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Positive Behaviour Support and Managing Aggression Policy

Purpose and Scope

This policy outlines our approach to promoting positive behavior and safely managing aggression in our care home. It applies to all staff, volunteers, and caregivers supporting adult service users (including older adults with dementia) in our CQC-registered facility. Our goal is to ensure that service users receive care in a manner that promotes dignity, respect, safety, and person-centered support while meeting the Care Quality Commission (CQC) requirements for safe and effective care. By following this policy, we aim to enhance quality of life for residents, prevent incidents of challenging behavior, and respond safely and ethically when aggression does occur.

Policy Statement and Values

We are committed to a Positive Behaviour Support (PBS) approach in all aspects of care. PBS is “a person-centred framework for providing long-term support to people … who have, or may be at risk of developing, behaviours that challenge”. This approach recognizes that “behaviour that challenges usually happens for a reason and may be the person’s only way of communicating an unmet need. PBS helps us understand the reason for the behaviour so we can better meet people’s needs, enhance their quality of life and reduce the likelihood that the behaviour will happen”. In line with this philosophy, our staff will strive to understand the underlying causes of distress or aggression (such as pain, confusion, fear or frustration in a person with dementia) and address those needs proactively rather than reactively.

Our values and principles include: person-centered care, respect for each individual’s rights and dignity, and a commitment to least restrictive practices. We uphold that every service user has the right to a good quality of life, including: participation in community life, meaningful relationships, personal choice and autonomy, opportunities to develop skills, and being treated with dignity and respect . We promote a culture that sees behaviour as communication, not as something to punish. All staff are expected to interact with service users in a non-judgemental, respectful, and caring manner at all times. As the MAPA® approach (Management of Actual or Potential Aggression) emphasizes, we respond to people with respect and dignity while supporting them to stay safe.

This policy is aligned with national best-practice guidance. We adhere to the Department of Health’s Positive and Proactive Care (2014) guidance, which requires providers to use recovery-based, person-centered approaches and PBS principles when supporting people who present challenging behaviours. This applies equally to those with learning disabilities or autism and to older people with dementia who may become confused or agitated. We also follow relevant NICE guidelines on managing violence and aggression in care settings to anticipate and reduce the need for restrictive interventions. Our approach supports compliance with key CQC Fundamental Standards: ensuring person-centred care (Regulation 9), safe care and treatment including risk management (Regulation 12), safeguarding from abuse and avoiding inappropriate restraint (Regulation 13), good governance through incident monitoring (Regulation 17), and staff training and competency in PBS and de-escalation (Regulation 18). All staff and managers are responsible for upholding this policy and its values in daily practice.

Definitions

Positive Behaviour Support (PBS): A comprehensive, evidence-based approach to understanding and addressing challenging behavior. PBS “is a blend of person-centred values and behavioural science and uses evidence to inform decision-making”. It focuses on improving quality of life and reducing behaviours that challenge by teaching new skills and adapting the environment to the person’s needs.
Challenging Behaviour (Behaviours that Challenge): Any behavior by a service user that may cause harm to themselves or others, or significantly disrupt their care or daily life. This can include verbal or physical aggression, self-injury, property destruction, or other disruptive actions. Such behaviours are viewed as expressions of distress or unmet needs. Staff must remember that challenging behavior is often a form of communication by someone who may have difficulty expressing themselves in other ways.
Management of Actual or Potential Aggression (MAPA®): A specific training framework we use for crisis prevention and intervention. MAPA® provides staff with skills to respond to aggressive behavior in a calm and safe manner. “MAPA® is about responding to people in a non-judgemental way, treating them with respect and dignity whilst supporting them to stay safe”. It includes a range of de-escalation techniques and, only when absolutely necessary, physical interventions to prevent harm. MAPA® teaches that any physical intervention must be a last resort, using the least force required, and never to punish or humiliate.
Restrictive Intervention (Restraint): Any method of intervening in which the freedom of movement of a service user is restricted, against their will or without their consent, to mitigate risks. This includes physical restraint (holding a person or using bodily control), and may also include other measures like seclusion or the use of emergency medication for sedation. In our care home, restraint refers primarily to physical intervention techniques taught in MAPA®, and only used to prevent immediate harm. Using restraint in any form is a serious intervention and is governed by this policy, the Mental Capacity Act, and safeguarding laws.

Assessment and Individualised Support Planning

Effective positive behavior support begins with understanding the individual. For any service user who exhibits, or is at risk of, challenging behavior or aggression, we will carry out a holistic assessment and develop a personalised Behaviour Support Plan (BSP). The assessment will gather information about the person’s history, health (including mental health, dementia, pain or discomfort), communication needs, likes/dislikes, and known triggers for distress. We use a functional assessment approach to identify why the behavior is occurring and what need the person is expressing. Specifically, when assessing behavior, we consider factors such as the appearance of the behavior (what it looks like), the frequency of incidents, the severity of impact or harm, the duration of episodes, and the likely function (purpose) of the behavior for that individual. Understanding these elements helps staff to pinpoint underlying causes (e.g., physical discomfort, environmental stressors, communication frustrations) and to tailor support strategies accordingly.

Each service user’s Behaviour Support Plan will outline proactive strategies to meet their needs and prevent challenging episodes, as well as reactive strategies to manage situations safely if behaviours escalate. Plans are developed in collaboration with the individual (to the extent possible) and their family or representatives, to ensure we respect the person’s preferences and life history. We presume that each adult has capacity to be involved in planning unless assessed otherwise. If a person is found to lack mental capacity to make decisions about their care or interventions, any actions and the BSP will be made in their best interests in accordance with the Mental Capacity Act 2005. We will also consider input from relevant professionals (e.g., psychologists, dementia specialists, community mental health teams) for additional expertise in designing effective support plans.

Behaviour Support Plans are living documents: they will be reviewed and updated regularly (at least annually, and sooner after any significant incident or change in behavior patterns). The plan will clearly specify the behaviours it addresses, known triggers, early warning signs, and step-by-step guidance for staff on how to prevent and respond to those behaviours. Our aim is to ensure that staff have a consistent, well-informed approach for each individual, fostering stability and trust. By planning ahead and individualising our care strategies, we reduce uncertainty for both the service user and staff, which in turn helps minimize situations that could lead to aggression or distress.

Proactive Prevention Strategies

Primary prevention is our first priority. “Primary prevention uses proactive strategies that are designed to meet the person’s needs to minimise the occurrence of incidents of behaviour that challenges”. This means we focus on creating an environment and daily routine where challenging behaviours are less likely to occur. Staff will get to know each resident well – their personal history, preferences, and the things that make them happy, anxious, or upset. We use this knowledge to adjust our care and environment in a way that keeps the person as content and engaged as possible. Key proactive strategies include:

Meeting Basic Needs: Ensure the person’s physical needs (comfort, pain management, hunger, thirst, toileting, rest) are met promptly. Many aggressive outbursts in dementia can be prevented by timely attention to such needs.
Environment and Routine: Adapt the environment to reduce excess stress or confusion. For example, maintain a calm atmosphere with appropriate lighting and noise levels, provide familiar objects or decorations that are comforting, and establish a consistent daily routine. If certain times of day or activities are known triggers, adjust them (e.g. offer alternative activities or more support during those times).
Meaningful Activity and Engagement: Provide regular stimulation and engagement tailored to the person’s abilities and interests. Boredom and lack of stimulation can lead to frustration. Activities (music, reminiscing, walking, simple household tasks, social interaction, etc.) that are meaningful to the individual can prevent frustration and reduce incidences of challenging behavior.
Communication and Understanding: Use effective communication strategies, especially for individuals with dementia or limited verbal ability. This may involve using simple language, visual cues, gentle tone, and allowing extra time for the person to process. Staff should watch for non-verbal cues of distress and respond early. We also validate the person’s feelings – for instance, if a resident is upset due to a delusion or confusion, staff will acknowledge their emotions and provide reassurance rather than arguing or correcting them.
Building Trusting Relationships: All staff should approach residents with warmth, empathy and patience to build trust. A person who feels safe and understood is less likely to become frightened or agitated. Consistency in caregivers where possible helps maintain trust and predictability.
Individualised Avoidance of Triggers: The Behaviour Support Plan will list any known triggers for each person’s agitation or aggression. Staff must be aware of and, when possible, avoid or minimize these triggers. For example, if a resident becomes anxious in loud crowds, we will arrange quieter one-to-one activities instead of group outings; if a certain topic upsets them, staff will be mindful to steer conversation in a comforting direction.

By focusing on quality of life and preventative care, {{org_field_name}} aims to reduce the frequency and intensity of behaviours that challenge. Positive reinforcement of good behavior, encouragement, and celebration of the person’s abilities are also important. We treat every day as an opportunity to support the person’s wellbeing, independence, and sense of control, thereby proactively reducing the potential for aggression or frustration.

Early Intervention and De-escalation Techniques

Despite our best preventive efforts, there may be times when a service user begins to show signs of distress or escalating agitation. All staff are trained to recognize early warning signs of potential aggressive or challenging behavior. Early signs could include changes in body language (e.g. pacing, restlessness, clenched fists, tense posture), verbal cues (raised voice, shouting, or increased confusion), or changes in mood (like sudden anxiety or anger). Recognising these signs allows staff to intervene early with de-escalation techniques before the situation reaches a crisis point.

When early signs are noted, staff should remain calm and follow the person’s Behaviour Support Plan strategies for secondary prevention (sometimes called secondary strategies or early intervention). Key de-escalation techniques and approaches include:

Calm, Empathic Communication: Speak in a slow, gentle, reassuring tone. Use simple, clear words. Show empathy by acknowledging the person’s feelings (e.g., “I can see you’re upset – I want to help”). Often, just feeling heard can reduce a person’s anger.
Provide Space and Time: If safe, give the person a bit of space rather than crowding them. Ensure other residents or unnecessary staff distance themselves to reduce stimuli. Sometimes, a person just needs a few moments alone (with supervision from a safe distance) to regain composure. Always ensure they are still being observed from a distance for safety.
Active Listening and Distraction: Listen to what the person is trying to communicate. Let them express frustration if possible. Where appropriate, gently redirect or distract to a positive topic or activity. For example, offer a cup of tea, or invite them to a quieter area to look at a familiar photo album. Distraction and changing the environment are proven reactive strategies to defuse escalation.
Offer Choices: Often challenging behavior escalates when a person feels out of control. Offering a small choice can restore a sense of control (e.g., “Would you like to sit in the garden or your room?” or “Which of these outfits would you prefer to wear?”). Even if the choices are minor, the act of choosing can reduce aggression.
Boundary Setting in a Non-Threatening Way: If the person’s behavior is beginning to endanger others (e.g., verbal threats), staff should set gentle, clear limits. For example, “I want to help you, but I cannot do that if you hit me.” This must be done without raising voice or making punitive statements – the goal is to help the person understand the situation, not to force compliance through fear.
Call for Assistance Early: There is no stigma in calling another staff member or a senior for help if a situation is escalating. A fresh face or additional support can sometimes ease tension (as long as it doesn’t overwhelm the person). All staff carry alert devices/know the procedure to summon help in our care home if needed, so they can get backup promptly while continuing to calmly engage the service user.

Throughout an incident, staff demeanor is crucial. Staff must maintain a supportive, composed stance – be aware of their own body language (non-threatening posture, open palms, soft eye contact). We never respond to aggression with aggression. Shouting, scolding, or rushing toward a person will only escalate things further and is strictly against our approach. Instead, staff focus on de-escalation – the goal is to help the person calm down and regain control as soon as possible, while ensuring everyone’s safety. If the person begins to de-escalate (signs like slower breathing, willing to talk, reduced tension), staff should reinforce and support this by quietly praising their cooperation or offering comfort. Given our client group (people with dementia and other cognitive impairments), it’s especially important to be patient and not take any aggressive words or actions personally – they are a product of the condition or distress, and our role is to be the calming presence.

Use of Physical Intervention (Restraint)

Physical intervention (restraint) will only be used in {{org_field_name}} as an absolute last resort when all other de-escalation attempts have failed and there is an imminent risk of serious harm to the individual or others. We recognize that any use of force can be traumatic and carries risk of injury, particularly for frail older adults or those with medical conditions. Therefore, our emphasis is always on preventing escalation (through the strategies above) so that physical intervention is rarely, if ever, needed.

If a situation has escalated to the point where a service user is actively violent (e.g., physically assaultive or endangering themselves/others) and immediate action is required, trained staff may employ MAPA® physical intervention techniques to ensure safety. According to our MAPA® training, interventions may include gently holding or guiding a person to prevent them from striking or injuring someone. “MAPA® interventions include talking and listening and when necessary may include holding someone to prevent harm to themselves or others”. Any such hold or physical redirection must be done by staff who have been trained and deemed competent in the specific MAPA® methods, and it must be done safely, ethically, and for the shortest duration necessary. Staff are taught to always use the least restrictive option for the shortest time possible. For example, this might mean holding a person’s arm only long enough for them to drop a weapon or cease hitting, and releasing as soon as they are no longer a danger.

When using physical interventions, staff must adhere to the following guidelines:

Last Resort and Proportionality: Physical restraint is only used when there is no other safe way to prevent immediate harm. The level of force used must be the minimum needed to remove the risk and must be proportionate to that risk. If a person is attempting to hit another resident, for instance, a staff member might intervene by holding the person’s hand or using an approved hold on their arms from the side or behind to stop the hitting – but only with minimal force and not longer than necessary. If the threat stops, the restraint stops.
Trained Techniques Only: Staff may only use restraint techniques that they have been trained in (via MAPA® or equivalent training). Unapproved holds (such as chokeholds, face-down/floor restraints, or any technique that restricts breathing or causes pain) are strictly prohibited. We do not use mechanical restraints (devices) in this care home setting, and seclusion (isolating someone in a locked area) is not used. The focus is on safety and non-harmful holds that protect the person and others until they can regain self-control.
Least Restrictive Principle: If a physical intervention is needed, staff should use the least restrictive intervention possible for the situation. For example, it may be enough to physically stand between two residents to block an altercation or to guide a person away by the arm, rather than using a more restrictive hold. More restrictive holds (involving multiple staff or more force) should only be used if absolutely necessary to prevent serious harm.
Duration and Monitoring: The intervention should last only as long as the immediate danger is present. The moment the person begins to calm or the risk reduces, staff must begin to safely release the hold. One staff member should be talking calmly to the person throughout, reassuring them that they are safe and will be let go as soon as possible. During the restraint, staff should continuously monitor the person’s wellbeing (breathing, level of distress) and the safety of all involved.
No Pain or Punishment: Under no circumstances is physical intervention to be used to punish, to enforce compliance with rules, or as a convenience. MAPA® explicitly is “not about using force, causing pain or injury, enforcing rules or as a punishment”. Any action that deliberately inflicts pain (e.g. joint locks, hitting, rough handling) is considered abuse and is forbidden. The purpose of any allowed physical intervention is solely to prevent harm in an emergency, not to discipline or control the person.
Legal and Ethical Considerations: When a person has capacity and is resisting care, staff should be mindful that any forced intervention could infringe their rights. If a person lacks capacity and is acting in a way that risks serious harm, the Mental Capacity Act allows proportionate restraint in their best interests only if it is necessary to prevent harm and a less restrictive alternative wouldn’t work. Any decision to restrain must consider the person’s human rights (right to liberty and security, freedom from degrading treatment) – we always seek the least restrictive, most respectful solution.

We strive to minimize the use of restrictive interventions through our emphasis on prevention and de-escalation. The care home’s leadership is dedicated to a “restrictive intervention reduction programme”, meaning we continuously work to reduce the need for any restraints. Each incident of physical intervention is treated seriously as an opportunity to learn and further improve our support plans.

Post-Incident Procedures (Reporting and Debriefing)

Any incident of aggression, challenging behavior, or use of physical restraint must be followed by thorough reporting, review, and debriefing to ensure transparency and continual improvement. The steps after an incident are as follows:

Ensure Immediate Safety and Care: Once the situation is under control, staff will attend to anyone who may have been hurt or distressed. This includes checking the service user involved in the incident for any injuries (even minor, especially after a restraint) and providing first aid or seeking medical attention if required. The individual will be comforted and reassured as soon as they are calm enough to engage. Other residents affected will also be checked and consoled as needed.
Inform Leadership: The senior staff on duty or the Care Home Manager must be notified as soon as possible after any significant incident, especially if restraint was used or if any injury occurred. They will provide guidance on immediate next steps and ensure support is given.
Document the Incident: Staff involved must complete an incident report (in line with our Incident Reporting Policy) before the end of their shift. The report will include a factual, detailed account of what happened: the context and triggers leading up to the incident, the behaviours observed, de-escalation efforts made, any physical interventions used (including duration and who applied them), and the outcome. It should also note the condition of the service user after the incident and any follow-up medical checks. This documentation is critical for accountability and learning.
Debrief with Staff and Witnesses: The manager or a designated senior will facilitate a debrief with the staff members involved (ideally immediately or within 24 hours of the incident). The purpose is to reflect on what happened, evaluate what strategies worked or didn’t, and provide emotional support to staff. Witnesses or other residents (as appropriate) may also be debriefed to address any trauma or concerns. According to best practice, an immediate post-incident debrief helps staff and services learn from the event and monitor any ongoing risks. During debrief, we ask: Were all preventive measures used?, Did we follow the plan and training?, What could we do differently next time? This is a no-blame discussion aimed at learning and improvement.
Follow-Up with the Service User: At a suitable time after the incident (considering the person’s cognitive ability and emotional state), we will check in with the service user involved. If they can understand, we gently discuss what happened and listen to their feelings. For those with dementia who may not recall or understand the event fully, this follow-up may simply be providing comfort and re-establishing trust (e.g., engaging in a pleasant activity together). We also involve the person’s family or representative if appropriate – for instance, informing them of the incident (as per our duty of candour) and explaining what is being done to support their loved one.
Review and Update Plans: The individual’s Behaviour Support Plan and risk assessment will be reviewed and updated in light of the incident. We consider whether new triggers were identified, whether the current strategies need changing, or if additional support (such as specialist input or medical review) is needed. If the incident was serious, a formal multidisciplinary review might be convened. Our goal is to learn from each incident to reduce the likelihood of recurrence.
Notifications and Safeguarding: If the incident meets certain criteria (for example, a serious injury occurred, or a safeguarding concern is identified such as unreasonable use of force), the manager will follow statutory notification procedures. This could include informing the CQC (via regulatory notification), the local safeguarding adults team, or the police if a crime may have occurred. The Registered Manager is responsible for determining if an incident requires external notification under regulations and for ensuring our duty of candour to the affected person/their family is fulfilled (i.e., being honest and apologising if harm was caused).
Support and Wellbeing: We recognize that incidents of aggression or restraint can be distressing for all involved – the service user, staff, and other residents. Post-incident, the care home will provide support as needed. This might involve counseling for staff (or access to an employee assistance program) if they are shaken, or therapeutic activities for the resident to help them recover emotionally. We strive to maintain a supportive environment where staff can openly discuss incidents and feel confident to report challenges without fear of blame, focusing instead on solutions.

All incident reports and outcomes of debriefings are reviewed by management. They are analysed for patterns or trends (e.g., is a particular time of day or activity often associated with incidents? Is a certain resident experiencing increased agitation recently?). This forms part of our continuous improvement and governance process.

Staff Training and Competency

To implement this policy effectively, all staff must have the knowledge and skills to support positive behavior and manage aggression safely. We are committed to providing comprehensive training and regular refreshers for our team:

Induction Training: On joining the care home, every staff member (including care assistants, nurses, and ancillary staff who have direct contact with residents) will receive training in Positive Behaviour Support principles and de-escalation techniques. This training covers understanding dementia and mental health, communication skills, identifying triggers, and how to respond to challenging situations with empathy and calm. New staff will be introduced to our ethos that behavior is communication and will learn the basics of proactive and reactive strategies.
MAPA® Training: Staff will undergo specialised MAPA® training (Management of Actual or Potential Aggression) by certified instructors. This training teaches non-violent crisis intervention skills. It includes recognising early warning signs, a range of verbal and non-physical de-escalation methods, and safe physical intervention techniques. Staff learn and practice approved holds and releases that are effective yet do not rely on pain or force. They also learn about the legal and ethical aspects of using restraint. Only staff who have successfully completed MAPA® (or equivalent accredited) training are authorised to participate in physical interventions. We ensure that this training is regularly refreshed (at least annually, or more frequently as needed) so that skills are maintained. As guidance recommends, “staff should be trained to avoid or minimise restrictive interventions, and in de-escalation techniques”; our training program emphasizes preventing incidents and safely defusing them without restraint whenever possible.
Ongoing Skill Development: Through supervision and team meetings, we reinforce PBS approaches. Scenarios and case studies are discussed so staff can continuously improve their responses. The care home may also organize periodic workshops on relevant topics (e.g., understanding dementia-related behaviours, therapeutic activities, or new best practices in behavior support).
Competency Assessment: After training, staff are observed in practice to ensure they apply the techniques correctly. The management or training lead will periodically conduct competency checks, especially for physical intervention skills, to confirm that staff can perform them safely according to MAPA® standards. If any staff member is found to be using techniques improperly or unsafely, they will be retrained immediately and taken off direct care duties involving potential behavior management until competence is assured.
Staff Support and Supervision: Managing challenging behavior can be stressful, so we include reflection on these issues in regular staff supervision sessions. Staff are encouraged to openly discuss difficulties, near-misses, or concerns with their supervisors. The organisation fosters a learning culture – feedback from staff about what strategies work or don’t work with individuals is valued and used to adapt care plans. We want staff to feel confident and supported by management when dealing with aggressive incidents, knowing that their safety and the residents’ safety are both priorities.

Ultimately, our staff training and support framework aims to equip everyone with the confidence to handle challenging situations in a calm, skilled, and professional manner. This not only keeps our residents safe but also protects staff from injury and reduces their anxiety about responding to aggression. Well-trained, attentive, and compassionate staff are the cornerstone of effective positive behavior support.

Governance, Monitoring, and Review

The implementation of this policy will be monitored by the management team to ensure it is effective and remains up-to-date with best practices. Our governance and quality assurance measures include:

Incident Monitoring: All incidents of challenging behavior or aggression (whether or not restraint was used) are logged and reviewed by the Care Home Manager (or a designated senior). We systematically audit incident reports to identify trends, such as increases in frequency or particular triggers that need addressing. CQC expects providers to monitor such incidents as part of good governance. If patterns are detected (e.g., a certain resident’s aggression is increasing or incidents often happen during a specific activity), the manager will initiate a review of the relevant care strategies or allocate additional resources/training as needed.
Restrictive Intervention Log: Every use of physical restraint is recorded in a dedicated log (including details like date, time, staff involved, duration, reason, and outcome). This log is reviewed by the Manager and discussed in staff meetings and governance reviews. Our aim is to track the use of any restrictive interventions and ensure we are indeed reducing and minimising their use over time. Unwarranted or frequent use of restraint will be investigated and addressed immediately.
Care Plan Reviews: As noted, each Behaviour Support Plan is reviewed at least yearly, or promptly after a significant event. These reviews involve, where possible, the multidisciplinary team (e.g., GP, psychiatrist, social worker) and the service user’s family. We ensure that any lessons learned from incidents are incorporated. The Manager ensures that reviews happen on schedule and that documentation is updated.
Feedback from Service Users and Families: We welcome and actively seek feedback from residents (to the degree they can participate) and their families regarding our care approaches. Complaints or concerns related to how challenging behavior is managed are taken seriously and will trigger a review of practice. Positive feedback about strategies that work is also shared with the team.
Safeguarding Oversight: The Registered Manager ({{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}) keeps oversight of any behavior incidents that might constitute abuse or neglect. Any concerns that staff may have inappropriately handled a situation are immediately investigated under our safeguarding and disciplinary procedures. We maintain transparency – if mistakes are made, we acknowledge them and take corrective action, aligning with the duty of candour.
Policy Review: This policy itself will be reviewed and approved by the management at least annually, or sooner if there are changes in relevant legislation, CQC guidance, or best practice frameworks. Staff will be consulted during policy reviews to incorporate their on-the-ground insights. Any updates or changes to the policy will be communicated to all staff, and additional training will be provided if new procedures are introduced.

By closely monitoring our performance and remaining vigilant, we aim to continuously improve our positive behavior support practices. Our overarching goal is to create a safe, supportive home for our residents – one where respect, compassion, and positive support are at the heart of every interaction, and where incidents of aggression are met with skilled, caring responses that uphold the dignity and well-being of all.

References and Guidance

Care Quality Commission (CQC) – Positive Behaviour Support brief guide and inspection expectations for managing behaviours that challenge.
Department of Health (2014) – Positive and Proactive Care: reducing the need for restrictive interventions (guidance for all health and social care services on supporting individuals who challenge).
MAPA® (Management of Actual or Potential Aggression) principles – emphasis on safety, dignity, least restriction .
Mental Capacity Act 2005 – framework for best-interest decisions and lawful restraint for people who lack capacity.
Gloucestershire County Council Adult Social Care PBS Policy (2023) – example of PBS values and planning elements .
National Institute for Health and Care Excellence (NICE) – guidelines such as NG10 (Violence and Aggression, 2015) and NG11 (Challenging behaviour and learning disabilities, 2015) for evidence-based strategies in managing aggression and reducing restrictive practices.
Internal related policies: Safeguarding Adults Policy, Incident Reporting Policy, Mental Capacity and DoLS Policy, Training and Development Policy. (Staff should refer to these for further detail on related procedures.)

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CH66-Positive Behaviour Support and Managing Aggression Policy