Complex Interaction ConferenceComplex needs, challenging behaviour, Active Support and Positive Behavioural Support (PBS) were the issues of the day for this well-attended event in Bristol (the fourth in the series jointly hosted by Real Life Options and the Association for Real Change) that drew in a receptive crowd of delegates from across Bristol, Wales, the Midlands, the three counties and the South West.

Chaired by Gary Hooper of RLO, proceedings were opened with an in-depth presentation on ‘Active Support as a Primary Prevention Strategy for Challenging Behaviour’, delivered by Dr. Edwin Jones and Professor Kathy Lowe from the AMB University Health Board. Backed by a burgeoning body of research and the results of three studies the two academics presented unequivocal evidence that Active Support, when introduced into provisions, not only helped reduce the incidence of challenging behaviour but was also instrumental in increasing the level of engagement in activities. By improving staff interaction and planning, and reducing the need for restrictive environments Active Support was shown to be a ‘powerful cultural change agent’ capable of significantly improving the quality of life for people with a learning disability.

For details of the Active Support Project, Training and Consultancy Services provided by the Association for Real Change Click here.

Jamie's StoryUp next and providing a real life example of Positive Behavioural Support (PBS) can help transform the lives of people with a learning disability were the duo of Alan Nutall and Jamie Silverthorne from Milestones Trust who presented a moving and amusing snapshot of Jamie’s life and how it had changed significantly thanks to the support of the trust and the ethos of employing a value-led support plan designed to meet the needs of the individual. Aided by Alan, Jamie took delegates through aspects of his life via a series of family snapshots and videos of a typical day, managing his preparations and bus ride to work. A positive and enjoyable experience.

A break for coffee was followed by another moving and fascinating insight into the life of a person with a challenging behaviour, this time narrated by Viv Cooper from the Challenging Behaviour Foundation. Talking with admirable honesty and candidness Viv led us through the challenges she and her family had endured and the trials and tribulations they had faced in fighting for the ‘right support’ at the ‘right time’ in the ‘right place’ for her son, Daniel. Some of the attitudes displayed towards Daniel and the barriers overcome were almost too incredulous to believe. Underlying Viv’s presentation was a real sense of her indefatigable determination to achieve the best support for her son despite the odds, and to do so by following the conviction that placing families at the centre of a localised partnership with the individual at the centre of decision making was the pathway most likely to lead to success. Early intervention, planning, individualised local support, the monitoring of outcomes and staff with knowledge and skills were essential for ensuring a good quality of support, good quality services and a good quality of life for the individual.

After lunch and an opportunity to network, delegates were treated to a presentation by Raj Gnanaiah, RLO’s incumbent Intensive Team Support Manager. Raj’s presentation focussed on the importance of staff attitudes and beliefs in managing challenging behaviour and the need to address these factors (so often ignored in training and post-scandal reports) to better achieve best practice. Backed up with research, Raj pointed out that staff are often more concerned about reducing challenging behaviour than truly understanding it and that changes to the ‘typical training approach’ were needed to successfully modify staff perceptions and ultimately improve positive interactions with individuals exhibiting challenging behaviour. Raj emphasised the need for consistent approaches and a supportive managerial culture.

Autism CareFollowing Raj was the entertaining partnership of Pete Cross and Zoe Armstrong from Autism Care UK who challenged delegates to ‘Think beyond the label’ and ask ‘is it a challenging behaviour or a challenging situation?’ This thoughtful and amusing presentation raised further questions by asking if successful intervention was about the provider changing or improving something they did in recognition that challenging behaviour was in fact a complaint from a customer. To round off, the pair implored that individuals should always be understood and described in terms of their talents and gifts first, rather than being unfairly labeled in terms of negative behaviour.

The last invited speaker of the day, Alicia Wood of the Housing and Support Alliance, injected further energy into proceedings with her frank appraisal of learning disability sector provision, post Winterbourne View – “as a sector we’ve never had such a worse reputation”. By outlining the similarities between the lives of people with learning disability in the 90’s and again in the ‘noughties’, Alicia argued that as a sector, “we simply haven’t come far enough”, highlighting a lack of person-centred approaches, a lack of understanding and poor commissioning and service provision. Describing the objectives of the Driving up Quality Alliance (of which ARC is a key member) and the subsequent drafting of the  Driving up Quality Code, Alicia laid out the need for a provider led campaign to raise the quality of care and support, calling for a new era of openness and accountability – “as an industry we need to take responsibility for our own behaviour… we also need to tell people what we’re doing right”. Alicia then went on to outline the 5 key areas of the code, how providers will publicly sign up to it and what people who use services, their families and advocates can expect from them. The launch of the code will take place in September 2013.

For further information about the Driving Up Quality Alliance and ARC’s involvement click here.

Rounding-up the day with her own perspective on all she had learned was Jacqui Bell, Association for Real Change’s CEO, who emphasised the need for strong leadership in implementing cultural change. She thanked speakers and delegates for a very successful day.

Feedback and comments from delegates:

Here are some of the responses received from delegates when asked what worked for them at the conference:

“The opportunity to meet with many professionals from numerous backgrounds.”

“The level of knowledge from speakers, backed with evidence.”

“Loved listening to all, especially Viv.”

“The consistent message, Alicia’s message (financial transparency, dismissing bad staff).”

“Really interesting to hear the family’s perspective.”


If you wish to download the presentations from the conference, click here.