Transforming staff confidence in resolving behaviours of concern
When FitzRoy took over at a highly complex needs supported living service for people with learning disabilities, autism, and mental health needs in Derbyshire, the incumbent staff had little confidence in resolving and supporting very challenging behaviour. For example, if a person said he didn’t want to see them that day, staff didn’t have the strategies or knowledge to deal with this. They would simply deliver his meals with minimal engagement.
Now, after formal training as well as support from the wider FitzRoy teams, staff have the confidence and skills to implement alternative approaches and strategies to engage differently and effectively. The team have been developed in the FitzRoy ways of working, so they know what good support looks like, and the difference between “doing something for” someone versus “doing it with” the person. Staff now know how to plan support times so they match a person’s chosen activities, and the rota is adapted to meet the individual’s needs, rather than what works best for staff. The Positive Behaviour Support team has visited several times to coach the staff and they have also attended training in mental health key conditions, trauma, and EUPD, as well as PROACT-SCIPr, Oliver McGowan, and STOMP.
In my role as Area Manager, I spent a lot of time at the service – I still speak with the management team daily as FitzRoy’s Mental Health Lead and visit the site at least fortnightly. The service management team and I meet with the staff monthly and agree what we’ll focus on improving in the upcoming month. Some of the topics covered so far include medication administration and supporting people with menu planning and activities. Doing regular reflective sessions with staff, both in team meetings and 1:1s, has helped them to really get to grips with the FitzRoy way of working and also means we’ve been able to check exactly how effective the training has been so far.
Having gained so much confidence, the staff have a lot more strategies to use. If one of the people says he doesn’t want to see them they now know that they can go back in calmly and confidently 20 minutes later and they’ll probably get a different answer. Because the staff are so much more confident after all their training, they’re getting a very different response from the people we support, which then boosts the staff’s confidence further.
The team really have made huge progress and are now seeing the benefits of implementing their learning through improved outcomes for the people supported.
For example, during a recent day trip with one of the people supported, the vehicle broke down twice on the way back. Last year, this situation would have caused escalating behaviours of concern, and significant amounts of stress for the staff. Now, however, the team were able to keep him calm by successfully distracting him as soon as they saw any signs of his behaviour changing. After the second breakdown it was getting so late that staff had to do a dynamic risk assessment and make the decision to move him to a different vehicle to get him home. The deputy manager put on a Disney playlist which kept him happy and occupied singing along all the way home, diffusing what could have been a very stressful situation for everyone. The fact that they were able to keep him calm and occupied for so long shows how much better a place he’s in generally – and how much stronger a bond they’ve built with him – and how much more belief the staff have in themselves.
When we took over at the service, the neighbours were upset and frustrated about the impact of certain aspects of the service. We have worked hard to build relationships through monthly correspondence from our Head of Operations and regular meetings to help improve their understanding of the service, discuss concerns, and agree solutions. This has transformed the atmosphere on the road, with one of the benefits being that neighbours understand how to acknowledge staff and people being supported whilst going for walks.
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