Moreways Healthcare

Specialist Behavioural Support

When a person is distressed, behaviour can become a powerful signal that something in their health, communication, environment, relationships or support is not working. Our approach focuses on understanding what is happening around the person, improving quality of life and creating support that is proactive, respectful and as least restrictive as possible.

Behaviour is information — not an identity

Look beyond the incidentWhat happened before, during and after matters.

Understand the personCommunication, sensory needs, health, trauma, relationships and environment can all be relevant.

Change the supportThe aim is not simply to stop behaviour, but to reduce distress and create better ways for needs to be met.
Understanding Behaviour

Start with curiosity, not judgement

Terms such as “challenging behaviour” are still used across health and social care, but they can unintentionally place the problem inside the person. We prefer to focus on behaviour that may challenge services, place someone or others at risk, or indicate significant distress.

A behaviour may have more than one purpose or contributing factor. Pain, sensory overload, anxiety, change, communication difficulty, trauma, boredom, lack of control, demands that feel overwhelming or an environment that does not fit the person can all be relevant. Understanding those factors is more useful than simply describing the behaviour itself.

01

Communication

What might the person be trying to express, avoid, obtain or make understandable?

02

Health

Pain, sleep, medication effects, physical illness and mental health can change behaviour significantly.

03

Environment

Noise, unpredictability, demands, sensory input and lack of meaningful activity can increase distress.

04

Relationships

Trust, consistency, communication style and previous experiences can shape how safe a person feels.

From Behaviour To Understanding

What we see is only the beginning

Good behavioural support moves from description, to understanding, to a practical response that makes everyday life work better.

What We May See

Observable behaviour is the starting point, not the explanation.

  • Self-injury or self-harm
  • Physical or verbal aggression
  • Damage to property
  • Withdrawal or refusal
  • Repetitive or high-intensity behaviour
  • Escalation around particular situations

What We Explore

We look for patterns and possible functions rather than assuming intent.

  • Communication and comprehension
  • Pain, health and emotional wellbeing
  • Triggers, demands and transitions
  • Sensory and environmental factors
  • Trauma and life experience
  • Access to choice, control and meaningful activity

How Support Responds

The response should make distress less likely and positive alternatives more available.

  • Adapt communication
  • Improve predictability
  • Change routines or environments
  • Teach and reinforce useful skills
  • Increase meaningful engagement
  • Plan safe, proportionate responses to escalation
Positive Behaviour Support

A whole-person approach to improving quality of life

Positive Behaviour Support combines person-centred values with evidence-informed understanding of behaviour. It is not a technique for making somebody “behave”. It is a structured way of making life, support and environments work better for the person.

1. UnderstandGather information about the person, their strengths, history, communication, health, sensory profile, relationships, routines and the circumstances surrounding distress.
2. Form A Working UnderstandingIdentify patterns and reasonable hypotheses about what may be contributing to or maintaining the behaviour.
3. Prevent & EnableAdjust support, environments and communication while increasing choice, meaningful activity, skills and access to things that matter.
4. Review & LearnMonitor what is changing, learn from incidents and positive periods, and adapt the plan as the person’s needs and circumstances evolve.
Prevention Before Crisis

The best crisis response often starts long before a crisis

Effective support does not wait for behaviour to escalate. It creates the conditions in which distress is less likely and the person has more effective ways to communicate, participate and exercise control.

Quality of life is part of risk management

Predictable support, meaningful relationships, good health, communication that works, ordinary activities and genuine choice are not “extras”. They can be central to reducing distress and helping a person feel safer and more in control.

Everyday FoundationsConsistent relationships, communication, sleep, health, sensory comfort, meaningful routines and opportunities for choice.
Early SignsRecognising individual changes in behaviour, mood, communication, pacing, withdrawal or tolerance before distress becomes acute.
Early ResponseReducing demands, changing the environment, offering space, regulating sensory input, using familiar communication and supporting coping strategies.
Crisis PlanningClear, person-specific guidance about how to keep everyone safe if escalation occurs, including when additional professional or emergency help is required.
Learning AfterwardsReviewing what happened without blame, understanding what helped or made things harder, and updating support so the same pattern is less likely to repeat.
How Support Develops

From assessment to everyday practice

A behavioural support plan only has value if it changes what happens in ordinary moments. The approach needs to be understood and applied consistently by the people around the person.

1

Listen

Understand the person’s history, preferences, communication and what a good life looks like to them.

2

Observe

Identify patterns around environments, demands, relationships, health and behaviour.

3

Plan

Develop practical proactive, early-response and reactive strategies around the individual.

4

Practise

Translate the plan into consistent everyday support, communication and meaningful activity.

5

Review

Use outcomes, incidents, feedback and changes in quality of life to refine support over time.

Step-Up & Step-Down Support

Keeping people connected to community life

The original page rightly highlighted both prevention of admission and discharge from inpatient settings. Those are two ends of the same principle: provide the right support at the right time, close to ordinary community life wherever possible.

Step Up

When Needs Increase

Where someone is becoming less settled, additional structure, monitoring, professional input or temporary increases in support may help stabilise the situation and reduce avoidable escalation.

Stabilise

Understand What Has Changed

Health, environment, relationships, communication, medication, sensory needs or life events may all need review. The aim is to address causes and restore stability, not simply contain risk.

Step Down

Return To Greater Independence

For people leaving hospital or moving from a more intensive setting, support can focus on transition, routines, community connections, practical skills and reducing dependence as confidence grows.

What Good Support Should Feel Like

Specialist does not have to mean restrictive

Behavioural complexity can lead services to become increasingly risk-focused. Good support should keep safety in view without allowing risk management to become the person’s whole life.

The ambition is a life with more choice, more participation, stronger relationships and fewer situations in which distress becomes the only effective way for someone to communicate or regain control.

Person-centredThe person is more than incidents, risks or diagnoses.
ProactiveSupport changes conditions that contribute to distress rather than relying primarily on reaction.
ConsistentTeams understand the plan and communicate in ways that are familiar and predictable.
Least RestrictiveAny restrictions should be necessary, proportionate, regularly reviewed and never used simply for organisational convenience.
Outcome-focusedSuccess includes quality of life, participation, relationships and independence — not merely fewer recorded incidents.
Trusted Guidance

Further information for families and professionals

These national resources provide independent information about behaviour that challenges and Positive Behaviour Support.

NICE Guidance NG11

NICE guidance on prevention and interventions for people with learning disabilities whose behaviour challenges, including assessment and understanding the causes of behaviour.

View NICE guidance →

Skills for Care — PBS

Information about Positive Behaviour Support, workforce development and the UK PBS competency framework.

Explore PBS resources →

NHS England — Community Support

Current guidance on the components that help autistic people and people with a learning disability live good and meaningful lives in their communities.

Read NHS England guidance →

Challenging Behaviour Foundation

Information and practical resources for families supporting someone with a severe learning disability whose behaviour challenges.

Visit the CBF →

Frequently Asked Questions

Behavioural support FAQs

Common questions about behavioural support, PBS and referrals.

Is Positive Behaviour Support about stopping behaviour?+
No. PBS is concerned with understanding why behaviour occurs and improving the person’s quality of life, support and environment. Reductions in distress or high-risk behaviour may follow from those improvements, but behavioural suppression is not the purpose of PBS.
Does behaviour always have one clear cause?+
No. Behaviour can be influenced by several interacting factors, including communication, physical or mental health, pain, sensory needs, relationships, demands, trauma, environmental conditions and previous learning. Assessment should avoid jumping to a single explanation.
Can Moreways support someone stepping down from hospital?+
Potentially, where the person’s needs are compatible with the service and an appropriate supported-living placement is being considered through the relevant referral, clinical and commissioning processes. Transition planning should be individual and multidisciplinary.
What if behaviour presents significant risk?+
Risk needs to be understood alongside the person’s needs, rights and quality of life. Support planning should include proactive prevention, early signs, clear responses to escalation and appropriate involvement of clinical, safeguarding or emergency services where required.
Are families and professionals involved?+
Where appropriate and with regard to the person’s wishes, consent and decision-making framework, support benefits from collaboration with families, advocates, social workers, health professionals and others who know the person well.
Professional Referrals

Planning support for someone with complex behavioural needs?

If you are a social worker, commissioner, clinician or other professional exploring supported living, step-down support or a community placement, contact our referrals team. We can discuss the person’s needs, current risks, support objectives and whether Moreways may be an appropriate option.