Login

CH182-Managing Childrens and Your Peoples Challenging Behaviour Policy

{{org_field_logo}}

{{org_field_name}}

Registration Number: {{org_field_registration_no}}

Managing Children’s and Young People’s Challenging Behaviour Policy

1. Purpose

The purpose of this policy is to ensure that {{org_field_name}} adopts a safe, proactive, trauma-informed, respectful and person-centred approach to understanding and responding to behaviour that communicates distress, unmet need, pain, fear, anxiety, trauma, sensory overload or other risk factors in children and young people receiving care or support. The policy explains how staff will prevent escalation wherever possible, use Positive Behaviour Support, communicate effectively, promote dignity and rights, and only use restrictive intervention where this is lawful, necessary, proportionate, in the person’s best interests or otherwise legally authorised, and the least restrictive option available.

This policy supports compliance with the Health and Social Care Act 2008, the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, including Regulation 9 Person-centred care, Regulation 10 Dignity and respect, Regulation 11 Need for consent, Regulation 12 Safe care and treatment, Regulation 13 Safeguarding service users from abuse and improper treatment, Regulation 17 Good governance, Regulation 18 Staffing, Regulation 19 Fit and proper persons employed, Regulation 20 Duty of candour and Regulation 20A Display of performance assessments, where applicable. It also supports compliance with the Care Quality Commission (Registration) Regulations 2009, including Regulation 18 Notification of other incidents, the Mental Capacity Act 2005, Deprivation of Liberty Safeguards where applicable to people aged 18 or over, the Human Rights Act 1998, Equality Act 2010, Children Act 1989, Children Act 2004, Children and Families Act 2014, SEND Code of Practice, Working Together to Safeguard Children, the Department of Health and Social Care and Department for Education guidance “Reducing the need for restraint and restrictive intervention”, and the Oliver McGowan Code of Practice on statutory learning disability and autism training.

2. Scope

This policy applies to all staff, agency workers, volunteers, and contractors working with children and young people at {{org_field_name}}. It covers behaviours that may pose a risk to the safety or well-being of the individual or others, including physical aggression, verbal outbursts, self-injury, destruction of property, defiance, or withdrawal. It applies to both planned interventions and emergency situations across all care settings.

This policy applies only where the service is carrying on a CQC-regulated activity and is not operating as a children’s home or other establishment for which Ofsted is the registration authority. Where a child or young person is placed in, visits, transitions through, or receives support from {{org_field_name}}, the Registered Manager must confirm that the placement is within the organisation’s registration, statement of purpose, staffing competence, safeguarding arrangements and legal authority. If the arrangement may fall within children’s home registration, unregistered children’s provision, education provision, secure accommodation or deprivation of liberty arrangements, the Registered Manager must seek immediate advice from the placing authority, safeguarding partners, legal advisers and the relevant regulator before the placement or arrangement proceeds.

3. Related Policies

This policy should be read in conjunction with:

4. Policy Details

4.1 Understanding Behaviour that Communicates Distress or Unmet Need

Behaviour that may challenge services is understood by {{org_field_name}} as behaviour that communicates distress, unmet need, pain, trauma, fear, frustration, sensory overload, communication difficulty, environmental stress, physical illness, mental health need or risk. Staff must not describe a child or young person as “the problem”. Staff must consider what the behaviour is communicating and what changes are needed in the environment, communication approach, care plan, staffing, routines, sensory support, health assessment or emotional support.

Behaviour may include, but is not limited to, physical aggression, verbal distress, self-injury, withdrawal, refusal of care, absconding or attempts to leave, damage to property, sexually inappropriate behaviour, distress during personal care, distress linked to medication, or behaviours linked to trauma, autism, learning disability, mental health needs or communication needs. All responses must be person-centred, trauma-informed, proportionate, non-punitive and based on Positive Behaviour Support.

4.2 Definitions of Restrictive Practice and Restraint

Restrictive practice means any action, intervention, restriction or environmental arrangement that limits a child or young person’s movement, liberty, choices, privacy, contact with others, access to items, access to areas, or ability to make decisions. Restrictive practice may be planned or unplanned, direct or indirect, and may include restrictions that are built into routines, staffing arrangements, locked doors, observation levels, medication arrangements or behaviour support plans.

Restraint means an act carried out with the purpose of restricting a person’s movement, liberty or freedom to act independently. Restraint must only be used as a last resort, where it is necessary to prevent serious and immediate harm, and where the intervention is proportionate, lawful and the least restrictive option available.

Physical restraint means direct physical contact used to restrict, hold, guide, move or prevent movement. Mechanical restraint means the use of equipment or devices to restrict movement, except where the equipment is used for a therapeutic or safety purpose and is the least restrictive option, risk assessed and care planned. Chemical restraint means the use of medication primarily to control behaviour or restrict movement rather than to treat an identified physical or mental health condition. Environmental restraint means restricting access to areas, exits, rooms, possessions, activities or people. Seclusion means supervised confinement and isolation away from others where the person is prevented from leaving. Seclusion must not be used unless there is clear lawful authority, safeguarding oversight, senior management authorisation and professional advice.

A restriction may be lawful and proportionate where it forms part of a care plan, risk assessment or legal framework and is necessary to keep the person or others safe. However, repeated, blanket, convenience-based, punitive, unauthorised or poorly reviewed restrictions may amount to improper treatment, unlawful restraint or an unauthorised deprivation of liberty.

4.3 Assessment and Behaviour Support Planning

Each child or young person who presents with behaviour that may place themselves or others at risk must have an individualised Positive Behaviour Support Plan. The plan must be based on assessment, observation, known history, communication needs, sensory needs, trauma history, physical and mental health needs, medication review where relevant, environmental factors, risk assessment and the views of the child or young person, their family or representatives, placing authority, social worker, education provider and involved professionals.

The Positive Behaviour Support Plan must include: known triggers; early warning signs; proactive strategies; preferred communication methods; sensory and environmental adjustments; trauma-informed approaches; cultural, religious and identity needs; agreed de-escalation strategies; known effective calming strategies; risks to the person and others; any agreed restrictive interventions; who may authorise and apply any intervention; what must never be used; post-incident support; family and professional contact arrangements; and clear review dates.

Any planned restrictive intervention must be specifically risk assessed, legally justified, documented, time limited and reviewed. The plan must show how restrictions will be reduced over time and what less restrictive alternatives have been considered. Behaviour support plans must be reviewed at least monthly where restrictive practice is used, after every significant incident, after any safeguarding concern, after any injury, following any medication change, following any change in placement or care arrangements, and whenever the child or young person, family, staff or professionals raise concerns.

4.4 Consent, Mental Capacity, Best Interests and Deprivation of Liberty

Staff must seek the child or young person’s involvement and agreement wherever possible, using communication methods appropriate to their age, understanding, disability, language and communication needs. Consent must not be assumed because a person is distressed, disabled, autistic, has a learning disability, has mental health needs, or communicates differently.

For young people aged 16 or 17, staff must consider the Mental Capacity Act 2005 where there is doubt about capacity for a specific decision at the time the decision needs to be made. Where the young person lacks capacity, any act or decision must be in their best interests, necessary, proportionate, the least restrictive option, and properly recorded.

Deprivation of Liberty Safeguards apply only to people aged 18 or over in care homes and hospitals where the person lacks capacity to consent to the arrangements and the arrangements amount to a deprivation of liberty. Where a person aged 18 or over is under continuous supervision and control and is not free to leave, the Registered Manager must ensure that the appropriate DoLS application is made to the local authority and that CQC is notified when required.

Where a child or young person under 18 may be subject to arrangements amounting to a deprivation of liberty, staff must not rely on DoLS. The Registered Manager must immediately escalate the matter to the placing authority, social worker, safeguarding partners and legal advisers so that the correct legal route is considered, which may include the High Court, family court or other lawful authority. No unauthorised deprivation of liberty must take place.

4.5 Staff Training and Competency

All staff working with children and young people must receive role-appropriate training, supervision and competency assessment before they are expected to support a person whose behaviour may place themselves or others at risk. Training must be proportionate to the staff member’s role, the needs of people using the service and the level of risk in the service.

Training must include: behaviour as communication; Positive Behaviour Support; trauma-informed care; autism and learning disability awareness; the Oliver McGowan Mandatory Training on Learning Disability and Autism, appropriate to the person’s role; communication support; sensory needs; mental health awareness; safeguarding children and adults; de-escalation; risk assessment; human rights; equality and non-discrimination; consent; Mental Capacity Act and best interests where relevant; DoLS where relevant to adults aged 18 or over; incident recording; CQC notification duties; duty of candour; and post-incident debriefing and learning.

Staff must not use any physical intervention, restraint technique, breakaway technique or restrictive intervention unless they have received approved training, have been assessed as competent, and the intervention is included in an individual risk assessment or is necessary in an emergency to prevent serious and immediate harm. Any emergency use must be the least restrictive option, for the shortest time possible, and must be reported, recorded, reviewed and escalated.

Competency must be checked through induction, direct observation, supervision, reflective practice, incident review, competency sign-off and refresher training. The Registered Manager must maintain a training matrix showing who is trained, the level of training completed, expiry dates, competency checks and any restrictions on practice.

4.6 Preventative and Proactive Strategies

Our care model prioritises the prevention of challenging behaviour by:

Staff work closely with families and education settings to ensure consistency and effective transitions.

Staff must consider whether behaviour may be linked to pain, constipation, infection, hunger, thirst, fatigue, medication side effects, withdrawal effects, sleep disturbance, trauma triggers, communication frustration, sensory overload, loneliness, bullying, abuse, neglect, unmet cultural or spiritual needs, change in routine or environmental factors. Where behaviour changes suddenly or increases in frequency, severity or duration, staff must seek appropriate health advice and escalate concerns to the Registered Manager.

Staff must avoid blanket restrictions. Restrictions must not be introduced for staff convenience, routine management, punishment, lack of staffing or organisational preference. Any restriction must be based on an individual risk assessment and must be necessary, proportionate and reviewed.

4.7 De-escalation and Intervention Techniques

When challenging behaviour arises, staff are expected to respond using non-restrictive methods first. These may include:

Restrictive intervention must only be used where there is a serious and immediate risk of harm to the child or young person or to others, and where non-restrictive approaches have been tried or would be insufficient in the circumstances. Any intervention must be lawful, necessary, proportionate, the least restrictive option available, used for the shortest possible time, and carried out in a way that protects dignity, privacy, communication, breathing, physical wellbeing and emotional safety.

Staff must continuously monitor the person’s physical and emotional presentation during any restrictive intervention, including breathing, colour, consciousness, distress, pain, injury, risk of positional asphyxia, medical conditions and known trauma triggers. Staff must stop the intervention as soon as the immediate risk has passed. Face-down restraint, pain compliance, punishment, humiliation, threats, deliberate isolation, withholding food or drink, and any intervention that restricts breathing or causes avoidable harm must not be used.

Any emergency intervention not already included in the person’s plan must be reported immediately to the senior person on duty and the Registered Manager, recorded as an incident, reviewed as a safeguarding and governance matter, and used to update the risk assessment and Positive Behaviour Support Plan.

4.8 Authorisation and Responsibilities

The Registered Manager is responsible for ensuring that any planned restrictive intervention is lawful, risk assessed, care planned, agreed with relevant professionals, reviewed and monitored. The Registered Manager must ensure that staff are trained and competent before they are permitted to use any approved restrictive intervention.

Senior staff on duty are responsible for providing immediate oversight during and after incidents, ensuring the safety of the child or young person, arranging first aid or medical assessment where needed, preserving evidence where safeguarding concerns arise, ensuring records are completed, and escalating to the Registered Manager.

Staff are responsible for using proactive and de-escalation strategies first, following the person’s Positive Behaviour Support Plan, using the least restrictive approach, calling for assistance early, protecting dignity and safety, recording incidents honestly and taking part in debriefs and reflective learning.

The Safeguarding Lead is responsible for advising whether an incident meets the threshold for safeguarding referral, ensuring concerns are referred to the local authority children’s or adults’ safeguarding team as appropriate, and ensuring that the person’s voice and wishes are considered.

4.9 Safeguarding and Rights-Based Approach

{{org_field_name}} has zero tolerance of abuse, degrading treatment, unlawful restraint, unnecessary or disproportionate restraint, discrimination, neglect and unauthorised deprivation of liberty. Staff must uphold the rights, dignity, privacy, safety, equality and emotional wellbeing of every child and young person. Responses to behaviour must never be punitive, retaliatory, humiliating, threatening or used for staff convenience.

Any restrictive practice must be treated as a significant event requiring recording, management review and learning. It must also be considered as a potential safeguarding concern. A safeguarding referral must be made where the intervention was unauthorised, excessive, avoidable, punitive, caused injury or psychological harm, involved poor practice, involved possible abuse or neglect, involved seclusion or suspected unlawful deprivation of liberty, was not properly recorded, or raised concerns about staff conduct, staffing levels, training, culture or management oversight.

Staff must report concerns immediately to the Registered Manager {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}} or the senior person on duty. Where there is immediate risk, staff must take urgent action to protect the person, seek medical help if required, contact emergency services where necessary, and follow safeguarding procedures. The Registered Manager must ensure that safeguarding partners, the placing authority, family or representatives, commissioners and CQC are notified where required.

4.10 Involving the Child or Young Person, Families and Professionals

The child or young person must be involved in behaviour support planning, risk assessment, review and post-incident learning as far as practicable, using communication methods they understand. Their wishes, feelings, preferences, fears, relationships, cultural needs, sensory needs and communication needs must be recorded and taken seriously.

Families, carers, advocates, social workers, education providers, health professionals, commissioners and other relevant professionals are partners in behaviour support planning. Their involvement must be sought where appropriate and lawful, while respecting confidentiality, consent, safeguarding duties and the child or young person’s rights.

Where behaviour increases in frequency, severity or risk, or where restrictive practice is being considered or used repeatedly, the Registered Manager must seek timely professional advice. This may include the GP, paediatrician, community learning disability team, CAMHS, speech and language therapy, occupational therapy, psychology, behaviour support specialist, social worker, safeguarding team or emergency services.

4.11 Recording, Reporting, Notification and Monitoring

All incidents involving behaviour that places the child or young person or others at risk, any restrictive practice, any restraint, any injury, any allegation of abuse, any safeguarding concern, any unauthorised absence, any police involvement, any use of emergency services, or any significant deterioration in emotional or physical wellbeing must be recorded promptly, accurately and factually.

Records must include: the date, time and location; people present; what happened before, during and after the incident; known triggers; early warning signs; de-escalation attempted; the child or young person’s communication and presentation; staff actions; any restrictive intervention used; why it was necessary; why it was the least restrictive option; duration; monitoring during the intervention; injuries or pain; first aid or medical assessment; body map where required; damage; witnesses; notifications made; family or professional contact; safeguarding actions; CQC notification consideration; duty of candour consideration; debrief offered; and changes required to the care plan or risk assessment.

The Registered Manager must review every incident involving restrictive practice and must decide whether the matter requires safeguarding referral, CQC notification, commissioner notification, placing authority notification, police referral, professional review, staff suspension or disciplinary action, duty of candour action, or urgent care plan review.

Incident data must be analysed at least monthly where restrictive practice is used, and at least quarterly as part of service governance. Analysis must consider frequency, duration, type of intervention, location, staff involved, injuries, time of day, triggers, protected characteristics, communication needs, staffing levels, training needs, environmental factors, medication factors, safeguarding themes and whether restrictive practice is reducing. Findings must be reported to the provider, senior leadership or board-level equivalent and used to improve practice.

4.12 Post-Incident Support, Debrief and Learning

After any significant incident or restrictive intervention, staff must check the immediate safety, dignity, physical health and emotional wellbeing of the child or young person and others affected. First aid, medical review or emergency services must be arranged where required.

The child or young person must be offered a debrief in a way and at a time that is appropriate for their communication needs, emotional state, age and understanding. The purpose of the debrief is to listen, repair relationships, understand what happened, identify what could be done differently, reduce trauma and prevent recurrence. The debrief must not be used to blame, punish or force an apology.

Staff involved must also receive a reflective debrief with a senior person. This must consider whether the care plan was followed, whether earlier action could have prevented escalation, whether the intervention was necessary and proportionate, whether any staff support or training is needed, and whether safeguarding or governance action is required.

Learning from the incident must be used to update the Positive Behaviour Support Plan, risk assessment, communication plan, environmental plan, staffing plan and training plan where needed.

4.13 Prohibited Practice

Staff must not use any practice that is abusive, degrading, punitive, humiliating, discriminatory, retaliatory, unsafe or not legally authorised. The following are prohibited: corporal punishment; threats; intimidation; deliberate humiliation; withholding food, drink, medication, contact, visits or personal care as punishment; locking a person in a room without lawful authority; unauthorised seclusion; face-down restraint; any restraint that restricts breathing; pain compliance; blanket restrictions; unauthorised mechanical restraint; medication used primarily for staff convenience or control; planned restraint not included in a risk-assessed plan; and any intervention by untrained staff except in an emergency where immediate action is necessary to prevent serious harm.

Any suspected prohibited practice must be reported immediately as a safeguarding concern and escalated to the Registered Manager or provider. Where the concern involves the Registered Manager, it must be escalated to the provider, nominated individual, safeguarding authority and CQC as appropriate.

4.14 Medication and Chemical Restraint

Medication must never be used for staff convenience, punishment, routine control or as a substitute for appropriate assessment, communication, staffing, environmental adjustment or therapeutic support. Where medication is prescribed to support anxiety, distress, agitation, sleep, mental health or behaviour-related risk, the reason for prescribing, expected benefit, side effects, review arrangements and monitoring requirements must be clearly recorded.

PRN medication must only be used in accordance with the prescriber’s instructions, the medication policy and the person’s care plan. The care plan must set out when PRN medication may be considered, what non-medication strategies must be tried first where safe, who may administer it, how effectiveness and side effects will be monitored, and when medical advice must be sought.

Any concern that medication is being used primarily to restrict movement, sedate, control behaviour or compensate for staffing or environmental issues must be escalated to the Registered Manager, prescriber, pharmacist and safeguarding lead for review.

4.15 Equality, Communication and Human Rights

Staff must make reasonable adjustments for disability, autism, learning disability, sensory need, communication need, language, culture, religion, sex, gender, trauma history and any protected characteristic under the Equality Act 2010. Behaviour support plans must identify how the person communicates distress, refusal, pain, fear, discomfort, choice and consent.

Where required, staff must use communication aids, visual supports, interpreters, objects of reference, social stories, sensory tools, quiet spaces, preferred routines and support from people who know the child or young person well. Failure to make reasonable adjustments may increase distress and risk and may amount to discriminatory practice.

Restrictive practice must always be considered through a human rights lens, including the right to life, freedom from inhuman or degrading treatment, liberty and security, respect for private and family life, and non-discrimination.

5. Policy Review

This policy is reviewed at least annually, and earlier where there are changes to legislation, CQC regulations or guidance, safeguarding guidance, the Oliver McGowan Code of Practice, local safeguarding procedures, NICE or government guidance, or where incident analysis, complaints, safeguarding concerns, CQC feedback, audit findings, professional advice, staff feedback, family feedback or the views of children and young people indicate that the policy requires review.

The Registered Manager is responsible for leading the review in consultation with the provider, safeguarding lead, staff, relevant professionals and, where appropriate, children, young people, families, advocates and commissioners. The review must consider whether restrictive practice is reducing, whether staff are competent, whether recording and notifications are effective, and whether the policy continues to meet CQC expectations and legal requirements. All changes must be communicated to staff and reflected in training, supervision, care planning and governance systems.

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}}
Copyright © {{current_year}} – {{org_field_name}}. All rights reserved.

Leave a Reply

Your email address will not be published. Required fields are marked *