Quality statement 3: Designated coordinator

Quality statement

People with a learning disability and behaviour that challenges have a designated person responsible for coordinating the behaviour support plan and ensuring that it is reviewed.

Rationale

A designated person responsible for coordinating the behaviour support plan will ensure continuity of care both for the person with a learning disability and their family or carers. It will also reduce the need for families or carers to repeatedly give the same information to different staff. Having a designated person responsible for ensuring that plans are reviewed will help to make sure that plans are adjusted as treatment, behaviours and the person's preferences change. This will in turn promote the use of proactive strategies to ensure regular and effective support for people with a learning disability and behaviour that challenges.

Quality measures

Structure

Evidence of local arrangements and written protocols to ensure that people with a learning disability and behaviour that challenges have a designated person responsible for coordinating the behaviour support plan and ensuring that it is reviewed.

Data source: Local data collection.

Process

a) Proportion of people with a learning disability and behaviour that challenges with a behaviour support plan.

Numerator – the number of people in the denominator with a behaviour support plan.

Denominator – the number of people with a learning disability and behaviour that challenges.

Data source: Local data collection.

b) Proportion of people with a learning disability and behaviour that challenges who have a designated person responsible for coordinating their behaviour support plan.

Numerator – the number of people in the denominator who have a designated person responsible for coordinating their behaviour support plan.

Denominator – the number of people with a learning disability and behaviour that challenges with an agreed behaviour support plan.

Data source: Local data collection.

c) Proportion of people with a learning disability and behaviour that challenges who have a designated person responsible for ensuring that their behaviour support plan is reviewed.

Numerator – the number of people in the denominator who have a designated person responsible for ensuring that their behaviour support plan is reviewed.

Denominator – the number of people with a learning disability and behaviour that challenges with an agreed behaviour support plan.

Data source : Local data collection.

What the quality statement means for service providers, health and social care practitioners, and commissioners

Service providers (secondary care services and social care providers) ensure that people with a learning disability and behaviour that challenges have a designated person responsible for coordinating the behaviour support plan and ensuring that it is reviewed.

Health and social care practitioners ensure that people with a learning disability and behaviour that challenges have a designated person responsible for coordinating the behaviour support plan and ensuring that it is reviewed.

Commissioners (clinical commissioning groups, NHS England and local authorities) ensure that they commission services that provide people with a learning disability and behaviour that challenges with a designated person responsible for coordinating the behaviour support plan and ensuring that it is reviewed.

What the quality statement means for service users and carers

People with a learning disability and behaviour that challenges have one person who is responsible for coordinating the plan that sets out how they will be supported. The person with a learning disability, and their family or carers, knows who this person is and how they can contact them. This gives them a familiar single point of contact and reduces the number of times they have to repeat information to staff. This person will also be responsible for ensuring that the plan is reviewed. The aim of the review is to make sure that the plan is appropriate for the person with a learning disability and supports their daily living.

Source guidance

Definitions of terms used in this quality statement

Behaviour support plan

A behaviour support plan should be developed and agreed with the person with a learning disability and behaviour that challenges and the people who support them, including their family or carers. The behaviour support plan should be based on a shared understanding about the function of the behaviour and should:

  • identify proactive strategies designed to improve the person's quality of life and remove the conditions likely to promote behaviour that challenges

  • identify adaptations to a person's environment and routine, and strategies to help them develop another behaviour that fulfils the same function by developing a new skill (for example, improved communication, emotional regulation or social interaction)

  • identify preventive strategies to calm the person when they begin to show early signs of distress

  • identify reactive strategies to manage any behaviours that are not preventable

  • incorporate risk management and take into account the effect of the behaviour support plan on the level of risk

  • be compatible with the abilities and resources of the person's family members, carers or staff, including managing risk

  • identify training for family members, carers or staff to improve their understanding of behaviour that challenges shown by people with a learning disability.

[Adapted from challenging behaviour and learning disabilities (NICE guideline NG11), recommendation 1.6.1]

Review of behaviour support plan

The review should involve the person with a learning disability and behaviour that challenges and the people who support them, including their family or carers. The review should help to identify how the plan is helping to make improvements to the person's life and to reduce or stop behaviour that challenges. The behaviour support plan should be reviewed every other week for the first 2 months and then once a month.

Equality and diversity considerations

The communication needs of people with a learning disability, particularly the needs of people who are unable to communicate through speech, should be taken into account in a health assessment. Practitioners may need to provide support for those who have limited speech and for those who have difficulty with English.