Negative Behaviour Approach.

[This policy should be read in conjunction with the associated policy on physical intervention]

Within Hayfield, physical intervention will only be used as a last resort and only by staff who are properly trained and accredited to do so.  In all other circumstances staff will attempt to prevent or de-escalate a situation and / or avoid physical contact.

Hayfield Support Services is an organisation that has been specifically developed to meet the needs of deaf people who experience additional problems.  These problems may be of a psychological, social or emotional nature and can, in some cases, result in the deaf person being disruptive within a caring household, or being unable to live independently in the community.  These additional problems may also be due to specific conditions, such as an Autistic Spectrum Disorder.

It is therefore likely that all staff will encounter behaviours deemed as negative, unacceptable or verbally / physically abusive (generally referred to as “challenging behaviour”) and be required to take appropriate action in order to prevent or minimise the effects of such behaviour, and wherever possible, to ensure the safety of the individual(s) exhibiting such behaviour, as well as other service users and staff .

This statement aims to give staff a guideline for action in the event of such an occurrence, and for subsequent reporting and recording of details of the incident.  It is important to note that behaviour can often be a form of communication for someone with Autism.

Procedure.

In all circumstances the first and primary aim of all staff should be the prevention of challenging behaviour.  Staff will be aware of the following guidelines...

• Hayfield is committed to non-aversive approaches to care and to positive programming to prevent or minimise the occurrence of crisis situations.

• Hayfield recognises that challenging behaviours can be prevented or minimised by effective organisational arrangements and by the professional approach of  trained staff to assist service users to maintain self-control.

• Prevention of crisis development must be the focus of this approach and is best achieved through proactive care planning, in which triggers for crisis are identified and strategies adopted to minimise risk.

• Primary prevention - Service users may be affected or influenced by their surroundings and environment (“setting conditions”). These setting conditions will be assessed for each service user and, if appropriate, recorded in their individual risk assessment.  Where possible the conditions will be modified to reduce the likelihood of challenging behaviour occurring.

• Secondary prevention – Staff will use procedures highlighted in their training and outlined in Hayfield policy to ensure that problematic episodes may be dealt with using non-physical interventions whenever possible.

• For each service user the focus of secondary prevention will be governed by the knowledge and experience of that individual, as recorded in their risk assessment.

• Each service user who presents challenging behaviour will have individualised strategies and procedures for staff response to such behaviour.  Such procedures should be designed to enable staff to respond effectively to potentially violent behaviours while ensuring the safety of all concerned.  

• Where appropriate, the strategies will include directions for the possible use of physical interventions, but will also identify individuals or situations which must not involve physical interventions, e.g. due to health grounds.

• Where required, these strategies and procedures will be recorded in the service user’s care plan and should be known and understood by all staff involved with that service user.

• Each service user’s care plan will be reviewed at least twice yearly, and any changes in preventative strategies will be recorded and made known to the appropriate care staff.

In the event of a service user displaying unacceptable behaviour, while under the care of Hayfield staff, it is imperative that staff should immediately ensure that no other service user, member of staff or other person is in a situation of risk due to the behaviour being displayed.  If necessary, all other people should be removed from the vicinity.

Staff should then make every effort to find out the reason for the disruptive behaviour.  This might be achieved by encouraging open communication with the person exhibiting the behaviour, and by trying to help them to discuss their feelings with staff on a one-to-one basis.  Sign language, gestures, role play, writing, drawing, picture diary, communication book, visual symbols etc., may be used to try to get an understanding of why the incident occurred.

It may be necessary to offer a "time out" method of practice, in order to relieve the stress put on other service users, as well as giving the disruptive person an opportunity to calm down.

Senior staff may be contacted at any time in order to provide guidance or advice and they may be summoned to give personal support if required.

In circumstances where staff are unable to calm or control a disruptive situation and where there is concern about the safety of the person causing the disruption or others, staff may involve the Police.  Staff should ensure the service user is told what is happening at each stage of this process.

[Only if all attempts to prevent or de-escalate a situation have failed, and only if there is a need to prevent the service user causing harm to themselves or others can staff consider using physical intervention.  Such intervention can only be used by appropriately trained and accredited staff, and in accordance with the instructions contained in the policy on "Physical Intervention”.]

Staff must always demonstrate a willingness to listen and care without allowing a service user to manipulate the situation.

All incidents involving challenging behaviour will be reported at the earliest opportunity to managers, who will ensure that all details of the incident including antecedents, behaviours and consequences will be recorded using the appropriate forms.

Follow up procedures should always be related to the type of incident involved.  It is important to counsel the service user(s) involved as to the consequences of their actions, in such a way that they might learn and develop from their experience, as well as giving staff an opportunity to discover the best ways to avoid a repetition of the incident.

It is the policy of Hayfield to offer support, guidance and trust within a caring, structured environment. It is necessary to follow-up all incidents in order to offer guidance and social learning.

Similarly, Hayfield will offer support and opportunities for de-briefing to staff who are involved in dealing with instances of challenging behaviour.

Details of incidents involving disruptive or negative behaviour will be considered at the regular reviews of the service users involved, and will be made available to the referring authority.  Such information obtained will be used in the production or re-assessment of care plans and risk assessments.

January 2009