1. Embedding Positive Behavioural Support in a Social Care Organisation
Frank Slokan
Behaviour Support Advisor

2. Embedding PBS in Social Care

3. Background Largest social care provider in Scotland
Support over 2000 adults
Support needs include learning disability, mental health,
autism, dementia, criminal justice
In-house PBS team since 2004
Specific PBS and Restrictive Interventions Policies
Developed accredited managers’ PBS training 2010

4. Positive Behavioural Support Team
First team of its kind in Scotland
Internal specialist resource
Take referrals from our services
Deliver organisational training
Monitor restrictive interventions
Provide some external PBS, e.g. Schools

5. Working in Services Carry out functional assessments
Implement behavioural strategies
Work with managers and staff
Direct support to service users
Monitor effectiveness of our intervention
Provide evidence-based data

6. Embedding PBS in Social Care
Dedicated PBS policy
Monitoring and Auditing Restrictive Interventions
Annual Challenging Behaviour Audit
PBS expertise in senior positions
Commitment to PBS from Directorate
Impact so far:
High levels of Engagements
Positive Staff Contact high
Managers’ Knowledge of PBS high

7. Common Barriers to Implementation
Maintenance of proactive strategies at a local level
Over reliance on central team
Managers receiving input are not able to transfer skills
High staff turnover, sessional/agency hard to reach
Resource implications
Changing needs of individual within a static service

8. Training Managers in PBS
Aim is to achieve skilled local staff teams
Natural agents have better outcomes of PBS
Better support to frontline staff, reduced turn-over
Cost effective approach to training
Lessens dependence on central team
Proactive approach, rather than fire fighting
Raises skill level of whole organisation

9. Overview of Training 1 year programme
2-day introduction, then 8 workshops, 6 weeks apart
Delivered by internal PBS team
Small-group workshops, high trainer ratio
Based on IABA PBS model
Accredited by Edinburgh Napier University
30 credits, Level 9
Practice-based course – homework between sessions

10. Workshops Session Content 2-day Training
Introduction to Positive Behavioural Support
Workshop 1
Functional Analysis: Defining & Recording Behaviour
Workshop 2
Functional Analysis: Antecedent & Consequence Analysis
Workshop 3
Behavioural Support Planning: Reactive Strategies
Workshop 4
Behavioural Support Planning: Activity
Workshop 5
Behavioural Support Planning: Interpersonal & PSR
Workshop 6
Behavioural Support Planning: New Skills
Workshop 7
Behavioural Support Planning: Focused Support
Workshop 8
Assessment

11. Evaluating Outcomes

12. Evaluation Measures ABC Forms
Aberrant Behaviour Checklist (Aman et al, 1985)
Active Support Measure (Mansell & Elliott, 1996)

13. ABC forms

14. Aberrant Behaviour Checklist

15. Active Support Measure

16. Lessons Learned
Despite positive outcomes, still some difficulties arose:
Time commitment of managers (in social care)
Frontline managers knowledgeable; not senior managers
High staff turn-over (managers moved to new services)
Financial pressures
Need for close mentoring
Skill level of frontline staff varies significantly

17. How do we roll out PBS across Scotland
Recommendations
How do we roll out PBS across Scotland

18. Recommendations Need for a tiered training approach
Support Workers
Senior Support Workers
Managers
Development of a skilled workforce
Coaching and mentoring at local level
Continuous Professional Development

19. Recommendations National PBS forum
Multidisciplinary approach involvement from all sectors
Development of agreed definition of PBS
Development of agreed monitoring standards
Need for regional expertise
Internal / External resource
Who funds implementation?