Purpose
To understand the function of behaviour and deliver PBS‑aligned interventions that reduce restrictive practices and improve quality of life.
Our PBS Principles
- Person‑centred: Support is built around the individual’s strengths, preferences, communication style, and life goals.
- Function‑led: Behaviours are understood as meaningful communication, not symptoms to be suppressed.
- Proactive first: We prioritise prevention, predictability, and environmental adaptation over reactive strategies.
- Least restrictive: Interventions follow the Mental Capacity Act 2005, the 2026 Supreme Court judgment, and human‑rights‑aligned practice.
- Trauma‑informed: Staff recognise the impact of trauma, attachment, and past experiences on current behaviour.
- Quality‑of‑life focused: The primary aim is improved wellbeing, engagement, and autonomy.
- Governance‑driven: All PBS activity is monitored, reviewed, and quality‑assured through UKSH’s clinical governance framework.
Core Components of the UKSH PBS Model
1. Functional Behaviour Assessment (FBA)
We complete a structured assessment to understand the function of behaviours, including:
- triggers and antecedents
- environmental contributors
- communication barriers
- sensory factors
- emotional and cognitive drivers
- reinforcement patterns
- unmet needs
This forms the foundation of all PBS planning and risk reduction.
2. Behavioural Formulation
Our clinicians produce a clear, defensible formulation that explains:
- why behaviours occur
- what maintains them
- what reduces or increases risk
- how the environment interacts with the individual
- how staff should respond to promote stability
This ensures all support is coherent, consistent, and clinically justified.
3. Proactive Support Strategies
We design proactive interventions that reduce distress and prevent escalation, including:
- structured routines and predictable transitions
- communication adaptations
- sensory regulation plans
- low‑arousal approaches
- environmental adjustments
- meaningful activity planning
- emotional‑regulation support
- rapport‑building and relational safety
These strategies form the daily foundation of support.
4. Skilled Staff Practice
All staff delivering PBS are trained in:
- trauma‑informed care
- low‑arousal approaches
- de‑escalation and emotional regulation
- safe community access
- structured engagement
- positive reinforcement
- early‑warning sign recognition
- least‑restrictive decision‑making
Where required, 1:1 staffing is deployed to ensure continuous proactive support and safe monitoring.
5. Reactive Strategies (Least Restrictive)
When behaviours escalate, staff follow a structured, governance‑approved plan that prioritises:
- safety
- communication
- emotional containment
- reduction of environmental demands
- supportive withdrawal
- non‑confrontational approaches
- post‑incident reflection and learning
Restrictive practices are never used unless lawful, necessary, proportionate, and clinically justified.
6. Quality‑of‑Life Outcomes
Our PBS model focuses on measurable improvements in:
- emotional stability
- engagement in meaningful activity
- community participation
- communication effectiveness
- autonomy and choice
- placement stability
- reduction in distress and crisis episodes
All outcomes are monitored through UKSH’s governance framework and reported to commissioners.
Governance and Oversight
PBS delivery is overseen by UKSH’s clinical governance team, ensuring:
- regular review of behavioural data
- risk‑rated reporting
- incident analysis and learning
- staff supervision and competency checks
- compliance with MCA 2005 and the 2026 Supreme Court judgment
- alignment with CHC, S117, and local authority commissioning requirements
- defensible documentation for MDTs, providers, and legal processes
Why Commissioners Choose UKSH’s PBS Model
- Reduces crisis episodes and placement breakdown
- Provides clear, defensible evidence for CHC/S117 decision‑making
- Ensures lawful, least‑restrictive practice
- Improves stability, engagement, and wellbeing
- Delivers consistent, skilled frontline support
- Integrates seamlessly with complex‑care pathways
- Produces commissioner‑ready documentation and outcomes reporting
Referral Pathway
Commissioners, MDTs, and providers can refer directly for:
- PBS assessments
- full PBS plans
- behavioural formulation
- 1:1 staffing justification
- risk‑rated behavioural summaries
- ongoing governance oversight
- complex‑case support and placement stabilisation
What We Deliver
- Functional behavioural assessments
- Behavioural formulations
- PBS plans
- Hour‑by‑hour behavioural analysis
- Risk‑rated behavioural summaries
- Staff coaching and implementation guidance
How We Work
- Review behavioural history and incident data
- Conduct structured observations
- Analyse triggers, functions, and maintaining factors
- Produce a clear behavioural formulation
- Develop PBS plans aligned to best practice
- Support staff with implementation
Outcomes
- Reduced incidents
- Improved behavioural stability
- Reduced restrictive practices
- Better staff confidence and consistency
- Improved quality of life
Commissioner Benefits
- Clear behavioural evidence
- Reduced placement breakdown
- Safer care environments
- Strong governance assurance
- Improved MDT coordination