Commissioning for People with Complex Needs From Rhetoric to Reality! Arlene Johnstone Complex Case Planning Manager

The Intent ... To provide people with complex support needs living in out of area placements, the opportunity to live in their own home, near their family. CB V5

The Aspiration ... To ensure that Positive Behaviour Support is a fundamental element of all the support provided.

CB V5

The Compromise ... Supplier Appraisal   Please describe how you have used positive behaviour support (or equivalent) to develop an understanding of individuals whose behaviour challenge services and provide an example of how you have used this to develop effective support. (Please limit answer to no more than 500 words) Evaluation Criteria: Provider demonstrates a commitment to and understanding of Positive Behaviour Support (or equivalent).

Results ... X recognises that service users may exhibit behaviour which can challenge and have developed a number of strategies to support service users and staff. X’s Positive Behavioural Support Policy, Procedures, Guidelines and Training and Management that supports their implementation, equips staff with appropriate, person centred approaches to service delivery, ensuring that people whose behaviour presents a challenge are supported to achieve as good a quality of life as possible. We understand behaviours described as challenging occur due to a number of factors including skill deficit, communication difficulties, avoidance strategies, and requests for attention. We have adopted the Positive Behaviour Support Model (PBSM) promoted by BILD which encourages individuals to consider the impact of their behaviours on self and others. X supports a number of individuals who present with behaviour which may challenge the service. As part of this, X uses a Positive Behaviour Support Approach.

Thoughts from evaluation ... Language - PBS, Pro-Active Approaches, BBS What is PBS? Professionals appear to define “important” elements of PBS depending on their background Family involvement - “the jargon is unbearable”

What happened next ... Provider was identified Completed Tender process Provider was identified First people moved into their new homes Beginning of August they served notice on ONE individual, citing recruitment issues Mutual termination of contract in Highland agreed mid August

Considerations ... Tender process – is it fit for purpose, people not products? How do we ensure providers deliver what they promise? How do we support providers to deliver what they promise? How do we make sure we’re all talking the same language and the same thing in relation to PBS?