Quality statement 4: Personalised daily activities

Quality statement

People with a learning disability and behaviour that challenges take part in personalised daily activities.

Rationale

People with a learning disability and behaviour that challenges often have limited opportunity to engage in meaningful occupation or activity, or may take part in activities that are not meaningful to them. Very high rates of behaviour that challenges have been reported in institutions that typically offer relatively limited activities. Ensuring that people with a learning disability have planned, personalised daily activities will help to reduce rates of behaviour that challenges.

Quality measures

Structure

Evidence of local arrangements to ensure that people with a learning disability and behaviour that challenges take part in personalised daily activities.

Data source: Local data collection.

Process

a) Proportion of people with a learning disability and behaviour that challenges with a personalised daily activity schedule.

Numerator – the number in the denominator with a personalised daily activity schedule.

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

Data source: Local data collection.

b) Proportion of people taking part in personalised daily activities.

Numerator – the number in the denominator who take part in personalised daily activities.

Denominator – the number of people with a learning disability and behaviour that challenges with a personalised daily activity schedule.

Data source: Local data collection.

Outcome

Service user experience of personalised daily activities.

Data source: Local data collection.

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

Service providers (such as health and social care providers, providers of residential care and providers in educational settings) ensure that systems are in place for people with a learning disability and behaviour that challenges to take part in personalised daily activities.

Health and social care practitioners (including staff in residential settings and educational settings) ensure that people with a learning disability and behaviour that challenges take part in personalised daily activities.

Commissioners (NHS England, clinical commissioning groups and local authorities) ensure that they commission services that plan personalised daily activities for people with a learning disability and behaviour that challenges.

What the quality statement means for service users and carers

People with a learning disability and behaviour that challenges take part in activities planned for each day. The activities should be interesting for the person and should be recorded in a daily activity schedule. This should form part of the behaviour support plan that sets out how they will be supported. The activity schedule should be developed with the person with a learning disability and behaviour that challenges and the people who support them, including their family or carers.

Source guidance

Definitions of terms used in this quality statement

Daily activity schedule

The daily activity schedule 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 planned activities should be of interest to the person and be meaningful to them. The activities should be recorded in the daily activity schedule and form part of the behaviour support plan.

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 is 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, and be able to be implemented within these resources

  • 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]

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.