Things you need to know

• The value base underpinning modern high quality services, including:
• The principles and practices of normalisation and inclusion, especially in relation to creating opportunities for increased community presence, stronger networks of relationships, greater participation in ordinary activities, making a greater number of choices, developing skills, and enhancing personal dignity and respect.
• The principles and practice of person centred planning and action.
• The importance and meaning of adopting the least restrictive approach.

Things you need to do

• Show dignity, respect, warmth, empathy, and compassion in all interactions.
• Treat every individual as a person and provide support that is tailored to meet need.
• Arrange and support participation in community activities and events.
• Search out and support the development of relationships.
• Arrange and support participation in activities of everyday life.
• Arrange and support meaningful choice.
• Arrange and support opportunities for learning and development.
• Help and support behaviour and daily interactions that make the person look and feel good.
• Minimise any restriction of activities or movement; and use positive handling strategies when needed in emergency situations.

Why is this important?

The key focus of learning disability support is enablement, which is different from other “hotel” models of care and support.

Things you need to know

• The importance of establishing clear leadership in setting the culture of the organisation.

Things you need to do

• Help shape and change, when appropriate, the values of the organisation.
• Support other staff to describe and deliver the values and core aims of the organisation, orally, in writing and in actions.
• Provide positive feedback on staff performance related to their support of the person’s community presence, relationships, choice, behavioural skills and image.
• Recruit team members with appropriate values and attitudes.
• Review and discuss team members’ attitudes regularly and support team members to demonstrate positive attitude to the person.
• Respond when positive attitudes are not present.
• Role model dignity, respect, warmth, empathy, compassion in interactions at all times, and monitor this in the team.
• Facilitate feedback from the person and their family and friends on how values are expressed in actions, and use this to shape and change the organisation.
• Actively manage staff and the environment to build a positive environment.

Why is this important?

The key focus of learning disability support is enablement, which is different from other “hotel” models of care and support.

Things you need to know

• Understand the policies and procedures that enshrine legislation and best practice and reflect the service philosophy base.
• Understand the principles of change management and the process of establishing an organisation-wide culture.

Things you need to do

• Develop a values led strategic vision and philosophy for the organisation.
• Create the necessary infrastructure to support a values-led culture and documents that clearly communicate principles, values, guidelines.
• Commission or develop training that will ensure that the service can provide the support required by the individuals that it supports.
• Develop partnerships with commissioners to ensure that they are able to be actively involved in the initial provision of service and its ongoing development.

Why is this important?

The key focus of learning disability support is enablement, which is different from other “hotel” models of care and support.

Things you need to know

• The importance of developing relationships and rapport.
• The person’s individual history and family/social context.
• The person’s interpersonal style, likes / dislikes, general skills and abilities.
• The person’s communication skills.

Things you need to do

• Develop a rapport with the person (can be evidenced by observing multiple positive interactions between the staff member and person supported).
• Identify and describe how the person expresses enjoyment and displeasure in activities.
• Directly support the person to access things that are important to them (preferences) and balances this with the things that are required for them to have a good quality of life.
• Support the person across a range of activities and contexts.
• Reflect on your relationship with the person.

Why is this important?

Social contact is a basic human need. In situations where the person receives unconditional, positive social interactions, in a way that suits their preferred communication style, they are often less likely to display challenging behaviour to obtain social interaction. However some individuals may not favour social contact. Understanding individual differences is important. Staff who establish good relationships with individuals can embed any necessary less positive interactions (e.g. physical care that may be uncomfortable or distressing). Most people (with and without developmental disabilities) want to receive positive social interactions from those around them. (Allen et al., 2013)

Things you need to know

• The person’s individual history, health needs, communication preferences, preferred activities / items, likes / dislikes, skills and abilities.
• Why this is important.

Things you need to do

• Proactively support other staff to develop and maintain positive relationship with the person, for instance, by suggesting/supporting joint activities relevant to person’s interests and interactional style, communication skills and abilities.
• Organise person’s personal documentation and collect, arrange or change this information as required by different agencies and systems.
• Support the team to reflect on relationship with client, both the positives and the negatives.
• Organise person’s support to include circle of support meetings, key worker meetings and activities with keyworker.
• Offer support and guidance if direct contact staff are finding rapport building difficult, for example organises staff training in interaction techniques.

Why is this important?

Social contact is a basic human need. In situations where the person receives unconditional, positive social interactions, in a way that suits their preferred communication style, they are often less likely to display challenging behaviour to obtain social interaction. However some individuals may not favour social contact. Understanding individual differences is important. Staff who establish good relationships with individuals can embed any necessary less positive interactions (e.g. physical care that may be uncomfortable or distressing). Most people (with and without developmental disabilities) want to receive positive social interactions from those around them. (Allen et al., 2013)

Things you need to know

• The evidence base behind the reasons why everyone who has direct contact with an individual needs to have a detailed knowledge of that individual.

Things you need to do

• Ensure that anyone having direct contact with a person either knows them or knows where and from whom to get pertinent information.
• Interact positively and respectfully with all persons within the service.

Why is this important?

Social contact is a basic human need. In situations where the person receives unconditional, positive social interactions, in a way that suits their preferred communication style, they are often less likely to display challenging behaviour to obtain social interaction. However some individuals may not favour social contact. Understanding individual differences is important. Staff who establish good relationships with individuals can embed any necessary less positive interactions (e.g. physical care that may be uncomfortable or distressing). Most people (with and without developmental disabilities) want to receive positive social interactions from those around them. (Allen et al., 2013)

Things you need to know

• Each person’s strengths, needs, preferences, hopes, dreams and aspirations.
• How to describe personally important outcomes for individuals that are observable, measurable, and timely.
• How to measure and assess change.
• How to check for balance and timeliness when scheduling the implementation of individualised goal-based support.
• How to identify and report progress, problems and barriers.
• How to communicate effectively with persons with limited verbal ability.
• How to communicate with family members and other significant persons.

Things you need to do

• Collect information about a person’s strengths, needs, preferences, hopes, dreams and desires.
• Help schedule the implementation of personally important goals.
• Help measure progress toward personally important goals.
• Help check that implementation balances across areas of life, type of outcome and preferences.

Why is this important?

Everyone’s strengths and needs are different and people’s aspirations and ambitions will vary. Competent environments match support to need on a moment to moment basis, and have in place ways of identifying, implementing, supporting and measuring a range of goals and outcomes that are personally important to the individuals that own them.

Things you need to know

• The importance of person-centred planning.
• How to implement a person-centred approach.

Things you need to do

• Liaise with circle of support.
• Organise and lead on collecting information about a person’s strengths, needs, preferences, hopes, dreams and desires.
• Schedule the implementation of and measure progress towards personally important goals.
• Check that implementation balances across areas of life, type of outcome and preferences.

Why is this important?

Everyone’s strengths and needs are different and people’s aspirations and ambitions will vary. Competent environments match support to need on a moment to moment basis, and have in place ways of identifying, implementing, supporting and measuring a range of goals and outcomes that are personally important to the individuals that own them.

Things you need to know

• Multiple systems for person-centred planning.

Things you need to do

• Implement personalised systems for goal-based person-centred outcome planning, implementing plans, and monitoring their impact.

Why is this important?

Everyone’s strengths and needs are different and people’s aspirations and ambitions will vary. Competent environments match support to need on a moment to moment basis, and have in place ways of identifying, implementing, supporting and measuring a range of goals and outcomes that are personally important to the individuals that own them.

Things you need to know

• The central functions and responsibilities of one’s own role and the roles of others to support the wellbeing of individuals (i.e., direct support workers are enablers not just to drive the bus, do all the cleaning/cooking etc.).
• The importance of establishing enabling relationships in empowering people to learn and manage as much of their lives as possible.
• To maintain high but realistic expectations.
• The relationship between one’s own behaviour and the behaviour of others.
• The importance of maintaining a sustainable pattern of work.
• The need to maintain professional boundaries (e.g., conflicts of interest, social media contacts).

Things you need to do

• Demonstrate appropriate level of support to the person, rather than doing too much for them, or not engaging with them.
• Demonstrate the difference between care and providing personalised and active support.
• Act as a key worker for one person or more.
• Provide peer support to colleagues.
• Actively participate in teamwork; attend and participate in team meetings and supervision.
• Maintain proper work timetables; advise supervisor if work hours risk becoming unreasonable.
• Reflect on own actions and feelings, and how these impact on the actions and feelings of others.
• Seek support from supervisor, manager or peers when needed.
• Declare any personal and/or professional relationships that will or might impact on job role or organisation’s functioning.
• Attend to own physical, psychological and emotional wellbeing.

Why is this important?

Staff are the key resource in any support service. Having high quality staff, low staff turnover and effective teamwork is critical to successful outcomes.

Things you need to know

• The role of supervision in terms of supporting the skills, training and personal wellbeing needs of others within the team such that they can fulfil their roles adequately.
• The importance of practice leadership.
• The impact of one’s own role; the roles of team members and other key stakeholders.
• The need for a consistent approach amongst team members.
• The relevance of positive monitoring, including Periodic Service Review (PSR).
• How to facilitate decision-making.
• How to resolve conflict.

Things you need to do

• Provide regular and frequent individual supervision for all staff (detailed in a supervision contract).
• Observe staff working practices and provide verbal and written feedback (practice supervision) and systematically check procedural fidelity in delivering agreed support plans.
• Demonstrate good supervision skills in training and developing staff around understanding behaviour, work relationship dynamics, maintaining personal boundaries and work–life balance.
• Monitor staff wellbeing and mentor staff in this area.
• Conduct appraisals, monitor staff performance, and identify and meet training needs of direct care staff.
• Monitor staff awareness of their own behaviour and provide feedback, guidance and supervision as needed.
• Lead and model the implementation of PBS in practice (practice leadership).
• Clarify staff roles in practice, and promote team work.
• Organise regular Periodic Service Review (PSR) and ensure assessments are valid and that the results are readily apparent to staff.
• Facilitate regular team meetings to review and update support plans, gain staff feedback, and involve staff in decision making.
• Set clear goals and vision with team involvement.
• Provide frequent and regular feedback to individuals and the team as a whole on everyday performance and progress toward goals.

Why is this important?

Staff are the key resource in any support service. Having high quality staff, low staff turnover and effective teamwork is critical to successful outcomes.

Things you need to know

• The strategic importance of effective team leadership.
• The importance of robust human resource management in the support of a positive environment.
• The importance of effective staff recruitment and on-going staff retention in a market in which there is often high turnover.
• The importance of supporting the supervisors.

Things you need to do

• Establish a human resource infrastructure and policies that facilitate effective team working and encourage staff involvement.
• Implement good human resource and personnel management and supervision procedures.
• Establish an effective staff recruitment process.
• Monitor reasons for high staff turnover and empower the management team to address this issue.

Why is this important?

Staff are the key resource in any support service. Having high quality staff, low staff turnover and effective teamwork is critical to successful outcomes.

Things you need to know

• That communication is critical for supporting autonomy, wellbeing and quality of life.
• That communication needs differ from person to person, moment to moment, and across settings and social contexts.
• Individualised communication plans should be developed for the person being supported.
• The need for modifying one’s own communication style for the audience and the importance of clear professional communication.

Things you need to do

• Effectively communicate and support the use of core communication systems (e.g., nonverbal, verbal, gestural, pictorial/textual) in all interactions with others.
• Use appropriate communication with different people depending on needs.
• Actively support, develop and change communication systems for each person (e.g., keep PECS symbols up to date, adapt to learning and behaviour change).
• Contribute to the development of a detailed description of how best to communicate with the person.
• Demonstrate appropriate communication methods at team meetings and in daily interactions with persons and colleagues.

Why is this important?

Challenging behaviour is less likely when the person understands and is understood by those around them. Most people (with and without developmental disabilities) want to communicate with those around them, especially those they are close to. (Allen et al., 2013)

Things you need to know

• That communication is critical for supporting autonomy, wellbeing and quality of life and the role of supervision in supporting this.
• The key functions of communication as they relate to behaviour that challenges (i.e., requests for tangible items and social contact, removing unwelcome demand).
• The importance of teaching and supporting alternative behaviour matched to the communicative function of challenging behaviour.

Things you need to do

• Implement service- or setting-wide systems to facilitate communication (e.g., words/signs/pictures used to label doors, visual menus in key settings).
• Ensure that all persons being supported have individual communication plans, and that these are regularly updated.
• Ensure that the team has access to appropriate training about communication.
• Ensure that the staff team creates opportunities, relationships and environments that increase a person’s motivation to communicate.
• Ensure team members know the assessed communicative function of challenging behaviour and how to support alternate behaviour in its place.

Why is this important?

Challenging behaviour is less likely when the person understands and is understood by those around them. Most people (with and without developmental disabilities) want to communicate with those around them, especially those they are close to. (Allen et al., 2013)

Things you need to know

• Functional communication training and the relevance of this to challenging behaviour.
• A comprehensive range of augmentative and alternative communication methods.

Things you need to do

• Establish system-wide structures that comply with the regulatory framework.
• Support communication development of staff (e.g., computer literacy training).
• Support staff in the understanding of more complex systemic communication needs.
• Support assessment and intervention components that address alternate functional communication.

Why is this important?

Challenging behaviour is less likely when the person understands and is understood by those around them. Most people (with and without developmental disabilities) want to communicate with those around them, especially those they are close to. (Allen et al., 2013)

Things you need to know

• The importance of providing options, and that people may express preferences in different ways.
• The importance of respecting a person’s choice, even if it may not be your own.
• The importance of supporting and, in some cases, teaching genuine choice making, of creating opportunities for choosing, and of providing experience and knowledge about options and consequences.
• The span of opportunities for choosing, from small day-to-day details to large life-defining matters, such as where to live and how to spend time.

Things you need to do

• Provide experiences that enable the person to be able to make an informed choice in respect of activities.
• Present opportunities for the person to make meaningful choices.
• Teach choosing skills.

Why is this important?

Challenging behaviour is also less likely when the person is doing things that they have chosen to do or with people that they have chosen to be with. Most people (with and without developmental disabilities) value the opportunity to decide things for themselves. (Allen et al., 2013)

Things you need to know

• The relationship between challenging behaviour and the opportunity for choice.
• How to support the team to present and help a person make informed choices.

Things you need to do

• Ensure that the staff team develops a person’s opportunities and ability to make informed choices and that these are acted upon.

Why is this important?

Challenging behaviour is also less likely when the person is doing things that they have chosen to do or with people that they have chosen to be with. Most people (with and without developmental disabilities) value the opportunity to decide things for themselves. (Allen et al., 2013)

Things you need to know

• The model of causality of challenging behaviour and the relationship between opportunities for choice and challenging behaviour.

Things you need to do

• Establish the necessary infrastructure that facilitates the making of informed choices and that these are acted upon.

Why is this important?

Challenging behaviour is also less likely when the person is doing things that they have chosen to do or with people that they have chosen to be with. Most people (with and without developmental disabilities) value the opportunity to decide things for themselves. (Allen et al., 2013)

Things you need to know

• The importance of knowing the health and physical needs of the individual being supported.
• The importance of monitoring physical and mental health needs.
• That people with learning disabilities and limited communication are less able to communicate needs directly and therefore have higher rates of ill health and mortality; hence support teams need to be extra vigilant on the person’s behalf.
• The signs of a health problem for the person.
• Medications specific to the person being supported, why they are taken and possible side effects.
• The administration of medication and any other prescribed treatment approaches.
• The management of any specific condition relevant to the person (e.g. epilepsy, diabetes, physical activity).
• The risk of over-medicating.
• Basic first aid.
• Who to contact for additional guidance on how to support a health need or condition.

Things you need to do

• Implement individual health care plans, including competent administration of medication.
• Support individuals to maintain physical health and wellbeing (cleaning teeth, checking testicles, healthy eating choices, weighing self, and exercise).
• Support access to health care systems, e.g. visiting the GP.
• Identify and interpret an individual’s physical and emotional state from non-verbal behaviours (i.e. facial expression, body movements, other behaviour).
• Correctly administer medication according to the agreed protocol.
• Record and report any medication administration correctly.
• Ask a senior manager or clinician for support or advice when needed.
• Articulate what they might feel and think in response to the strategies that are being implemented.

Why is this important?

Challenging behaviour is less likely when the individual is healthy and not in pain or discomfort. Most people (with and without learning disabilities) attach the highest possible value to good health and want to receive personal support in dignified ways. (Allen et al., 2013)

Things you need to know

• The physical and mental health needs of each individual and the appropriate health professional to contact for advice and support.
• The possible relationships between unmet physical or mental health needs and behaviour that challenges.
• The possible impact of adverse life events on physical and mental health (e.g. historic abuse, neglect or current poverty and social isolation).
• When to seek specialist input, how it is obtained, and what the barriers to accessing services are.
• Methods of monitoring physical and mental health needs.
• Treatments and interventions to support good mental health that are evidence-based for the persons being supported.
• How to present information to specialist health professionals involved in the person’s care in a planned way and in an emergency.

Things you need to do

• Ensure each person is registered with a GP and has an annual health check.
• Ensure each person has a health action plan that is reviewed regularly and is up to date, that includes as a minimum the need for annual health checks, that indicates how the person expresses pain and discomfort, and that contains details of medication and other treatments.
• Establish and maintain good working relationships with all support services to ensure multi-disciplinary team work is effective.
• Design health access and care protocols (e.g. desensitisation to needles).
• Authorise and sign off as required (PRN) medication protocols.
• Ensure team members are competent to administer medication and any other prescribed treatments and supports when needed.
• Monitor team administration of medication and other treatments and other strategies to promote wellbeing.
• Maintain data systems and prepare for meetings with specialists (e.g. psychiatrists).
• Support access to any additional professional help and respond rapidly to acute health concerns.

Why is this important?

Challenging behaviour is less likely when the individual is healthy and not in pain or discomfort. Most people (with and without learning disabilities) attach the highest possible value to good health and want to receive personal support in dignified ways. (Allen et al., 2013)

Things you need to know

• What health and social care systems and resources are available to support complex cases.
• The complexities involved in co-morbidity.
• Ways of collecting and analysing data on health and wellbeing.
• Medication, including as required (PRN) medication protocols.
• Intervention strategies from behaviour analysis that enable a person to access mainstream or specialist health services.

Things you need to do

• Establish and maintain good working relationships with all health and care services to ensure multi-disciplinary team work is effective.
• Collect and analyse data on physical and mental health and wellbeing.
• Provide clinical expertise in complex cases involving co-morbidity.
• Develop a clear strategy for ensuring that the amount of medication used is never more than is therapeutically necessary; establish monitoring and data collection processes; ensure that data collected is fed back into prescribing and administering processes.
• Promote mental and physical wellbeing activities for persons supported as well as staff.
• Facilitate joint working with other disciplines (e.g. psychiatry colleagues).
• Design and support the implementation of a programme to enable a client to visit their GP or local hospital.

Why is this important?

Challenging behaviour is less likely when the individual is healthy and not in pain or discomfort. Most people (with and without learning disabilities) attach the highest possible value to good health and want to receive personal support in dignified ways. (Allen et al., 2013)

Things you need to know

• The potential benefit of having a circle of support.
• The key people in the person’s circle of support.
• The importance of engaging with, and supporting, each person’s relationship with family members and other people in his or her social network.

Things you need to do

• Actively engage with professionals, family and friends.
• Actively support friendships and relationships with others.
• Communicate effectively with the person’s circle of support by supporting the person to maintain key relationships, facilitating contact and visits, and keeping family members and friends informed.
• Use formal and informal ways of sharing information.
• Seek advice from the circle of support regarding best-interest decisions.

Why is this important?

Challenging behaviour is less likely when the person is with family members or others with whom they have positive relationships. For most people (with and without learning disabilities), relationships with family and friends are a central part of their life. (Allen et al., 2013) One of the defining features of PBS (Gore et al., 2013) is the recognition that the people who are the most important part of a person’s day-to-day life are those who are most likely to be involved in their support, and are also connected to how challenging behaviour develops and is maintained (Hastings et al., 2013).

Things you need to know

• The importance of maintaining and developing each person’s relationships with family and his or her social network.

Things you need to do

• Ensure that each person has a circle of support.
• Facilitate and support staff to involve the circle of support in each person’s life and to involve them in decision making.
• Identify and develop opportunities to build social inclusion.
• Ensure goals relating to relationships with family, friends and the wider community are prominent in person-centred planning and implementation.

Why is this important?

Challenging behaviour is less likely when the person is with family members or others with whom they have positive relationships. For most people (with and without learning disabilities), relationships with family and friends are a central part of their life. (Allen et al., 2013) One of the defining features of PBS (Gore et al., 2013) is the recognition that the people who are the most important part of a person’s day-to-day life are those who are most likely to be involved in their support, and are also connected to how challenging behaviour develops and is maintained (Hastings et al., 2013).

Things you need to know

• The importance of community involvement in the lives of persons at risk of engaging in challenging behaviour and the strategic importance of engaging with the family and wider community.

Things you need to do

• Establish the networks necessary to ensure family and community participation.

Why is this important?

Challenging behaviour is less likely when the person is with family members or others with whom they have positive relationships. For most people (with and without learning disabilities), relationships with family and friends are a central part of their life. (Allen et al., 2013) One of the defining features of PBS (Gore et al., 2013) is the recognition that the people who are the most important part of a person’s day-to-day life are those who are most likely to be involved in their support, and are also connected to how challenging behaviour develops and is maintained (Hastings et al., 2013).

Things you need to know

• The importance of maintaining a safe, predictable and stable environment.
• That some aspects of the environment can be risk factors for challenging behaviour for some people, e.g. sensory aspects such as noise, light, space.
• That those being supported may experience difficulty in predicting, understanding and controlling the environment.
• That unpredictability and lack of control can evoke behaviour that challenges.

Things you need to do

• Use strategies to help the person predict, understand and control their environment (e.g. visual timetables or social stories).
• Identify and, if possible, avoid aspects of the environment that may be a risk factor for challenging behaviour.
• Implement interventions designed to help people cope with challenging environments.
• Develop personal activity schedules with routinely occurring activities as anchors and a menu of other activities for choice and responsive flexibility.

Why is this important?

Challenging behaviour is more likely when the person is supported inconsistently or when in transition between one activity or environment and another. Most people (with and without learning disabilities) value consistent and predictable support. (Allen et al., 2013) Challenging behaviour is less likely in the absence of environmental “pollutants” (e.g. excessive noise). Most people (with and without learning disabilities) want to live and work in safe, attractive environments where they feel at home. (Allen et al., 2013)

Things you need to know

• How to structure, review and monitor environments to maintain consistency.

Things you need to do

• Implement service-wide strategies to support consistent environments (e.g. service- or class-wide timetables, clear rota of staff).
• Model the use of systems (e.g. visual timetables).
• Ensure that scheduled activities take place.
• Observe and provide feedback to staff on interventions to extend consistency and control of the environment.

Why is this important?

Challenging behaviour is more likely when the person is supported inconsistently or when in transition between one activity or environment and another. Most people (with and without learning disabilities) value consistent and predictable support. (Allen et al., 2013) Challenging behaviour is less likely in the absence of environmental “pollutants” (e.g. excessive noise). Most people (with and without learning disabilities) want to live and work in safe, attractive environments where they feel at home. (Allen et al., 2013)

Things you need to know

• Systems and procedures necessary to maintain safe, consistent and predictable environments.

Things you need to do

• Design policies and procedures to establish safe, consistent and predictable environments.
• Monitor the safety, consistency and predictability of environments that define the service.
• Influence and change the system of support if it does not produce a safe, consistent and predictable environment.

Why is this important?

Challenging behaviour is more likely when the person is supported inconsistently or when in transition between one activity or environment and another. Most people (with and without learning disabilities) value consistent and predictable support. (Allen et al., 2013) Challenging behaviour is less likely in the absence of environmental “pollutants” (e.g. excessive noise). Most people (with and without learning disabilities) want to live and work in safe, attractive environments where they feel at home. (Allen et al., 2013)

Things you need to know

• The link between engagement, activity and wellbeing.
• What makes activity meaningful for a particular person.
• The importance of developing a person’s skills so that they are able to engage in activities as independently as possible or as they wish.
• The importance of help (support and assistance) to bridge the gap between what is needed to do an activity and what a person cannot yet do independently.
• The link between activity engagement and self-image, personal accomplishment and the perception of others.

Things you need to do

• Identify activities a person likes and create opportunities for the person to make them a part of daily life.
• Help the person do something they like for most of the time.
• Help the person do things they do not like, but that are essential.
• Introduce new activities so that a person has more activities to choose from.
• Support the person to develop skills in order to do things as independently as possible.
• View complex activities as a series of simpler activities arranged in a sequence of steps that a person is able to do with help.
• Adapt the level of help for each step so the person can join in as much as possible.
• Supply extra motivation and reward for low- or non-preferred activities.
• Schedule the day so the person has at least one activity available at all times (most often more than one) and the support required to perform the activity.
• Intersperse low-preference and high-demand activities with low-demand, high-preference activities.
• Keep track of what people do to make sure it is often enough, of good quality, spread out in time, and has enough variety and interest.

Why is this important?

Challenging behaviour is less likely when the person is meaningfully occupied. Skilled support ensures that they can participate at least partially even in relatively complex activities so that they learn to cope with demands and difficulties that might otherwise provoke challenging behaviour. Most people (with and without learning disabilities) like to be busy. (Allen et al., 2013) The development of new skills and independent functioning enables the individual to have more control over their life. Most people (with and without learning disabilities) like to be independent. (Allen et al., 2013)

Things you need to know

• What meaningful engagement means for each service user.
• How careful presentation of activities can avoid evoking behaviour maintained by escape from aversive demands, and can instead lead to engagement that will often create the feeling of control, and contact with attention from others and contact with tangibles.
• What each service user has as their next goal, e.g. to go on holiday, to go for a trip out, to do a course, to work.
• Local community organisations and what they offer.

Things you need to do

• Ensure that staff supporting the person develop good links with the local community.
• Support staff to identify and develop meaningful activity for each person throughout each day, using core activities as anchors.
• Coach staff to break down complex activities into steps (carry out task analysis) and vary the help they provide at each step.
• Coach staff to provide just the right amount of help.
• Monitor that each service user has meaningful activity in their life, and things they are looking forward to and goals they want to achieve.

Why is this important?

Challenging behaviour is less likely when the person is meaningfully occupied. Skilled support ensures that they can participate at least partially even in relatively complex activities so that they learn to cope with demands and difficulties that might otherwise provoke challenging behaviour. Most people (with and without learning disabilities) like to be busy. (Allen et al., 2013) The development of new skills and independent functioning enables the individual to have more control over their life. Most people (with and without learning disabilities) like to be independent. (Allen et al., 2013)

Things you need to know

• A detailed understanding of available resources, including sources of funding that might be used to provide meaningful activities within services.
• Understands the model of causality of challenging behaviour and the relationship between meaningful engagement and challenging behaviour.

Things you need to do

• Secure the resources necessary to ensure that all persons supported are able to engage in meaningful activities.
• Provide a clear expectation that participating in everyday activity is a key outcome.
• Supply operational and procedural guidance for supporting activity engagement, including active support training and practice leadership.
• Measure participation and community involvement as outcomes and report these to stakeholders along with data on the occurrence of challenging behaviour.
• Design interventions that enable persons to develop new skills and to access and participate in meaningful activities.

Why is this important?

Challenging behaviour is less likely when the person is meaningfully occupied. Skilled support ensures that they can participate at least partially even in relatively complex activities so that they learn to cope with demands and difficulties that might otherwise provoke challenging behaviour. Most people (with and without learning disabilities) like to be busy. (Allen et al., 2013) The development of new skills and independent functioning enables the individual to have more control over their life. Most people (with and without learning disabilities) like to be independent. (Allen et al., 2013)