Using Positive Behaviour Support within Adult Mental Health Services

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. 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