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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.
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Services For Children & Young People Who Display Challenging Behaviour Well Matched and Skilled StaffA Pamphlet for commissioners Dr Sarah H Bernard Consultant Psychiatrist The Michael Rutter Centre London
Services For Adults with Learning Disabilities who Display Challenging BehaviourWell 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