1. Framework for Working with People whose behaviour is perceived as challenging Pre-Registration Learning Disability Field UK l.hume@napier.ac.uk

2. Part One Outline of the project

3. LDN workforce development 2012 To undertake a range of activities to support implementation of the educational recommendations arising from ‘Strengthening the Commitment’

4. Recommendation 16  “Learning disabilities nurses need mechanisms to share best practice and develop the evidence base to continue to advance as a profession. Services must support learning disabilities nurses to participate in appropriate networks. A UK academic network for learning disabilities nursing will be created to support this drive”  Learning/Intellectual Disability Nursing Academic Network (LIDNAN)

5. Context of the Framework  Map existing learning outcomes related to positive behaviour support  Consider a national approach to ensuring students were equipped during their training with the relevant skills and competencies in this area

6. Task & Finish Group  L.Hume  D.Atkinson  C.Hermon  D.Phillips  J.Ridley  J.Devereux  J.Delree  J.Lay  J.Kiernan  B.Roberts  D.Williams  P.Griffin  N.James  D.Teeluck  A.Masterman  E.Kwiatek  H.Powell  P.Millington

7. Task & Finish Group  Representation from all four countries  Scoping of materials and learning outcomes  Knowledge and Skills required by learning disability nursing students  Minimum requirement on completion of the pre-registration programmes  National Guidance and Policy

8. Part Two Project Outcomes

9. The Framework  Area 1:  Introduction to values-based care and behaviour  Area 2:  Positive Behaviour Support  Area 3:  Building blocks to a meaningful life  Area 4:  Person-centred approaches to managing crisis

10. Area 2: Positive Behaviour Support What the student will understand  what Positive Behaviour Support is and the evidence base that underpins Positive Behaviour Support  that there is a relationship between specific conditions and syndromes where challenging behaviour is an integral feature  that increased understanding and prevention is preferable to dealing with challenging behaviour  understand that the behaviour will impact on families and carers  the importance of objectively describing behaviour  the theoretical explanations of self injurious behaviours

11. Area 2: Positive Behaviour Support What the student will understand  the “ABC” assessment mode and other assessment methodologies  understand the role and value of collecting data to inform functional assessment  he component parts of the Multi-element Model and how to structure and develop proactive strategies reflecting other models (assault cycles, recovery model)  positive strategies to support and address behaviours  understand the need for consistency in care  how behaviours are maintained  the importance of post incident support for the person and their support infrastructure

12. Area 2: Positive Behaviour Support What the student will be able to do  model best practice in promoting positive behaviour to colleagues and others  determine when referral to a specialist team/service is required  describe observable behaviour in an objective manner  accurately collect data to inform a behavioural assessment  contribute to discussions regarding assessment, formulation and evaluation of positive support plans

13. Area 2: Positive Behaviour Support What the student will be able to do  assess the person whose behaviour is perceived as challenging using a recognised methodology and involving all stakeholders including the person’s family or carers  work with supervision from an appropriately qualified practitioner to support the development and delivery of a functional assessment and Positive Behavioural Support plan in a consistent manner  contribute to the evaluation of interventions through maintaining factual, accurate and complete records of actions taken in accordance with legal and organisational requirements  acknowledge the limitations of your competence and seek support where appropriate

14. Part Three Recommendations

15. Good person-centred support should not be viewed as something extra or specialist Max Jake

16. Benchmark tool for PBS competencies in pre-registration learning disability nursing training programmes Learning Outcomes Recommendation met? Current activity/evidence that learning outcomes are achieved Additional actions needed to meet learning outcomes Deadline Named lead Area 1: Introduction to values-based care and behaviour By the end of the undergraduate programme the student will understand the following: Knowledge the process of person-centred planning the importance of working in partnership with the person their carers and families that values, attitudes and emotional responses will affect how you respond to behaviours perceived as challenging and how people respond to you that each individual will have a unique way of communicating what is meant by “behaviour” and the phrase “behaviours perceived as challenging” that challenging behaviour may be communicative that a range of factors may impact on behaviour that there could be a relationship between behaviours that are perceived as challenging with both physical and mental health understand the need for educating other staff in meeting the Behaviour needs of people with learning disabilities

17. References  Nursing and Midwifery Council (2010) Standards for Pre-registration Nursing Education. London, NMC.  Scottish Government (2012) Strengthening the Commitment: the report of the UK review of learning disabilities nursing. Edinburgh, Scottish Government.  National Institute for Health and Clinical Excellence (2014) Challenging Behaviour and Learning Disabilities: Prevention and intervention for people with learning disabilities whose behaviour challenges. Clinical guideline. Methods, Evidence and Recommendations (Draft for consultation), London, National Institute for Health and Clinical Excellence.