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Positive Behaviour Support and Managing Aggression Policy

1. Purpose

The purpose of this policy is to ensure that {{org_field_name}} promotes a person-centred, positive approach to behaviour management while effectively preventing and managing aggression or challenging behaviour in a way that protects the dignity, rights, and safety of service users and staff. This policy aligns with the Positive Behaviour Support (PBS) framework, which emphasises understanding the causes of behaviour and using proactive strategies to reduce distress.

This policy ensures compliance with:

• The Regulation and Inspection of Social Care (Wales) Act 2016 – Requires care providers to manage behaviour in a way that upholds dignity and human rights【32】.
• The Social Services and Well-being (Wales) Act 2014 – Emphasises a person-centred approach to care.
• Care Inspectorate Wales (CIW) Regulations – Mandates effective safeguarding measures to protect individuals from harm【35】.
• The Mental Capacity Act 2005 – Ensures decisions regarding behaviour support are made in the best interest of the service user.
• The Human Rights Act 1998 – Prevents restrictive practices unless absolutely necessary.

2. Scope

This policy applies to:

• All employees, including care workers, managers, and administrative personnel.
• Service users who may exhibit challenging behaviour due to medical, cognitive, or emotional conditions.
• Family members, advocates, and external healthcare professionals involved in behaviour support planning.

It covers:

• Principles of Positive Behaviour Support (PBS).
• Identifying triggers and risk factors.
• Preventative strategies and de-escalation techniques.
• Safe intervention and incident management.
• Staff training and competency requirements.
• Incident reporting and learning from events.

3. Principles of Positive Behaviour Support (PBS)

Positive Behaviour Support (PBS) is a proactive, evidence-based approach that focuses on:

• Understanding the causes of challenging behaviour rather than just reacting to incidents.
• Promoting independence, choice, and engagement to improve quality of life.
• Using least restrictive interventions and avoiding punishment or unnecessary restraint.
• Ensuring that staff respond with empathy, patience, and professionalism.

4. Identifying Triggers and Risk Factors

Challenging behaviour often arises from unmet needs, frustration, or distress. Staff must recognise and document:

4.1 Common Triggers for Aggression or Challenging Behaviour

• Pain or medical conditions (e.g., dementia, anxiety disorders).
• Communication difficulties leading to frustration.
• Changes in routine or unfamiliar environments.
• Fear, anxiety, or past trauma.
• Side effects of medication or withdrawal symptoms.

4.2 Risk Assessment and Behaviour Support Plans

• A Positive Behaviour Support Plan (PBSP) must be developed for service users who require additional support.
• PBSPs should include:
  • Known triggers.
  • Preferred de-escalation strategies.
  • Alternative coping techniques.
  • Emergency response plan.
• Staff must review risk assessments regularly and update PBS plans when necessary.

5. Preventative Strategies and De-escalation Techniques

The best way to manage challenging behaviour is to prevent incidents from occurring.

5.1 Creating a Supportive Environment

• Maintain clear communication and provide visual aids if needed.
• Offer structured routines to reduce anxiety.
• Provide calm, quiet areas for individuals who need to de-stress.
• Allow service users to make choices about their care whenever possible.

5.2 Proactive Behaviour Management

• Engage service users in meaningful activities to prevent boredom.
• Encourage the use of relaxation techniques such as deep breathing.
• Use positive reinforcement to reward good behaviour.
• Adapt care plans based on the individual’s needs and preferences.

5.3 De-escalation Strategies During an Incident

If a service user becomes distressed, staff should:

1. Stay calm and use a non-threatening tone.
2. Respect personal space to avoid escalating aggression.
3. Acknowledge feelings and provide reassurance (e.g., “I understand this is frustrating for you.”).
4. Redirect attention to another activity or topic.
5. Encourage problem-solving by offering choices and solutions.

6. Safe Intervention and Incident Management

6.1 Avoiding Restrictive Practices

• Physical intervention must only be used as a last resort when there is an immediate risk to the service user or others.
• Any intervention must be proportionate, reasonable, and recorded.
• Staff must never use force, punitive measures, or unnecessary restraint.

6.2 Managing Aggressive Incidents

If a situation escalates to physical aggression, staff should:

1. Call for assistance immediately.
2. Ensure their own safety and the safety of others.
3. Follow training guidance on safe interventions.
4. Use verbal communication to de-escalate whenever possible.
5. Seek medical attention if required after an incident.

7. Incident Reporting and Learning from Events

All incidents of challenging behaviour or aggression must be documented and reviewed.

7.1 Reporting and Documentation

• Complete an Incident Report Form within 24 hours.
• Record:
  • Date, time, and location.
  • Triggering events and staff response.
  • Techniques used to de-escalate the situation.
  • Any injuries or damage sustained.
  • Service user’s emotional state after the incident.

7.2 Reviewing Incidents for Improvement

• The Registered Manager and PBS Lead will review all incidents to:
  • Identify trends and triggers.
  • Adjust behaviour support plans accordingly.
  • Implement further staff training if required.
• Lessons learned will be shared with the team to improve future responses.

8. Staff Training and Competency Requirements

• All employees must complete mandatory PBS training upon induction.
• Annual refresher training covers:
  • De-escalation techniques.
  • Crisis intervention strategies.
  • Identifying and responding to triggers.
  • Legal and ethical considerations.
• Staff competency is assessed regularly through observation and supervision.

9. Monitoring and Compliance

• The Registered Manager ensures compliance with this policy.
• Quarterly audits assess the effectiveness of PBS strategies and staff training.
• Feedback from service users, families, and staff is used to improve practices.
• CIW inspections will evaluate the management of challenging behaviour.

10. Related Policies

This policy should be read in conjunction with:

• Safeguarding Adults from Abuse and Improper Treatment Policy (DCW13).
• Health and Safety at Work Policy (DCW16).
• Whistleblowing (Speaking Up) Policy (DCW29).
• Risk Management and Assessment Policy (DCW18).

11. Policy Review

This policy will be reviewed annually or sooner if required by legislative changes, CIW regulations, or operational needs.

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Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
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