1. Moving to MAPA

2. What prompted the change? High level of restrictive interventions Use of supine restraint All staff trained to the highest level Culture of the norm in regard of restraint Lack of staff confidence in managing challenging behaviour Lack of advice regarding specific challenges 2

3. Why MAPA Suitability to meet needs across ASD spectrum Comprehensive workbook for staff Prioritising student’s individual needs Used with adults and children Quality Assurance Measures BILD Accreditation 3

4. Behaviour Support Committee Review of Behaviour Policy Oversight of Trends across the schools Driver of change from previous system to MAPA Review of all documentation Development of Behaviour Leads in schools Dedicated full time Trainers to advise schools Review of new legislation 4

5. 5 MAPA Foundation MAPA foundation level has been designed to enhance understanding and management of disruptive, aggressive and/or violent behavior. This approach aims to ensure that everyone involved in crisis situations which include disruptive, challenging or violent behavior can maintain the care, welfare, safety and security of all involved.

6. First Impressions are important All Managers to attend Foundation training – giving them the ability to feed back positive information on the change. Plan in place to train the Care and Education Team – Teachers and Assistant Team Managers Countdown to MAPA – Staff Move to a restraint free environment Change of culture 6

7. MAPA Skills – More in your tool box The MAPA programme aims to ensure that the necessary foundation skills will reduce the likelihood of risky or dangerous behavior occurring in the first place. As well as to manage such behavior when it does occur, using a range of MAPA physical interventions that aim to minimize risk without damaging the professional and supportive relationships between individuals. 7

8. Map out plan for school SMT meeting to discuss initial thoughts having completed the foundation training Meeting with full MDT and behaviour support team looking at individual students and which MAPA skills we ‘think’ will work. Risk assessment of environment – seating internal / external 8

9. CPI assessment of ‘individual’ needs CPI consultancy was accessed to meet exceptional individual needs. CPI assessment concluded that additional training was required at Level 3, adding a 3 rd person, and Level 4, emergency floor hold. 9

10. Documentation Change all documentation to support the MAPA approach – Individual Behavioral Risk Assessment Behaviour Support Plan Student Guidelines Incident Form Physical Intervention Log 10

11. Staff Needs Managing staff expectations of support and how it is provided – Care Get Together Days Detailing agreed approach for student - IBRA/BSP maintaining an individualised approach 11

12. Case Study - Luke  Luke displays self-injurious behaviour including headbutting and biting his hand, and physically harmful behaviour towards others including hitting, headbutting and biting.  Sometimes it is necessary for staff to physically intervene to support Luke to ensure he does not seriously harm himself or others  Luke uses the soft play room as an area to calm, often pacing and taking time away  If Luke’s challenging behaviour escalates staff would physically support Luke to calm, including a three person supine intervention with up to three more staff supporting 12

13. Luke  This intervention ensured rapid safe control of the situation however Luke was not always able to calm whilst supported in a three person supine intervention and would require time away to continue the de-escalation period  Luke would headbutt the floor whilst supported in this intervention 13

14. Luke  During December 2013 Luke had 47 incidents and 30 required a three person supine intervention, plus additional staff support  Luke began putting himself into the supine position, and when staff disengaged his behaviour would escalate  MAPA was introduced during January 2014, and a transition period started  Initially Luke was unsure of the intervention, therefore he still required a three person supine support, however each month this frequency reduced – transition was gradual. 14

15. Luke  Luke began to understand the new MAPA intervention and adapted his behaviour  Staff developed a consistent approach using MAPA interventions that best suited him to successfully calm. The medium standing/transition hold is less restrictive and intrusive  Since March 2014 Luke has not been supported with a three person supine, and medium MAPA continues to be successful for his needs 15

16. Graph 1 16

17. Graph 2 17

18. Continuous Improvement Monitoring of individual students incidents Quality Assurance standards for training Centre Accreditation MAPA trained Behaviour Leads in all schools Monitoring of schools incidents and support to achieve a restraint free environment. Continuous revisiting core principles 18