Services For Children & Young People Who Display Challenging Behaviour Well Matched and Skilled Staff A Pamphlet for commissioners Dr Sarah H Bernard Consultant Psychiatrist The Michael Rutter Centre London

Services For Adults with Learning Disabilities who Display Challenging Behaviour Well Matched Skilled Staff A pamphlet for commissioners Dr Peter Baker Consultant Clinical Psychologist Sussex Partnership NHS Foundation Trust

Why Have These Pamphlets Been Written?

   Suggestion arose at a CB-NSG meeting during an action planning group on commissioning. Child and adult pamphlets In order for commissioners to be well informed

Background

        Challenging behaviour is more common in people with LD Underlying causes are multiple Association with childhood mental health problems Communication difficulties increase risk of CB Not a diagnosis – descriptive Early intervention important Family breakdown more common Isolated siblings

Contents

     1. Which professionals should be involved?

2. What should you look for from a service?

3. Skills required 4. Monitoring 5. Case vignette

   

The Workforce

Psychological/Mental health services Physical needs Social care For children & young people: Education  Key point – best practice guidance emphasises the need to have a multi-disciplinary approach to the assessment and treatment of challenging behaviour in order to meet the individual needs of each person

What should you look for from a service?

  Comprehensive assessment Holistic approach  Key point – to understand the individual needs of a person who is displaying CB, a range of assessments are required and this information should be used to inform how the person is supported

Skills

   Training Supervision Communication strategies  Key point – Supporting a person with severe learning disabilities perceived as challenging is a skilled role and support staff must have appropriate, adequate and on-going training and supervision

Monitoring – children’s version

   Satisfaction surveys Burden of care surveys Measures of behavioural disturbance

Monitoring – adult’s version

    Robust organisational framework Behaviour support plans include preventative strategies Individualised timetable of community activities Skill development  Key point- good services use a range of ways of checking and improving the quality of their services to ensure it delivers good outcomes for people and their families

Conclusions

   Commissioners need to be well informed It is not just about using the cheapest service Communication between those commissioning the service, those offering the service and those using the service is essential