CONTENTS
1. What is Behaviour that Causes Concern?
Dealing with behaviour that causes concern which is displayed by adults with care and support needs can be frustrating and difficult for everybody, but particularly the adult and their family.
Sometimes such behaviour can hide other things that the adult is feeling, such as difficult emotions or physical illnesses, that they cannot talk about.
It is important therefore that, once the incident has been sorted out, that staff consider other possible causes of such situations and work with the adult to reduce or prevent further incidents occurring.
2. Different Types of Behaviour that Causes Concern
There are two main types of behaviour that causes concern that staff may have to respond to. These are verbal and physical.
Verbal abuse can include:
- unpleasant comments which maybe racist, homophobic or being rude about someone’s physical appearance for example;
- threats of physical violence;
- bullying and emotional abuse;
- non-verbal abuse, such as making rude signals.
Physical abuses can include:
- physical assaults, which may include weapons of some type;
- damaging or destroying other people’s property or belongings;
- damaging or destroying property and / or furniture;
- different types of illegal behaviour, including graffiti, making a lot of noise etc.
If the adult has committed an act which may have broken the law when behaving in this way, the manager should contact the police. If an adult is being physically abusive, staff should contact the police immediately via 999 if they think an immediate response is needed to protect people or property.
3. Causes of Behaviours of Concern
There may be a number of different physical and emotional reasons why an adult behaves in a way that causes concern. These include:
- discomfort and / or pain, including constipation for example;
- being under the influence of alcohol or drugs;
- a disability that means they cannot communicate verbally, or are not very mobile for example;
- being frightened or scared about their circumstances or something they feel is threatening them;
- being physically, sexually or emotionally abused or neglected by others.
4. Responding to Behaviour of Concern
There are a number of different approaches that can be useful for staff, family and friends, in managing an adult’s behaviour that causes concern. Trained staff and managers are responsible for working with the adult and their family to decide the best approach to managing their behaviour, and communicating this to staff who work with the adult regularly. Such approaches can include:
- talking to the adult in a reassuring and calm manner, particularly if it it feels that the situation may escalate;
- putting the adult at the centre of the process in working out approaches to managing their behaviour. It may help if they feel they have some say in what happens;
- supporting the adult to develop coping strategies, particularly if they feel anxious or stressed;
- using rewards for positive behaviour or sanctions for negative behaviour, which have already been agreed with the adult and their family;
- being supportive and listening to adults, who need support particularly if they are feeling worried or anxious.
5. Staff Support
All staff should receive training about working with adults whose behaviour causes concern, appropriate to the role they have. This should include diversion and de-escalation tactics, how to respond to concerning situations and the importance of staff attitudes and responses to an adult exhibiting such behaviour, as this is vital in managing such situations.
Care workers should be involved in de-briefs following incidents, which will support staff as well as everyone having an opportunity to learn from the experience.
Staff supervision is also very important as it gives staff opportunity and time to express how they feel about particular situations, including if they were frightened or anxious. Managers should offer support as appropriate, including arranging additional training if required.
