1 September 2022
Creating behaviour support plans that better support residents
- Providers should review their approach and governance of behaviour support plans (BSPs) to ensure they meet the criteria outlined below:
- Comprehensive ongoing person-centred assessments should be used to develop a BSP.
- BSPs should proactively prevent behaviour changes from occurring and support a resident should they experience changed behaviour.
- BSPs must be reviewed and updated on a regular basis, and after any change in the resident’s circumstances.
It’s been a year since it became a requirement for you as a provider to have a behaviour support plan (BSP) in place for residents who need one.
The Commission continues to see ongoing gaps in provider knowledge around BSPs.
Many BSPs are being identified as insufficient, not fit for purpose, and not person-centred. BSPs are not effective when generic and superficial strategies, and ‘cut and paste’ templates are used that don’t consider the person’s background and lifelong likes, dislikes and interests. A suggested approach was outlined previously in the Quality Bulletin.
Providers are reminded to ensure that BSPs are:
- a cohesive, fit-for-purpose, identified document that is inclusive of all information as set out in the Quality of Care Principles, and able to meaningfully inform care.
- informed by comprehensive person-centred assessments, including behaviour assessments that seek to identify and support:
- any unmet needs of the resident
- underlying causes or potential triggers for the changed behaviour
- the impact or effect of the behaviour on the resident and others.
- person-centred with tailored and individualised strategies, not just general behaviour support strategies such as reassurance, redirection etc. The documented success or failure of these attempted strategies should guide and inform future care.
- a comprehensive and accessible document which any staff member (whether casual or permanent) can access and understand when providing care.
- able to guide staff on the use of restrictive practices (if a resident requires or may require them). Restrictive practices should only be used as a last resort, in the least restrictive form and for the shortest time possible – to protect and enhance quality of life and compliance with the Quality of Care Principles.
- reviewed and updated regularly in consultation with the resident, relevant decision maker (if required) and health practitioners. The frequency of reviews should be based on the resident’s individual care needs and must consider any change in the resident’s circumstances. For example:
- an escalation or improvement in a resident’s behaviour
- behaviour support strategies tried and found to be ineffective
- changes in a medication that may be a restrictive practice (chemical)
- effect of any restrictive practice on the behaviour and on the resident e.g. distress, falls, confusion or sedation.
BSPs are required for any resident who experiences changed behaviour (defined by Dementia Support Australia (2021) as ‘any behaviour which causes stress, worry, risk of or actual harm to the person, carers, family members or those around them’) and any resident who may require the use of restrictive practices as part of their care to manage clearly articulated risks of harm.
Remember that good behaviour support is also good care and should seek to enhance and optimise a person’s quality of life, not just prevent them from doing things. Boredom and loneliness can contribute to changed behaviour and severely impact quality of life.
Providers can access further information on BSPs here:
- Dementia Support Australia – Behaviour Support Plans
- Dementia Support Australia – Behaviour Support Plan resources
Please share this alert with management and staff who are responsible for governance of Restrictive Practices and those directly involved in establishing and implementing BSPs for your residents.
Dr Melanie Wroth MB BS, FRACP
Chief Clinical Advisor