Glossary

Active Support: Active Support changes the style of support from ‘caring for’ to ‘working with’, it promotes independence and supports people to take an active part in their own lives. For example, staff might help them to wash their own clothes, step by step, in a way they can manage.
Antidepressant medication: These are types of psychotropic medication that are licensed to treat depression.
Antipsychotic medication: These are types of psychotropic medication that are licensed to treat mental health problems which symptoms include psychotic experiences such as hallucinations or disorganised thinking.
Autism: Autism is a lifelong neurodevelopmental condition, the core features of which are ongoing difficulties in social interaction and the presence of rigid and repetitive behaviours, resistance to change or restricted interests. Autism is a spectrum, a range, of abilities and needs, so is called Autism Spectrum Disorder (ASD). Asperger’s is part of ASD.
Best interests: The principle that any act done for, or any decision made on behalf of, a person who lacks capacity must be done, or made, in that person’s best interests. It takes account of what is best for them given their preferences and past experiences, and also what they would decide if they had the capacity to do so.
Capacity Assessment: A process laid out by the Mental Capacity Act (2005), which determines whether someone has the mental capacity (ability) to make a particular decision at a particular time.
Challenging behaviour: How we talk about a range of behaviours which some people with a learning disability, autism or both may display to get their needs met. ‘Challenging behaviour’ or ‘behaviour that challenges’ is not a diagnosis but is a description of any behaviour that presents challenges to services, family members or carers.
Communication Passport: A document that explains how the person communicates and how others should communicate with them, to be used by support workers and anyone new meeting the person.
Communication Support Plan: Sets out the aids and strategies that will be used to enable communication for a person with learning disabilities, following advice from a Speech and Language Therapist.
Court of Protection: Established under the Mental Capacity Act (2005), to make a decision or to appoint a decision-maker on someone’s behalf, in cases where there is no other way of resolving a matter affecting a person who lacks capacity to make the decision in question.
Deputyship: A legal role giving the person power to make certain decisions on behalf of someone who lacks capacity. Deputies are appointed by the Court of Protection.
Diagnostic overshadowing: When a physical or mental health need is not seen because the symptoms are put down to the person’s main diagnosis (e.g. learning disability or autism).
Education, Health and Care Plan: A plan for 0-25 year olds, describing the outcomes the person and those that support them are aiming for, and what support and services are needed. Replaces previous statements of educational need and includes health and social care services as well as education.
Health Action Plan: A document describing the specific actions that are needed, when and by whom, to keep the person healthy in the short term and long term. May include what reasonable adjustments are needed to help the person access healthcare.
Learning disability: A learning disability is defined by 3 core criteria: lower intellectual ability (usually an IQ of less than 70), significant impairment of social or adaptive functioning, and onset in childhood.
Least restrictive option: Before somebody makes a decision or acts on behalf of a person who lacks capacity to make that decision or consent to the act, they must always question if they can do something else that would interfere less with the person’s basic rights and freedoms.
Nearest Relative: A legal term for a family member, within the Mental Health Act (1983). It is usually the person’s spouse or if not married, it is the eldest of the person’s parents or siblings. The nearest relative has specific rights under the Mental Health Act when their relative is detained under a section of the act.
Over-medication: Also referred to as ‘inappropriate medication’; when someone is prescribed too much medication or medication that they do not need.
Parental responsibility: A set of legal rights and responsibilities as a parent, which include providing a home for the child, protecting them and agreeing to any medical treatment.
Person-centred care: The care and support is focused on the needs of the person rather than services.
Person-centred Plan/Planning: A plan of short-term and long-term goals and how they will be supported, based on what is important to the individual. It should be aspirational and evolve over time as the person changes. Planning should involve the person and those most involved in their life.
Physical intervention: Any action in response to challenging behaviour that restricts the person’s movement, including physical holds (restraint), an object that restricts movement (such as straps) or seclusion in a room or space.
Positive Behaviour Support (PBS): A person-centred approach to supporting people with a learning disability who may be at risk of displaying challenging behaviours. PBS is backed by evidence. It considers the person as a whole, and provides support based on inclusion, choice, participation and equality of opportunity. It seeks to understand the reasons for behaviour so that unmet needs can be met. It focuses on teaching new skills to replace behaviours that challenge.
Positive Behaviour Support (PBS) Plan: A PBS Plan should describe in detail what support the person needs when they are in various levels or anxiety or displaying certain behaviours. It should describe how you know what state the person is in. It should describe specific strategies, for different places/situations, including strategies that are proactive, for de-escalation, reactive and for calming down.
Proactive strategies: These are strategies used to support someone to reduce the need for and avoid behaviours that challenge. They are used when the person is calm and happy to enable their communication, choice, health, relationships and independence.
PRN: Medication to be taken as it is needed or ‘as required’. PRN is a medical term: Latin for ‘pro re nata’.
Psychotropic medication: Any medication that affects the mind and includes antidepressants, antipsychotics, mood stabilisers, stimulants and anti-anxiety medication. These medications are usually given to help with mental health needs.
Reactive strategies: Any support strategy used to make a situation or a person safe when they behave in a way that is challenging for those supporting them. This includes procedures for increasing personal space, releasing from grabs and holds, PRN (as-needed) medication and more restrictive interventions.
Restrictive practice: Restrictive practices/interventions are any that limit a person’s freedom or movement. These include physical, mechanical and chemical restraint (over-medication), as well as seclusion.
Second Opinion Appointed Doctor (SOAD): The SOAD decides whether the treatment given to people detained under the Mental Health Act is appropriate, when the person either refuses the treatment or is unable to consent. The Care Quality Commission arranges for the doctors to visit patients.
Seclusion: When a child or adult is isolated in or confined to a room or space that they cannot leave. It does not have to be a room with a locked door to be classed as seclusion.
Sensory Integration Plan/Diet: Completed by an Occupational Therapist, who assesses the way the person processes sensory input, using detailed history from parents and/or carers and observations of the person doing a variety of sensory activities. The plan or ‘Sensory Diet’ is a document that explains which sensory stimuli the person is under- or over-sensitive to, and what activities or adjustments will help them cope with their environment.
STOMP: Stopping over-medication of people with a learning disability, autism or both. A national programme led by NHS England, launched in 2016.
Transition Plan: Completed when the person is aged between 14-19 years, the Transition Plan forms over time and describes what support the young person will need as they move into adult services. It should include: social care (style and amount of support), accommodation, education and continued learning, volunteering and employment options, and contact with family and friends. The Transition Plan is a legal requirement of the Care Act 2014.