Section G Getting it right
Ways of improving support
One of the first ways of improving support for someone with a learning disability, autism or both is for all the people who are involved in their life to work together. It goes both ways that family carers and professionals can try to understand each other’s viewpoints and work in partnership to make decisions and support the person consistently.
Person-centred support is essential for people with learning disabilities and autism. This means that an individual’s care and support is based around their needs and choices, rather than trying to make that individual fit the needs of the system.
Some people may be supported by a service that does not meet their needs and a change of support service is the best way to improve their life, because:
- The number of people living there is not right for the person;
- The person and others living there are not compatible;
- The physical environment is difficult for the person;
- The staff are not experienced enough to offer the right support; and/or
- The culture of the organisation does not suit the person’s needs.
Any change of service must be planned very carefully and the person should be supported with the decision, or a decision should be made in the person’s best interests.
The level of staff support may need to be adjusted. Consider whether the person may have too many or too few staff with them throughout the day. For example whether they are crowded by too many people, the person prefers the company of one person at a time or there are not enough staff available to help them participate in activities. This type of planning is called person-centred planning.
PBS is an approach that is used to support behaviour change in a child or adult with a learning disability and improve their quality of life. The focus is not on ‘fixing’ the person or the challenging behaviour and never uses punishment as a strategy for dealing with challenging behaviour. PBS is based upon the principle that if you can teach someone a more effective and more acceptable behaviour than the one that you find challenging, the challenging behaviour will reduce. Implementing a PBS plan properly and consistently can make a huge difference to someone’s life.
Good quality training for families and staff is important in improving support. Both would benefit from learning about PBS. Many paid carers are not given much training specific to the needs of the people they support, so would benefit from a better understanding of their needs and how they can make changes to the support they offer. Training also needs to be backed up with good management, in which managers support their staff and show them how to do their job well.
Support can be improved by putting a focus on proactive strategies, which that aim to support someone in a way that can reduce the need for challenging behaviour and therefore avoid it. These are different to reactive strategies, which are used to respond to challenging behaviour once it has occurred. There are many different proactive strategies that work well to meet the needs of different individuals; some examples are given in the scenarios in this section.
Intensive interaction is a way of engaging with someone by observing their body language and interests, and using these to establish communication. Using sensory signals that are familiar to the person can help to find some common ground and begin a meaningful connection. Intensive interaction can lead onto supporting someone to use other forms of communication and learn new skills.
This is a combination of supporting both sensory needs and communication needs. Time is taken to observe the individual to understand which sensory stimuli they prefer and which they find distressing. This information is used to create a sensory environment that minimises distressing stimuli and maximises those the person prefers in order to support communication. Once these preferences are understood, intensive interaction is used to establish a connection and communication with the individual.
This is a way of supporting someone that aims to use everyday activities as an opportunity to learn new skills and participate in an ordinary life. This approach sees activities as made up of a series of steps, all of which are equally valuable. Individuals can be supported to participate in as many of these steps as possible with each step seen as an achievement.
Low arousal support
This type of support focuses on the person’s environment and sensory needs. By minimising the sounds, lights, visual stimuli and other stimulating things around the person, they are calmer and more able to engage with people and activities.