Challenging Behaviour – National Strategy Group (CB-NSG)

Charter

Members of the CB-NSG have worked together to develop a charter to set out a shared vision and action required to deliver it. This is reproduced below and an easy read charter has also been developed. Click here to view the easy read charter

Introduction

Valuing People Now (England) says “The vision for people with more complex needs is the same as for everyone: inclusion and participation in all areas of community life, including living independently and having paid work. To assume that some people cannot, and will never, achieve these is to set a ceiling on what progress can be made, both by an individual and by society.” This vision is reflected in Equal Lives (Northern Ireland), The Same As You (Scotland) and Fulfilling The Promises (Wales).

This charter concerns the needs of individuals with learning disabilities who are perceived as challenging to services and others.

Text Box: “From the start they only saw the behaviour and the unique much loved son and brother with feelings, gifts and needs was obscured by it” (Parent) “Our job is not to fix people but to design effective environments” (Rob Horner)

Challenging behaviour is often perceived as a ‘problem’ or ‘illness’ to be ‘treated’, ‘cured’ or ‘stopped’. The problem is seen as being part of the person rather than the focussing on what needs to change around the person, such as their environment or how people support them. This is unhelpful and potentially damaging for these individuals. We need to look beyond the behaviour, understand what the behaviour is communicating and then provide appropriate person centred, holistic support to enable individuals to achieve their full potential.

In this charter we are adopting the following definition:

Text Box: “Behaviour can be described as challenging when it is of such an intensity, frequency, or duration as to threaten the quality of life and/or the physical safety of the individual or others and it is likely to lead to responses that are restrictive, aversive or result in exclusion.” (Challenging behaviour – a unified approach; RCPsych, BPS, RCSLT, 2007)

We know that much better support and services could be provided for children and adults who are perceived as challenging. This charter sets out the rights of these individuals and the action that needs to be taken.

By signing up to this charter you endorse the rights of these individuals and commit to working in partnership with the National Strategy Group to influence real change.

The charter is a living document and we are happy to receive comments and views.

Rights & values:

1.) People will be supported to exercise their human rights (which are the same as everyone else’s) to be healthy, full and valued members of their community with respect for their culture, ethnic origin, religion, age, gender, sexuality and disability.

2.) All children who are at risk of presenting behavioural challenges have the right to have their needs identified at an early stage, leading to co-ordinated early intervention and support.

3.) All families have the right to be supported to maintain the physical and emotional wellbeing of the family unit.

4.) All individuals have the right to receive person centred support and services that are developed on the basis of a detailed understanding of their support needs including their communication needs. This will be individually-tailored, flexible, responsive to changes in individual circumstances and delivered in the most appropriate local situation.

5.) People have the right to a healthy life, and be given the appropriate support to achieve this.

6.) People have the same rights as everyone else to a family and social life, relationships, housing, education, employment and leisure.

7.) People have the right to supports and services that create capable environments for individuals which are developed on the principles of positive behavioural support and other evidence based approach and which draw from additional specialist input as needed. This will respond to all the needs of the individual.

8.) People have the right not to be hurt or damaged or humiliated in any way by
interventions. Support and services must strive to achieve this.

9.) People have the right to receive support and care based on good and up to
date evidence.

Action to be taken:

1.) Children's and adults' services will construct long term collaborative plans across education, social and health services and jointly develop and commission support and services to meet the needs of children and adults with learning disabilities, their families and carers.

2.) Local Authorities and the NHS will develop and co-ordinate plans to:
• Reduce the exposure of young children with learning disabilities to environmental conditions that may lead to behavioural challenges.
• Promote the resilience of young children with learning disabilities who face such environmental conditions.
• Provide early intervention, support and services that will meet the individual needs (including communication needs) of young children who are showing early signs of developing behavioural challenges.

3.) Active listening to the needs of the family will lead to the provision of appropriate and timely support, information and training.

4.) People will be supported to have a good quality of life by individuals with the right values, attitudes, training and experience.

5.) The NHS and services will proactively plan to ensure that people receive the same range, quality and standard of healthcare as everyone else, making reasonable adjustments when required. People will have an individualised health action plan and be supported to have access to annual health checks to ensure all health needs are met.

6.) People and their family carers will receive support and services that are timely, safe, of good quality, co-ordinated and seamless. They will be proactively involved in the planning, commissioning and monitoring of support and services including both specialist and general services.

7.) A person-centred approach that enables and manages the taking of risk will be used to ensure that people have access to family and social life, relationships, housing, education, employment and leisure.

8.) Local authorities and the NHS will know how many children and adults live in their area and how many they have placed out of area. On the basis of information from person-centred plans all agencies will plan and deliver local support and services.

9.) Services will seek to reduce the use of physical intervention, seclusion, mechanical restraint and the inappropriate or harmful use of medication with the clear aim of eliminating them for each individual.

10.) All services and agencies will strive to improve continually, using up to date evidence to provide the best support, care and treatment to deliver positive outcomes for individuals.

To download the charter click here

To sign up to the charter click here to download a sign up form