, start by gradually introducing them to it. This can begin with showing them pictures or videos of the new environment, allowing them to visualise and become accustomed to the space before they even step foot in it.

Organising visits and positive activities

After the initial introduction through pictures, organise visits to the new environment. During these visits, plan enjoyable activities that the service user already loves, helping them associate the new space with positive experiences. This approach helps build positive memories and reduces any anxiety related to the new environment.

Personalising the space

Encourage the service user to bring personal items with them to the new environment. Familiar objects, such as a favourite blanket, photos, or personal artwork, can make the space feel more like home. This personalisation not only provides comfort but also reinforces the feeling of ownership and control over the environment.

Control of environmental factors

Environmental factors such as noise levels, lighting, and overall sensory input can have a significant impact on the service user’s behaviour and comfort. Managing these factors effectively is crucial in creating a supportive environment for PBS.

Noise, lighting and crowded spaces

Noise, lighting, and overcrowding are some of the most common environmental triggers that can affect behaviour, particularly for individuals with sensory sensitivities.

• Noise levels: It’s important to monitor and manage noise levels in the environment. Sudden loud noises or constant background noise can be distressing for some service users. Consider using soundproofing, soft furnishings, or noise-cancelling devices to create a quieter, more peaceful environment.

• Lighting: Harsh lighting, such as neon lights, can be particularly irritating for individuals with hypersensitivity. Opt for soft, natural lighting whenever possible, and avoid the use of neon lights. Adjustable lighting that allows the service user to control the brightness can also be beneficial.

• Crowded environments: Busy, overpopulated spaces can be overwhelming for some individuals. Encourage team members to be aware of this and to prevent communal spaces from getting too overcrowded.  

Promoting autonomy and independence

One of the primary goals of PBS is to promote independence and empower the service user to take an active role in their own life. Creating an environment that encourages and supports independence is key to achieving this goal.

Allowing independence in daily tasks

Encouraging the service user to perform tasks independently whenever possible is essential for building confidence and self-reliance. This might include daily activities such as dressing, cooking, or personal care. Staff should provide minimal assistance, stepping in only when necessary to offer guidance or support.

Minimal assistance, maximal autonomy

The role of staff in promoting independence is to support without taking over. This means offering verbal prompts or physical guidance only when necessary and gradually reducing this support as the service user becomes more capable. The aim is to help the service user develop the skills and confidence needed to perform tasks on their own.

Active participation reduces anxiety

When service users are given the opportunity to take an active role in their daily activities, it not only promotes independence but also helps reduce anxiety. Being actively engaged in their own care and routine gives the service user a sense of control and predictability, which can significantly lower anxiety levels and promote positive behaviour.

Gradual support reduction

As the service user becomes more independent, the level of support provided by staff should be gradually reduced. This process, known as gradual support reduction, is a key strategy in PBS for fostering long-term independence.

Techniques for building independence

Gradual support reduction can be implemented through a variety of techniques, starting with more hands-on support and moving towards full autonomy.

• Mirroring: Initially, staff might demonstrate tasks by performing them alongside the service user, allowing them to observe and learn through imitation.

• Verbal prompts: As the service user becomes more familiar with the tasks, staff can transition to providing verbal prompts, offering reminders or instructions rather than direct assistance.

• Encouraging autonomy: Eventually, the goal is for the service user to perform tasks independently, with staff available only as a resource if needed. This progression should be paced according to the service user’s comfort and ability, ensuring that they feel supported throughout the process.

Creating an environment where PBS can thrive requires careful consideration of various factors that influence the service user’s behaviour, comfort, and independence. By prioritising predictability, matching interests, gradually familiarising the service user with their environment, managing environmental factors, promoting independence, and gradually reducing support, you can establish a setting that empowers the service user and supports the goals of the PBS plan. This thoughtful approach to the environment not only enhances the effectiveness of PBS but also contributes to the overall well-being and quality of life of the service user.

Did you know we have a webinar on creating PBS plans with true PBS torchbearer, Giuseppe Di Martino? Watch the webinar below for key insights into the power of PBS.

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In Chapter 4, we’ll walk you through how to secure organisational buy in for PBS, including how to get senior management on board.

Positive Behaviour Support (PBS) is not just a framework for managing individual behaviours but a philosophy that should permeate every level of an organisation. From senior management down to frontline staff, everyone must be on board for PBS to be effective.

Gaining senior management buy-in for PBS

To truly embed PBS, it’s essential to secure buy-in at the organisational level, particularly from senior management. Without their support, even the most well-intentioned PBS plans can fall short. Senior management plays a pivotal role in setting the tone and allocating the necessary resources to implement PBS effectively.  

Securing the support of senior leadership is often one of the most challenging but crucial steps in embedding PBS within an organisation. Leaders are typically focused on stability, risk management, and business growth, so it’s vital to frame PBS in a way that aligns with these priorities.

Leveraging tools and data

To appeal to senior leadership, it’s crucial to demonstrate that PBS is supported by robust data and established tools.  

Use a variety of tools to demonstrate the effectiveness of PBS:

• Motivational assessments and ABC charts: These tools help in understanding service users' behaviours and the outcomes of PBS interventions.

• Quality of life tools, PERMA model, and capable environment framework: These provide a broader perspective on the benefits of PBS, not just in terms of behaviour management, but also in enhancing overall well-being.

• Incident dashboards: Incident dashboards can be used to showcase the reduction in incidents influenced by successful PBS plans.

Data collection

Collecting and presenting data in a clear, logical format is vital. Using digital tools such as Log my Care to organise and report this data, makes it easily accessible for analysis. Senior leaders are more likely to support PBS if they can see that it’s underpinned by solid, quantifiable evidence.

Just some of the data available with Log my Care's Incident Management feature:

Building a case for PBS

Once you’ve addressed risk concerns, the next step is to build a compelling case for PBS by highlighting the positive outcomes it can achieve and its benefits to the organisation.

Focus on tangible benefits

To persuade senior leadership, focus on the tangible benefits of PBS, such as improving outcomes for service users and enhancing the organisation’s reputation and business prospects.

Demonstrate through success stories

Share success stories that demonstrate the effectiveness of PBS plans. Highlight cases where PBS has enabled service users to transition out of secure units, reducing restrictive practices and support needs. These examples show how PBS improves quality of life and makes financial and operational sense.

Emphasise the long-term prospects

Highlight the long-term benefits of PBS, including increased business opportunities and an enhanced reputation. Successful implementation can position the organisation as a leader, attracting more referrals and becoming the preferred choice for commissioners.

Lead with a value and evidence approach

Emphasise that PBS is value-driven and evidence-based, aligning with the organisation’s mission. This focus on ethical and practical benefits appeals to senior leaders and commissioners.

Provide senior leaders with both positive stories and robust data to demonstrate PBS's effectiveness. This dual approach appeals to both the emotional and logical sides of decision-making, increasing the likelihood of support.

Present PBS as a theory-driven, evidence-based approach that aligns with the organisation’s goals. By showing that PBS is grounded in research and supported by data, you can reassure senior management that it’s a sound investment.

In the next chapter, we will explore how you can effectively engage and train your team on the PBS framework. After all, they will be your greatest asset in making PBS a success at your organisation.

A Positive Behaviour Support (PBS) plan is only as effective as the carers driving them forward. For PBS to truly succeed within an organisation, it’s essential that the team who interact with supported people every day are fully engaged, well-supported, and confident in their roles. By empowering staff and providing the necessary tools and support, organisations can ensure that PBS is not just a plan on paper, but a living, breathing approach that improves the lives of service users and carers alike.

In this chapter, we’ll explore practical strategies for supporting and empowering your team, from reflective practices and ongoing training to the management of agency staff. Understanding and addressing the challenges that staff face is crucial for creating a positive and effective PBS environment.

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Assigning a PBS champion  

Assigning a PBS champion within each team can significantly enhance the consistency and effectiveness of Positive Behaviour Support (PBS) plans. A PBS champion is a dedicated staff member responsible for overseeing the implementation of PBS strategies, providing guidance, and supporting colleagues. This role ensures that PBS remains a central focus within the team, promoting consistent, person-centred care.  

The PBS champion should be well-versed in PBS principles and serve as a key resource, helping to lead reflective practice sessions and address any PBS-related challenges. This approach fosters a supportive environment and encourages continuous improvement across the organisation.

Reflective practice and staff engagement

For PBS to be successful, it’s crucial to engage and support the staff who will be implementing it. Reflective practice provides a structured way for staff to discuss their experiences, feelings, and insights, helping to reinforce their understanding and commitment to PBS.

Purpose of reflective practice

Reflective practice creates a space for staff to share their thoughts on the PBS plan and its effectiveness. It allows them to voice concerns, suggest improvements, and feel heard within the organisation.

Process of reflective practice

Hold weekly sessions that focus on the team’s experiences rather than on service users. Encourage open discussions where staff can express their emotions, discuss challenges, and share ideas. This not only helps improve the PBS plan but also fosters a supportive and collaborative working environment.

Training and reinforcement

Comprehensive training is critical to the successful implementation of PBS. However, training should not be a one-time event but an ongoing process that includes regular reinforcement and opportunities for continued learning.

Initial training

Provide thorough initial training on the PBS plan, ideally delivered by a reliable provider with expertise in PBS. This training should cover the theoretical foundations of PBS, practical strategies for implementation, and specific details about the service users they will be supporting.

Continuous learning

Use reflective practices to revisit and reinforce training concepts. Address specific concerns that arise, such as staff feeling unsafe during certain situations, by discussing practical steps to enhance their comfort and effectiveness. Continuous learning ensures that staff remain confident and capable in their roles.

Supporting staff well-being

The well-being of staff is directly linked to the success of PBS. When staff feel supported, valued, and equipped to handle the challenges of their work, they are more likely to implement PBS effectively and provide high-quality care.

Acknowledging staff emotions

Recognise the emotional toll that working with distressed service users can take on staff. Acknowledging and addressing these emotions is crucial for maintaining staff well-being and preventing burnout.

Providing support

Ensure that staff have access to the support they need, whether through internal resources, such as supervision and reflective practice, or external support, such as counselling services. Recognising that staff well-being is directly linked to the success of PBS is key to creating a supportive work environment.

Debrief and reflect after incidents  

Regular debriefing sessions after incidents are vital for ensuring that staff cope well with the emotional impact of their work. These sessions allow staff to express their feelings, share their experiences, and receive support from their colleagues and supervisors.

After any significant incident, hold debrief sessions to help staff process what happened, discuss what went well, and identify areas for improvement. These sessions provide an opportunity for staff to reflect on their actions and experiences, helping them to learn and grow in their roles.

Assess your team’s coping mechanisms  

Use these sessions to assess whether staff are coping well after witnessing or being involved in an incident. If staff are struggling, provide additional support or resources to help them manage their emotions and continue providing high-quality care.

External support

Leverage external resources, such as health professionals or clinical psychologists, to provide additional support and guidance to staff. Regular visits from these professionals can help staff feel more confident in their roles and provide them with the tools they need to manage challenging situations.

The Care Workers’ Charity and local resources

Encourage staff to access support from organisations like The Care Workers’ Charity, which offers financial and emotional support to care workers in need. Additionally, local authorities often provide free mental health services that staff can utilise. Promoting these resources can help ensure that staff have the support they need to maintain their well-being.

Empowering the care team

Empowerment is a core principle of PBS, not just for the people in our care, but for the team as well. By empowering team members, you enable them to take ownership of the PBS plan and contribute to its success.  

Empowering staff means giving them the tools, training, and agency they need to perform their roles effectively. It also involves recognising their contributions and ensuring they feel valued and respected.

Tools and agency

Provide staff with the resources and autonomy they need to implement PBS effectively. This could include access to training, digital tools for data collection, and the authority to make decisions about how best to support service users.

Ownership of the PBS plan

Foster a sense of ownership among the team by involving them in the development and ongoing refinement of the PBS plan. Encourage them to share their insights and ideas and recognise their contributions to the success of the plan.

Managing agency staff in PBS

The effective management of agency staff is a significant challenge, particularly in the context of the ongoing staffing crisis in the care sector. Agency staff can play a vital role in supporting PBS, but they need to be carefully managed to ensure consistency and quality of care. Agency staff may be skilled, but they often lack the familiarity and connection with supported people that is so crucial when it comes to PBS.  

Lack of familiarity

Agency staff often lack the same level of familiarity with service users and their specific PBS plans as permanent staff, which can lead to mistakes and inconsistent care. This unfamiliarity can also cause distress for service users, who may find it unsettling to be supported by someone they don’t know well. The combination of these factors can increase the likelihood of incidents, highlighting the importance of managing agency staff effectively to maintain high-quality, consistent care.

Higher incident likelihood

Data indicates a correlation between the number of agency staff and the likelihood of incidents. This highlights the importance of carefully managing agency staff and ensuring they are well-prepared to work with the people you support.  

Strategies for effective management of agency staff  

To mitigate the challenges associated with agency staff, it’s essential to implement strategies that ensure consistency, build familiarity, and provide adequate preparation.

Consistent staffing

Where possible, secure agency staff for longer-term assignments, such as three to six months, to provide consistency. Pair agency staff with permanent staff who know the service user well, allowing the permanent staff member to lead the support while the agency staff focuses on the more practical tasks (such as cleaning, or prepping for the day’s activities).

Pre-shift preparation

Arrange for agency staff to arrive a day or two before their shift to participate in activities the service user enjoys and to get acquainted with the other staff and the specific tasks. It’s important to introduce the agency staff to service users early on to foster familiarity and build rapport.

Information sharing

Provide agency staff with anonymised PBS plans, particularly the communication section, which generally lacks sensitive personal information. This helps them understand the specific needs and strategies for supporting the service user.  

Cost considerations

While lengthy inductions for agency staff can be beneficial, they are often costly and may not be feasible for all providers. Weigh the cost of extensive inductions against the potential benefits of having well-prepared agency staff. You could consider cheaper alternatives like sending one pager profiles to aid in familiarity ahead of new team members joining.  

Embedding PBS within your organisation is a complex but essential process that requires buy-in from all levels of the organisation, from senior management to frontline staff. By securing senior management buy-in, engaging and empowering staff, and carefully managing agency staff, you can create a supportive environment where PBS can thrive. This, in turn, leads to better outcomes for service users, improved staff well-being, and a stronger, more resilient organisation.

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In Chapter 6, we'll explore the growing role of technology in PBS.

Technology is increasingly becoming an integral part of Positive Behaviour Support (PBS), offering innovative solutions for managing and enhancing PBS plans. In this chapter, we will explore how digital tools are revolutionising the way PBS is implemented, monitored, and refined, leading to better outcomes for service users and more efficient management for care providers.

The benefits of digital systems in PBS

Enhanced data collection and analysis

Digital tools have significantly improved how data is collected, stored, and analysed in care:

• Real-time data entry: With digital platforms, staff can record behaviours, incidents, and interventions as they happen. This real-time data entry ensures that information is accurate and up to date.

• Advanced analytics: Modern digital tools can analyse large sets of data, identifying trends and patterns that might not be immediately obvious. This helps in understanding the effectiveness of interventions and making informed decisions.

Improved communication and coordination

Technology facilitates better communication among care teams and with service users:

• Centralised information: Digital care management systems centralise all relevant information, making it accessible to all team members. This ensures everyone is on the same page and can easily collaborate on the PBS plan.

• Enhanced collaboration: Integrated communication tools within these systems allow for seamless interaction between staff, service users, and their families, fostering a more cohesive support network.

Streamlined PBS plan implementation

Digital tools make the implementation of PBS plans more efficient and consistent:

• Automated reminders: Set up automated reminders for staff to carry out specific interventions or check on progress, ensuring that the PBS plan is followed consistently.

• Customisable interventions: Use digital platforms to create and manage interventions that are tailored to the specific needs of each service user, enhancing the personalisation and effectiveness of the PBS plan.

Key technologies supporting PBS

Digital care management systems

These systems are the backbone of digital PBS management:

• Care planning: Create and update PBS plans digitally, with the ability to incorporate real-time feedback and make necessary adjustments.

• Progress tracking: Use integrated tools to monitor the service user’s progress against the goals set out in the PBS plan.

• Incident reporting: Record incidents digitally, allowing for immediate analysis and quicker response times.
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• Service user engagement: Empower the service user to sign their PBS plans, giving them a sense of ownership and autonomy.

Mobile applications

Mobile apps are increasingly used to enhance the portability and accessibility of PBS tools:

• Behaviour tracking: Staff can use mobile apps to track behaviours and interventions on the go, providing immediate data for analysis.

• Communication tools: Mobile platforms enable real-time communication between staff, helping to coordinate care more effectively.

Complex Care providers love Log my Care's PBS plan feature as the Carer App makes it so quick and easy to view service user's PBS plans.

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Log my Care's PBS feature

Log my Care is leading the way with developing the features that learning disability providers need to deliver outstanding care. That’s why it’s fast becoming the intuitive care management platform loved by complex care providers.  

Our PBS plans feature empowers care providers to design smarter, more person-centred PBS plans that provide a clearer path to behavioural progress.  

As you now know, levelling up PBS can have a dramatic impact on the lives of your service users. With Log my Care’s PBS plans feature, you will not only gain a much deeper understanding of the individuals you support, but you will also be able to demonstrate and provide evidence of it.  

Explore our PBS plans feature in an interactive demo
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Looking to the future: Emerging tech in PBS

Artificial Intelligence (AI)

AI is set to play a significant role in the future of PBS which could look a little like:

• Predictive analytics: AI can predict potential behavioural issues and suggest proactive interventions based on past data, offering a powerful tool for preemptive support.

• Personalised interventions: AI-driven tools can create highly personalised support strategies, adapting in real-time to the needs of the service user.

Wearable technology

Wearable devices are also emerging as valuable tools in PBS:

• Real-time monitoring: Wearables can monitor physiological indicators that might inform behavioural assessments, providing real-time data that can be integrated into PBS plans.

• Activity tracking: Track activity levels and behavioural patterns, offering a more holistic view of the service user’s well-being and the effectiveness of interventions.

As technology continues to evolve, its role in Positive Behaviour Support (PBS) will only grow, offering new opportunities to enhance the quality of care and the effectiveness of PBS plans. By embracing digital tools and staying ahead of emerging trends, care providers can ensure they are delivering the best possible support, improving the lives of service users while making the process more efficient and sustainable for everyone involved.

In Chapter 7, we'll guide you through a step by step action plan for implementing PBS plans for service users in your organisation.

Using all the tools and guidance you’ve learnt from this e-book; you can now start to create PBS plans. Below, we have put together a suggested step-by-step process to follow when creating and implementing a new PBS plan for a service user.  

Creating a successful Positive Behaviour Support (PBS) plan is a meticulous process that requires collaboration, a deep understanding of the individual, and a commitment to continuous improvement. In this chapter, we’ll outline a step-by-step guide to developing and maintaining person-centred PBS plans that truly make a difference in the lives of service users.

1. Start with a comprehensive assessment

Gather detailed information

Begin by collecting comprehensive data about the service user. This includes understanding their life history, medical background, and behavioural patterns. Use tools like ABC Charts, Motivational Assessment Scales, and quality of life assessments to build a complete picture.

Engage the service user and their circle

Involve the service user in the assessment process as much as possible and gather input from their family, carers, and external agencies. This collaboration ensures that the PBS plan is grounded in a holistic understanding of the individual’s needs and context.

Identify strengths and challenges

Focus on identifying the service user’s strengths, interests, and areas where they experience difficulties. A strengths-based approach is key to developing proactive strategies that build on what the individual can do well, rather than focusing solely on managing behaviours of concern.

2. Develop a person-centred PBS plan

Set clear, achievable goals

Establish specific, measurable goals that align with the service user’s interests and aspirations. These goals should be realistic, reflecting both short-term milestones and long-term outcomes aimed at enhancing the individual’s quality of life.

Design proactive strategies

Proactive strategies are at the heart of an effective PBS plan. These strategies should be personalised to prevent behaviours of concern by addressing the service user’s needs in a positive and constructive way. Examples include increasing participation in preferred activities, modifying the environment to reduce triggers, and improving communication methods.

Prepare reactive strategies

While the focus is on proactive approaches, it’s important to include reactive strategies for when behaviours escalate. These should be the least restrictive options available, aimed at ensuring safety and de-escalation without compromising the individual’s dignity.

Develop crisis strategies

In cases of known risky behaviors that could disrupt business continuity or lead to hospital admissions, it's essential to have a crisis plan. This plan should outline what to do when all other strategies have failed, including using restrictive practices if necessary. It may also involve contacting the police, crisis teams, or following internal escalation procedures to ensure the safety and well-being of all involved.

3. Implement the PBS plan daily

Integrate into daily routines

Once the PBS plan is developed, the next step is to integrate it into the service user’s daily routines. It’s essential that all staff members understand their roles in implementing the strategies consistently.

Encourage collaboration and communication

Ensure that everyone involved in the service user’s care, including family members and external agencies, is aware of the PBS plan and their specific roles in its implementation. Regular communication is key to maintaining alignment and consistency.

Provide ongoing support and training

Continued support and training for staff are crucial to the successful implementation of the PBS plan. Use reflective practices and regular team meetings to discuss challenges, share successes, and reinforce key strategies.

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4. Monitor and adjust the PBS plan

Regularly review progress

PBS is a dynamic process that requires continuous monitoring. Regularly review the service user’s progress against the goals set in the PBS plan. Use data from incident reports, ABC Charts, and other tracking tools to assess what’s working and what isn’t.

Adapt strategies as needed

Be prepared to adjust the PBS plan as the service user’s needs and circumstances change. Flexibility is key—what works today might need to be refined tomorrow, and that’s part of the ongoing process of providing effective support.

Involve the service user in reviews

Keep the service user involved in the review process. Their feedback is invaluable for understanding their experiences and making the plan more effective.

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5. Overcome challenges in PBS implementation

Address time and resource limitations

Time pressures and limited resources are common challenges in PBS. To overcome these, ensure that your team is empowered with the right tools, training, and support to implement the PBS plan effectively. It can also be a good idea to schedule in time dedicated to reviewing how an individual’s PBS plan is going either on a weekly or monthly basis.  

Maintain consistency across the team

Consistency is crucial for the success of a PBS plan. Make sure that all team members are aligned with the plan and committed to applying the strategies consistently. Regular check-ins and training refreshers can help maintain this alignment.

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6. Collaborate with external agencies and families

Share insights and strategies

Families and external agencies can provide unique perspectives that enhance the PBS plan. They may have a more detailed context about the individual’s life that is critical to a PBS plan’s success. Work together to ensure a unified approach to supporting the service user, sharing insights and strategies that can be applied across different environments.

By following these steps, you can create and maintain PBS plans that are truly person-centred, proactive, and effective. Remember, a successful PBS plan is not just a document—it’s a living, evolving process that adapts to the changing needs of the individual, ensuring they receive the best possible support to lead a fulfilling life.  

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Speak with the Log my Care team about levelling up PBS

Want to talk to a member of the Log my Care team about levelling up PBS plans in your organisation? Book some time with the team to get a personalised demo of our PBS plans feature and other complex care features such as Goals & Outcomes and Incident Management.  

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In this final chapter, we’ll discuss strategies for long term success: staying ahead of regulatory changes, continuing investment in resources and technologies and strengthening your industry partnerships. 

Staying ahead of regulatory changes

Staying informed about potential changes in regulatory standards and expectations is crucial for maintaining compliance in care environments. 

The Care Quality Commission (CQC) frequently updates its guidelines and standards to ensure the highest quality of care. Regularly reviewing these updates, as well as industry guidelines, is essential to ensure your goal-setting practices remain compliant. 

There are a number of ways you can stay ahead of the curve here:

• Subscribing to regulatory newsletters (we’d always recommend subscribing to Log my Care’s newsletter for the latest insights on high quality care provision). 
• Attending relevant training sessions and online webinars (again, stay tuned for future webinars and training sessions from the Log my Care team). 
• Participating in industry forums and attending conferences.  

Developing this proactive approach to regulation makes it easier to ensure your staff training is up to date and aligned with CQC standards. Likewise, regularly updating documentation practices to align with the latest guidelines is also critical. 

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Set up your team for long-term success 

By encouraging continuous professional development and fostering a culture of learning and innovation, staff become better equipped to support service users effectively. 

Regular training sessions, workshops, and access to online courses can enhance staff skills in setting, tracking, and achieving goals. Building a flexible workforce ensures that staff can respond to each service user's unique needs, align with their aspirations, and adjust to evolving goal-setting practices.

And, as Log my Care’s resident expert Mark Topps explains, it’s vital to encourage your own staff to set their own goals too. It engenders personal and professional growth and encourages resilience and self-reflection as they work with service users. 

Strengthen your industry partnerships

Collaborating with technology providers, industry experts, and other care homes is vital for staying ahead of trends and sharing best practices. 

Building strong partnerships can help care homes access new resources, gain valuable insights, and enhance their service delivery. These partnerships can also provide support during the implementation of new systems, ensuring a smoother transition and better integration of new technologies and practices.

Invest in new resources and technology 

Investing in the latest technologies is a crucial strategy for long-term success if you’re a care home manager. 

Technologies that support goal setting and tracking, such as software for electronic health records, data analytics tools, and communication platforms, can enhance the efficiency and effectiveness of care. 

These tools not only streamline administrative tasks but also provide valuable insights into service user progress, helping to set more realistic and achievable goals.

Investing in technology also prepares care homes for future advancements, ensuring they remain at the forefront of industry standards.

Ultimately, new technologies are also the key to ensuring that your goal setting strategy contains these three crucial pillars:

1. It’s personalised

Digital care systems allow for highly personalised care plans tailored to each resident's unique needs and preferences. 

By documenting specific criteria, exercises, and milestones, these systems ensure that every goal is relevant and achievable for the individual. Personalisation enhances the resident's engagement and motivation, making their care journey more meaningful and effective.

2. Visualise progress & maintain consistent documentation

One of the standout features of digital care systems is their ability to provide easy visualisation of progress. 

Carers and residents can see real-time updates and track improvements effortlessly. This visual clarity helps in celebrating milestones, identifying areas that need attention, and keeping everyone informed and motivated. 

Additionally, these systems facilitate compliance by making it easier for your team to keep documentation accurate, up-to-date, and easily accessible for audits and inspections. This helps your care home meet regulatory standards and demonstrates your commitment to high-quality, accountable care.

3. Quality of care

This is the most important pillar of all. 

Embracing digital care systems means you’re embracing the opportunity to significantly elevate the quality of care provided in care homes. With real-time data access, seamless communication, and efficient documentation, carers can deliver more accurate and responsive care. 

This technology supports better decision-making, ensures that all team members are working towards the same goals, and allows for immediate adjustments based on the resident's current needs. The result is care provision that is more efficient, effective and compassionate. 

And we’d argue that striving for this high quality care is the most important goal of all! 

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Let us help you put person-centred care at the heart of your practice

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The well-being and progression of your service users are at the core of everything you do.

Working with service users on goal setting should be:

• Streamlined for your team
• Effective for the service user
• Simple for management to be able to track

Collecting data to evidence the impact of your team’s care delivery and service user goal achievements can also be challenging. Even more so when dealing with stacks of paper or systems that just weren’t built for your needs.

This is why we built Outcomes and Goals.

It’s easy to use, as comprehensive as you need it to be, and enables you to level-up your ability to empower service users to achieve goals. Plus, when you need to submit evidence of this person-centred care approach, you can do so with ease.

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Book your 1-1 demo to see Log my Care in action and learn about how we can support you in putting person-centred care at the heart of what you do.

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