CHALLENGING BEHAVIOUR

Policy

Care workers have the right to expect that they should not be subjected to undue stress or risk during the course of their work, and that customer’s who display challenging behaviour do not present an unacceptable risk to their safety and well being.  

The Care Worker Agency has a responsibility under the law to all employees to provide them with a safe working environment. By undertaking a package of care that has been deemed ‘high risk’ we may be in breach of that requirement and therefore the company would be unable to provide care under such conditions.

Some customers may display challenging behaviour which is variable and unpredictable due to an underlying medical or mental health condition such as a neurological condition i.e. brain injury or dementia or depression, which can alter a person’s normal behaviour. In this situation a thorough risk assessment will seek to identify any potential danger to staff and will either allow the package to go forward (if the risks and dangers are acceptable and containable) or will reject the package as unsafe.

Other customers may present behaviours that challenge on a more predictable and regular basis, which may be triggered by certain factors, activities or events. This may be one of the reasons that the individual requires a support package as they may have complex needs and specialist requirements. For example a person with learning disabilities who may have behaviours that challenge.

The Care Worker Agency will provide service to individuals where restraint practices are required, only after a thorough risk assessment has been carried out and all of the risks have been identified and considered to ensure everyones’ safety as a result of behaviours that challenge, as stated in our restraint policy.

If there are situations whereby customers or their families choose to manipulate their care workers (or some of their care workers) in an inappropriate manner because of their medical condition in order to meet their own objectives/desires this shall be deemed to be reason to terminate a care package. We will offer some level of behavioral contract if the customers is happy to work with us to improve their challenging behaviour and move the package forward with greater understanding of how they must behave around their care and support staff, and this will be subject to regular review to ascertain if the care and support delivery is sustainable.

Procedure

  1. When a customer displays challenging behaviour prior to the commencement of a care package, which the risk assessor identifies as being of high risk to cause possible harm either to the customer or the care and support worker the assessor must inform the customer or their representative of their findings. In such circumstances, The Care Worker Agency will not provide a service if they feel this poses an uncontrollable risk.

  1. Care and support workers (and other staff) must not place themselves in any danger and must ensure their own safety and welfare as a priority.  

  1. Where the company provide a service for customers who may have behaviours that challenge the following procedure applies:

  • The provision of a service must only take place following an agreed plan of care with the customer and all significant others involved and must include a risk assessment process to reduce/minimise the identified risks.
  • Guidelines must be in place regarding how to respond to and manage the behaviours and these must be agreed and communicated to everyone involved in the customer's care.
  • Care and support workers must prioritise their own safety and not place themselves at risk and should a member of staff find themselves in danger they must leave the situation immediately and summon help as soon as possible.  
  • Any specialist guidelines (behaviour management guidelines) in place to enable staff to respond appropriately, safely and consistently to manage the behaviour should be produced and agreed by relevant professionals and behaviour management specialists (for example the community learning disability nurse specialist; psychologist, psychiatrist).
  • The behaviour management guidelines must also be in place to ensure the rights, welfare and safety of customers and to ensure a consistent response is communicated to them.
  • The customer must be central to the process of care planning and risk assessment and be provided with information in a way that they are able to understand and in accordance with their level of ability.
  • Risk assessments and behaviour management guidelines must be available with the customers’ plan of care and must be regularly reviewed.
  • All staff involved in any person’s care who displays behaviours that challenge must receive appropriate training regarding how to manage such behaviour and be fully up to date with any guidelines in place. This must be completed prior to a member of staff providing support and/or a service commencing and include relevant risk assessments.
  • All staff involved in the customers' care must follow the relevant and agreed behaviour management guidelines at all times.
  • Any changes in response by the customer or with regard to the behaviour which may have increased in its severity for example, must trigger an urgent care plan review with significant persons involved in the care. Similarly if the agreed plan of care and management of the behaviours becomes less or ineffective. In such circumstances the care and support worker must contact the care manager immediately for advice and guidance.
  • Staff must report all incidents of challenging behaviour to the care manager immediately or when able to do so and record all incidents in line with our reporting and recording policy and procedure.
  • Where required all staff supporting the customer must have completed the required mandatory training and induction relating to the specific needs of the customer (for example, the Oliver McGowan & Challenging Behaviour and Restraint training.
  • If a customer’s condition should deteriorate once a care package has commenced and the situation is considered no longer safe either for the customer or the care an support worker then the right to withdraw care is paramount.
  • The care manager must ensure the customer or their representative are aware that care can no longer be provided and the reasons why and a suitable notice of termination of contract given, depending on the circumstances.

Reviewed april 2025 by Fay Townsend-Jackson