Behavioural Support Plan Reference Guide

1 Behavioural SU PPORT plan Reference Guide For ADULT DEVELOPMENTAL SERVICES To be used in accordance with the r equirements outlined in Ontario Regulation 299/10 Quality Assurance Measur es (QAM) and the Policy Directives for Service Ag encies made under the authority of Services and Supports to Promote the Social In clus ion of Persons with Develo pmental Disabilities Act, 2008 (SIPDDA) February 2017 2 Table of Contents Foreword 3 Legend 5 Definitions 6 Be haviour Support plan 6 Challenging Behaviour 6 Intrusive Behaviour Intervention 6 Pos itive Be hav iour Intervention 7 Re quirements 8 Be haviour Support plan 8 Intrusive Behaviour Intervention 10 Train ing 15 Third Party Review Committee 17 Ministry of Community and Social S ervices Queens s Printer for Ontario, 2015 ISBN 978-1-4606-5073-8 (PDF)

2 01/15 Disponible en fran ais 3 Foreword The Services and Supports t o Pr omote the Social Inclusion of Persons with Developme ntal Disabilities Act, 2008 (SIPDDA), gui des the transformation of developmental services with a focus on progressive, communi ty-based living that puts inclusion at the forefront. The SIPDDA legislation sets out standards under Ontario Regulation 299/10 known as Quality Assurance Measures (QAM). QAM standards help ensure agencies and Developmental Services Ontario provide high quality services and supports to their clients.

3 Policy directives issued by the Ministry of mmunity and Social Services (MCSS) help interpret the QAM standards. All developmental service (DS) agencies funded by MCSS were required to comply with these as follows: As of January 1, 2011, all 280 quality assur ance measures. As of June 1, 2012, all requirements outlined in the P olicy Directive for Service Agencies. Purpose of this Guide This Guide provides information to help clarify the re quirem ents on behaviour Support plans as outlined in QAM, Part III, Behaviour Intervention Strategies, and Polic y Directive : Support Pe ople with Challenging B ehaviour Under these requirements, service agencies must develop an individual behaviour Support plan for every client with a developmental disability who has challenging be havior.

4 4 These requirements only apply to service agenc ies that provide any of the following types of services and supports: 1. Supported group living residence s. 2. Intens ive suppor t residences. 3. Co mmunity participation services and supports. 4. Activ ities of daily living services and s upports. 5. Caregiver res pite services and supports. SIPDDA, QAM and the policy directives are the source docum ents used in writing this Reference Guide . 5 Legend Re quirem ents rel ated to behaviour Support plans that include intrusive measures have the word i ntrusive bolded and underlined.

5 This text is po licy interpretation and/or additional information to help clarif y the re quirements of QAM and the Policy Dir ective for Service Agencies. 6 Defi niti ons Behaviour Support plan means a document that is based on a written functional assessment of the person that considers historical and current, biological and medical, psychological, social and environmental factors (a bio-p sycho-social model) of the person with a developmental disability that outlines intervention strategies designed to focus on the development of positive behav iour, communication and adaptive skills.

6 (QAM, (2) definitions) The written functiona l assessment refers to a detailed analysis of the behaviour relative t o its contingencies and as a best practice shoul d be based on direct observation and data. Challenging Behaviour means behaviour that is aggressive or injurious to self or to others or that causes property damage or both and that limits the ability of the person with a developmental disability to participate in daily life activities and in the co mmunity or to learn new skills or that is any combination of them.

7 (QAM, (2) d efiniti ons) Intrusive Behaviour Intervention means a procedure or action taken on a person in order to address the person w ith a developmental disability s challenging behaviour, when the person is at risk of harming themself or others or causing property damage. (Q AM, (2) definiti ons) For purposes of the definition of intrusive behaviour intervention , th e following are examples of intrusive procedures or actions: 1. Physical restraint 2. Mec hanical restraint 3. Secure isolation or confinement ti me out in a designated, secure space.

8 4. Prescribed medication to assist the person in calming thems elf, with a clearly defined protocol developed by a physician as to when to administer the medication and how it is to be monitored and reviewed (Q AM, (4)) The ministry established the Ex pert Panel on Behaviour Interve ntion Safeguards to give advice and make recommendations on permissive and non-permissive Behavioural management standards in Support of qua lity services and SIPDDA. 7 Mem bers of the Ex pert Panel include d repr esentatives from developme ntal services agencies, professionals with exp ertise in mental healt h (and dua l di agn osis), psychol ogy, behavi our therapy, a representati ve from a co mmunity advocacy group, and representatives from MCSS.

9 The Exp ert Panel helped inform the development of the behaviour interve ntion requirements in QAM. Positive Behaviour Intervention means the use of non-intrusive behaviour intervention strategies for the purpose of reinforcing positive behaviour and creating a supportive environment, with a goal of changing the behav iour of the person w ith a developmental disability. The fol lowing are examples o f non-intrusive behaviour intervention strategies: 1. Teac hing or learn ing compone nts, including teaching proactive skills and co mmunication strategies to maximize the person s abilities and to minimize challenging behaviour.

10 2. Rei nforcement. 3. A review of the person s living environment, including the physical space, and Support and social networks, to identify possib le causes of challenging behaviour and making changes to the living environment to reduce or eliminate those causes. (QAM, (5)) 8 Requirements Behaviour Support plan Each service agency shall develop an indivi dual behav iour Support plan for each person with a developmental disability who has challengi ng b ehaviour. (Q AM, (1)). The behaviour Support plan s hall be in addition to the person s individual Support plan (QAM, (3)) QAM and the Policy Directives for Service Agencies d o not specify who must develop a behaviour Support plan .