1. Winterbourne View: what are the lessons for other services Avon & Wiltshire Positive Behaviour Support Network

2. Background  Panorama documentary on TV  Showed the abuse of people with a Learning Disability in a private hospital  Police investigation  Staff arrested  Hospital closed  Other hospitals checked by CQC  Some other problems in other places

4. Reflection Spend 5 minutes acknowledging your emotional response to the documentary.

6. What went wrong?  Staff attitudes and behaviour  Insularity & lack of networking  Inspections didn’t show problems  People who new about the problems weren’t listened to

7. What went wrong?  Poor leadership at different levels  Multi-agency relationships  People placed too far from home  Monitoring arrangements didn’t show problems

8. What does this mean for other services? Could any of these problems happen in other services?

9. What went wrong?  Staff attitudes and behaviour  Insularity & lack of networking  Inspections didn’t show problems  People who new about the problems weren’t listened to

10. What went wrong?  Poor leadership at different levels  Multi-agency relationships  People placed too far from home  Monitoring arrangements didn’t show problems

11. Question?  Can the positive behavioural support model help us to overcome what went wrong?

12. What is PBS? Positive Behavioural Support (PBS) is an approach that blends values about the rights of people with disabilities with a practical science about how learning and behaviour change occur. The overriding goal of positive behavioural support is to enhance quality of life for individuals and their support providers (Horner, 1999)

13. The Values of Positive Behavioural Support People are individuals with gifts & hopes People are individuals with gifts & hopes People are members of families, peer groups & society People are members of families, peer groups & society People influence their circumstances in personally meaningful ways People influence their circumstances in personally meaningful ways People have the right to be treated with dignity & understanding People have the right to be treated with dignity & understanding Relationships and contexts impact the quality of a person’s life Relationships and contexts impact the quality of a person’s life

14. The characteristics of PBS Comprehensive lifestyle change Comprehensive lifestyle change A lifespan perspective A lifespan perspective Ecological validity Ecological validity Stakeholder participation Stakeholder participation Social validity Social validity Systems change and multi-component intervention Systems change and multi-component intervention Emphasis on prevention Emphasis on prevention Multiple theoretical perspectives Multiple theoretical perspectives Reduction in CB occurs as a consequence of effective support Reduction in CB occurs as a consequence of effective support

15. Activity What went wrong?How might the PBS model overcome this? 1 2 3 4 5 6 7 8

16. What needs to be different?  Listening to service-users  Listening to worries  Checking out worries  Better training for staff  Better leadership in services  Better local services  Better inspection  Better monitoring of placements

17. Question? What one thing will I do differently?