Accentuate the positive | QCS

Accentuate the positive

Dementia Care
July 18, 2013

If you have worked for some time in supporting adults with learning disability, then there is a fair chance that you have encountered behaviour that has challenged you and the service you work in. The likely explanation for this is not that all people with intellectual disabilities lack the ability to control their mood, as I was told once by an unenlightened soul, but more about the way support staff deal with communication, emotional understanding and choice.

It is a fact that many people with a learning disability in care environments are there because they need additional support in their daily lives. The late Dr Jim Mansell’s excellent 2007 report ‘Services for people with learning disabilities and challenging behaviour or mental health needs’[1] discusses the many risk factors associated with the development of challenging behaviour; mental ill health, vision problems, hearing loss, autism and communication impairments. He says that challenging behaviour is more likely to develop in services where staff do not respond well to the needs of these people.

So how can we ensure our services are more enlightened? For many of us, the possibility of developing our staff teams through intensive training and formalised education is unaffordable. Indeed, many services for adults with learning disability rely on relatively unskilled care staff, and turnover is high where challenging behaviour is a feature.

Providing formalised training is great, but as managers, we can do more for less outlay if we demonstrate a culture of respect and understanding among our staff. A very simple way to work towards this is to stop defining individuals by their challenges. Encourage staff to first see the positive aspects of each service user; individual support plans should reflect on what they can do, what they have achieved, and how to develop these areas. Too many times I have read descriptions of people that begin ‘Joe is a 45-year-old man with severe challenging behaviours………’

I recommend to you the Skills for Care guidance ‘Supporting Staff working with People who Challenge Services’[2], which contains a wealth of material designed to help you as employers tackle how your service helps people with learning disabilities. As they state, ‘Not recognising the assets that people have in their life …… is one of the greatest failings of services’.


[1] Services for people with learning disabilities and challenging behaviour or mental health needs

(revised edition) Mansell, J.  Department of Health, 2007

[2] Supporting staff working with people who challenge services: Guidance for employers; Skills For Health, 2013

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Ginny Tyler

Learning Disabilities Specialist

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