CB-NSG 8th November 2019



The Autumn Challenging Behaviour National Strategy Group was held on 8th November 2019 at Skills for Care, London. It was a busy and productive day focused around the theme of ‘Resilience’ from an individual, organisational and collective perspective. At the start of the day, resilience was defined as the capacity to recover quickly from difficulties. Resilience does not mean putting up with bad practice, but rather it is strengthening the ability to manage unexpected challenges that arise.


The planned outcomes for the day were:

  • To understand the importance of building resilience for individuals and their families, staff and the wider system 
  • To share best practice about building resilience and consider ways to replicate it 
  • To provide expert input to the development of regional specialist learning disability and advisory groups for the NHSE Transforming Care lead 
  • To identify and co-ordinate individual, organisational and collective actions to take forward that will make a difference and deliver positive outcomes for children, young people and adults with learning disabilities and their families.  




Family Carer Presentation:

Debbie alongside her presentation

The first presentation was delivered by Family Carer, Debbie Austin, who spoke about the early intervention Positive Behaviour Support (PBS) she received for her daughter, and the difference this made in their lives. However, Debbie’s first slide was a picture of a tightrope walker. She said that initially she felt this described her life as a family carer, but realised that it better described her daughter’s life: precarious, unstable, dangerous- the balance beam are her skills and mum and dad are the safety net that will always have to be there. Despite her daughter’s balance beam of skills, Debbie described access to support as a ‘lottery’; Debbie only found out about the Challenging Behaviour Foundation, PBS, and Learning Disability Nurses through her job in the Learning Disability Team as a physiotherapist. Debbie highlighted the importance of co-production with parents and valuing them as paid members of boards. Her comparison with physical disability emphasised the importance for services to listen to parents about what their child can and cannot do, stating: ‘If my child were in a wheelchair, you would not say ‘leave her with us and we’ll have her running up the stairs in a few days. The same applies when I say my daughter struggles with socialising’; Debbie stressed that challenging behaviour needs to be understood as a communication of unmet need. You can find the slides from Debbie’s powerpoint presentation here.


slide from Debbie's presentation


Staff Wellbeing:

The second presentation was given by Peter Baker from the Tizard Centre. He spoke about his research study and the importance of staff wellbeing in supporting people with learning disabilities and behaviour that challenges. Interestingly, his research indicated that there is no clear link between staff wellbeing and instances of challenging behaviour. Rather, low staff wellbeing directly affected staff’s resilience to challenging behaviour. Where there were no support systems around staff, challenging behaviour was found to be more aversive. Peter highlighted the importance of creating a system for staff with ‘kindness throughout’. Good working relationships and support from the system will affect staff resilience to support those they care for. Peter Baker’s presentation can be viewed here.



PBS Evaluation Pilot:

Marie presenting alongside her presentation

Later in the day, Marie Lovell spoke about work Skills for Care is doing to evaluate PBS training. Approximately 14 organisations who provide PBS training have signed up to be peer evaluated by other PBS training organisations to see that all training provided is meeting the PBS standards. Skills for Care intend to expand the evaluation to approximately 50 organisations by 2020. 


The Royal Salford Trust and Good Practice:

The final presentation came from the Royal Salford Foundation Trust with representatives Dave Williams and Stef Smith. They described how services in Salford are commissioned by explaining that funding is pooled across Health and Social Care, promoting a joined up and collaborative approach to supporting people. It was highlighted that in Salford each individual with learning disabilities has a named co-ordinator and that the managers and commissioners are involved on an individual level with each person. Dave and Stef shared the work of their area as an example of good practice and their presentation can be found here.


Updated Positive Behavioural Support Resource Launch:

The afternoon began with a launch of the PBS Academy and Challenging Behaviour Foundation’s updated Positive Behavioural Support information pack for family carers. Dr Freddy Jackson Brown and Jill Chaplin introduced the updated resource. The updated PBS resource is free to download and can be found here.



Attendees had the opportunity to attend 2 of 8 workshops running throughout the day:


Regional Expert Group Planning

The morning workshops were an opportunity for CB NSG members to help NHS England with their knowledge, expertise and practical advice to ensure appropriate learning disability and autism expertise is available in each NHS Region.  


Attendees were assigned to one of the four workshops, each with the aim of discussing one component of the potential ‘Regional Expert Groups’:  

  • Membership: the range of knowledge and expertise required
  • Purpose and function: strategic vs individual case support, and proactive vs reactive
  • Working organisation and practicalities: e.g. resources required, who should chair the group and how often they should meet
  • How it fits in with other work: where does it sit? Who does it report to?

Overall, there were many commonalities in the discussions in each of the workshops. The groups agreed overwhelmingly that there was a need for learning disability and autism expertise in each region, and this was a much needed resource, currently lacking in many areas. These panels should be strategic and influencing the system rather than becoming involved in individual cases. The group also confirmed that the panels should not ‘reinvent the wheel’ and become a talking shop; they would need to have authority, wherever they sat, over commissioning and organisation of the regions’ health and social care, holding Local Authorities accountable for this. For this reason, the inclusion of ‘advisory’ in the orignally proposed name (Regional Expert Advisory Groups) was not supported.

Equally, each group identified that the issues in each region and Local Authority would not be the same, and therefore each group would likely need to have their own statement of purpose. The final commonality was that all groups stressed that family carers and individuals with lived experiences should be valued participants in these new groups. It was felt there should be at least two family carers/ those with lived experience per panel, with one group suggesting 50% families and individuals with lived experiences. Ray James (NHSE) listened to CB NSG members and has committed to returning in March 2020 to update on progress with the development of the groups. CB NSG members will be feeding into ideas over the coming weeks and these will be passed onto NHSE for consideration.


Resilience Workshops

The afternoon workshops were focused on resilience for different stakeholders. Attendees could choose to join one of the four afternoon workshops. Each workshop began with a short presentation from the facilitator which was used as a springboard for discussion to enable all to contribute ideas on how to take the work forward.

The four workshops along with a summary of the discussions and actions are available here:

The workshops were productive and yielded several positive and practical actions that CB NSG members are taking forward, many of which had already been assigned an individual/ group to carry them out before the meeting was over. The actions from the afternoon workshops have been collated by the CBF and are available here. 




associate member poster on display

Core and Associate Members were invited to apply to present a poster of their work relating to resilience. Some fantastic posters were produced, revealing the ways in which many areas are promoting methods and research to help build resilience in individuals, organisations and services. The following posters were presented at the meeting and can now be viewed below:

Overall the day was received positively by attendees and was rated overwhelmingly as ‘useful’ or ‘very useful’ by attendees. To read a full summary of the evaluation please see here.


Thank you to everyone who attended and contributed to the ongoing work of the CB-NSG.






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