1. Using Positive Behaviour Support within Adult Mental Health Services
Ward 15

2. Positive and Safe
Safewards Staff Culture Positive Behavioural Support Individualised care

4. Why are these approaches so important to Ward 15 ?
Isolated Unit
Located on the first floor
Not purpose built
Limited response
Mostly a female staff team
No access to outside space without staff involvement
Without OT, Fitness instructors, Activity co ordinators

5. Positive Behavioural Support
A multi component framework for delivering a range of evidence based supports to increase quality of life and reduce the occurrence, severity or impact of behaviours that challenge

6. Positive Behavioural Support Framework
Assess the behaviour Formulate an understanding of why these behaviours occur Develop Behavioural support plan Monitor effectiveness and review when necessary

7. Current Process – Assess the behaviour
Patient admitted to the ward
Over the first 72 hours:
Patients are observed and behaviours of concern identified
Carer/family feedback gathered
Assessments completed such as GAD 7, PHQ9
About me booklet completed with support from staff
ABC Charts implemented
Formulation documents prepared and meeting held

8. Formulate an understanding of why these behaviours occur
Gap Identified =
PBS Group Developed

9. What is PBS Group?

10. Agenda Review formulation documentation and current medication
Discuss staffs observations and the completed About Me booklet
Identify behaviours of concern
Identify triggers – fast and slow
Early warning signs
Develop and agree interventions – Green, Amber, Red, Blue
Review other patients plans when required

11. Proactive strategies that prevent behaviour from occurring
Green Interventions
Proactive strategies that prevent behaviour from occurring

15. Amber Interventions
Noticing those early warning signs and intervening with person centred approaches to prevent further escalation

16. Red Interventions
Providing a crisis management strategy that remains service user focused and rapidly brings the crisis to an end

17. Blue interventions
Displays of behaviours that challenge can be traumatic. How do we support all individuals involved ?

18. Benefits Opportunity to review practice
Process creates increased engagement between staff, families and patients
Staff of all grades and professions involved
Increased communication
Staff are developing their knowledge and skills
Joined up approach to delivering care
Increased confidence within the team and feelings of being safe
Monitor PRN medication usage and minimise rapid tranq events
Lower number of aggressive incidents, restraints and seclusions

19. Challenges
Time