“I was at an assessment and
treatment unit for about 12
years. It was not nice being
there. Now I’m in my own home
and I am much happier”
Michael, Out of Sight
CHALLENGING BEHAVIOUR NATIONAL STRATEGY GROUP
The Challenging
Behaviour Charter
Mendonça 2010“Our job is not to fix
people but to design
effective environments”
(Rob Horner)
Introduction
This charter, concerning the needs of individuals with learning disabilities who
are perceived as challenging to services and others, was compiled in 2008
and published in 2009. Since then many individuals and organisations have
signed up to the charter. You can find out who they are on the Challenging
Behaviour Foundation website www.challengingbehaviour.org.uk . Following the
Panorama programmes on the Winterbourne View abuses and reports flowing from
that, we are republishing this charter in 2013. There is still so much to be done.
Challenging behaviour is often perceived as a ‘problem’ or ‘illness’ to be ‘treated’,
‘cured’ or ‘stopped’. The problem is seen as being part of the person rather than
focussing on what needs to change around the person, such as their environment
or how people support them. This is unhelpful and potentially damaging for these
individuals. We need to look beyond the behaviour, understand what the behaviour
is communicating and then provide appropriate person centred, holistic support
to enable individuals to achieve their full potential.
We know that much better support and services could be provided for children
and adults who are perceived as challenging. This charter sets out the rights of
these individuals and the action that needs to be taken.
By signing up to this charter you endorse the rights of these individuals
and commit to working in partnership with the National Strategy Group to
influence real change.
In this charter we are adopting the following
definition: “Behaviour can be described as challenging
when it is of such an intensity, frequency,
or duration as to threaten the quality of life
and/or the physical safety of the individual
or others and it is likely to lead to responses
that are restrictive, aversive or result in
exclusion”.
(Challenging behaviour – a unified approach;
RCPsych, BPS, RCSLT, 2007)
The charter is a living document and we are happy
to receive comments and views.1) People will be supported to exercise their human rights (which are the
same as everyone else’s) to be healthy, full and valued members of their
community with respect for their culture, ethnic origin, religion, age,
gender, sexuality and disability.
2) All children who are at risk of presenting behavioural challenges have
the right to have their needs identified at an early stage, leading to
co-ordinated early intervention and support.
3) All families have the right to be supported to maintain the physical and
emotional wellbeing of the family unit.
4) All individuals have the right to receive person centred support and
services that are developed on the basis of a detailed understanding of
their support needs including their communication needs. This will be
individually-tailored, flexible, responsive to changes in individual
circumstances and delivered in the most appropriate local situation.
5) People have the right to a healthy life, and be given the appropriate
support to achieve this.
6) People have the same rights as everyone else to a family and social life,
relationships, housing, education, employment and leisure.
7) People have the right to supports and services that create capable
environments. These should be developed on the principles of positive
behavioural support and other evidence based approaches. They should
also draw from additional specialist input as needed and respond to all
the needs of the individual.
8) People have the right not to be hurt or damaged or humiliated in any way
by interventions. Support and services must strive to achieve this.
9) People have the right to receive support and care based on good and up
to date evidence.
Rights and Values:1) Children’s and adults’ services will construct long term collaborative plans across
education, social and health services and jointly develop and commission support
and services to meet the needs of children and adults with learning disabilities,
their families and carers.
2) Local Authorities and the NHS will develop and co-ordinate plans to:
 Reduce the exposure of young children with learning disabilities to
environmental conditions that may lead to behavioural challenges.
 Promote the resilience of young children with learning disabilities who face
such environmental conditions.
 Provide early intervention, support and services that will meet the individual
needs (including communication needs) of young children who are showing early
signs of developing behavioural challenges.
3) Active listening to the needs of the family will lead to the provision of
appropriate and timely support, information and training.
4) People will be supported to have a good quality of life by individuals with the right
values, attitudes, training and experience.
5) The NHS and services will proactively plan to ensure that people receive the same
range, quality and standard of healthcare as everyone else, making reasonable
adjustments when required. People will have an individualised health action plan
and be supported to have access to annual health checks to ensure all health
needs are met.
6) People and their family carers will receive support and services that are timely,
safe, of good quality, co-ordinated and seamless. They will be proactively involved
in the planning, commissioning and monitoring of support and services including
both specialist and general services.
7) A person-centred approach that enables and manages the taking of risk will be
used to ensure that people have access to family and social life, relationships,
housing, education, employment and leisure.
8) Local authorities and the NHS will know how many children and adults live in their
area and how many they have placed out of area. On the basis of information from
person-centred plans all agencies will plan and deliver local support and services.
9) Services will seek to reduce the use of physical intervention, seclusion, mechanical
restraint and the inappropriate or harmful use of medication with the clear aim of
eliminating them for each individual.
10) All services and agencies will strive to improve continually, using up to date
evidence to provide the best support, care and treatment to deliver positive
outcomes for individuals.
Action to be taken: