Care Management Group's method for delivering positive behaviour support has been shaped by the people it supports.
Positive Behaviour Support (PBS) has been recognised internationally for a number of years as an effective way for supporting people with learning disabilities and autism who can present complex and challenging behaviours.
"Julie identified what in particular it was that she found hard about public transport, so that the team could develop a plan for travelling to college in an alternative way."
PBS is a framework used to gain a detailed understanding of a person – their skills, behaviour, health and needs. The key elements of a PBS approach are to develop new skills and opportunities which help to enhance quality of life, build self-esteem, and provide alternatives to behaviours that may be considered challenging.
CMG’s PBS team has launched a tailored approach based on personal outcomes, known as Progress 5. Progress 5 builds on the principles of PBS to enable people to build skills, helping them to identify and achieve their goals through a person-centred approach, and enabling them to set objectives in areas of their life that are important to them.
Progress 5 uses task analysis, person-centred planning and visual prompts and has a strongly collaborative approach. It involves the individual, a Progress 5 coach and support staff to devise and review their plan.
We begin the process with a full assessment of the person's current skills and a discussion with them about their personal goals and preferred outcomes. For example, this can be anything from getting a job, to making friends or managing their money, to being more independent. In doing this, we will look at what areas they feel they need to improve or achieve, to reach their objective, which in turn enables them to enjoy an enhanced quality of life.
- See also: Join LDT London 2018
- See also: Here's how personal assistants can support decision making
The Progress 5 initiative utilises a very visual way for people to identify the skills they need to achieve outcomes across 5 areas referred to as ‘Life Zones’. These zones were identified by the people that we support as the areas most important to them are those often at the core of their frustrations.
Life Zone 1 is around communication, as many of the people we support find living with a number of people quite difficult. For example, one service-user says that they don’t always know how to get themselves understood. Life Zone 1 focuses on improving social communication skills, building confidence and assertiveness, understanding others and expressing choices, preferences and opinions.
Life Zone 2 is based on relationships, which focuses on building opportunities, skills and individual needs to meet new people, maintain existing friendships and family relationships, and to navigate the complicated world of romance!
Life Zone 3 is all about problem solving. We know that it is not uncommon for individuals we work with that at CMG to feel stressed or overwhelmed when things don’t always work out the way they expect them to. Life Zone 3 addresses approaches to resolving current problems and problems that can arise in the future. Effective problem-solving systems are devised to be used in multiple situations.
Life Zone 4 is for planning ahead. It entails supporting individuals with the skills and opportunities needed to plan for goals, such as going on holiday, and to manage time. Approaches to this include working with schedules, budgeting, developing work skills in preparation, or following a plan.
Life Zone 5 is focused on the sensory environment. One individual we work with at CMG told us a challenge they face is that they like to have things tidy, but they don’t like the hoover. Life Zone 5 is about exploring the living and leisure environments of the individual, with an aim of supporting them to feel more comfortable in their home or developing ways for them to manage difficult sensory situations. It might also include developing their cleaning, cooking or D.I.Y skills, to advance their independence.
We have seen some real results with the initiative so far. We know the approach is supporting the people we serve to live the life they want to lead. One individual we have worked with, Julie (not her real name), wanted to attend college, but found public transport very difficult, often meaning that she was arriving at college feeling stressed and overwhelmed. This made it hard for her to participate in her course. She eventually began to avoid college and was frequently late, which meant that she could risk losing her place. This would create a negative emotional impact for her. Julie’s support involved two Life Zones: sensory environment and planning ahead. By assessing Julie’s skills and needs, the coach and Julie identified what it was in particular that she found hard about public transport, so that they could develop a plan for travel to college in an alternative way and to manage the parts of travel she found difficult.
Ultimately, by setting objectives with the individuals we work with and breaking things down into smaller tasks, Progress 5 is empowering the people we support to achieve their goals and really take control of their lives, so that they can live the most fulfilling lives possible.
Lynsey Way is the PBS Strategic Lead at Care Management Group (CMG), a national provider of residential and supported living services for children and adults with profound learning disabilities, autism, mental health and associated complex health needs.