Primary and secondary prevention

7.1   Primary prevention uses proactive strategies that are designed to meet the person’s needs to minimise the occurrence of incidents of behaviour that challenges. We must focus on all aspects of the person’s life. We approach primary prevention by using two simultaneous preventative strategies to promote behavioural change: 

1. Making changes to the person’s environment, routine or circumstances to reduce stress and anxiety to minimise the likelihood of a targeted behaviour occurring, for example by: 

• • Addressing any mental or physical health concerns
  • Identifying factors likely to trigger or maintain a targeted behaviour then reducing triggers / modifying the person’s environment wherever possible

Helping the person to develop new skills and coping mechanisms that mean they are better able to cope when feeling frustrated, angry or anxious.  

7.2   Primary prevention is a long-term intervention as:  

• A person may have multiple triggers and multiple behavioural responses
• Behaviours are usually a learned response built up over time. It takes time to change familiar responses and to develop new ones

7.3   Staff in all services will use primary and secondary prevention to: 

• Support adults to maintain positive behaviour patterns
• Reinforce behaviours that promote inclusion
• Prevent targeted behaviours, reduce their frequency or intensity, or de-escalate behaviours 
• Avoid the use of reactive strategies (wherever possible) 

Primary Prevention: Safe environment, respect and inclusion 

7.4   In-line with our duty of care to create safe environments we will, where possible, create environments that are conducive to the person’s needs, both at our day centres and respite unit. We will share what works for person with their family, friends and carers so that adaptations can be considered for other settings in which the person spends time. 

7.5   By understanding that behaviours that challenge are influenced by a person’s environment. We can make recommendations to:  

• Find opportunities for people to have control over their own environments
• Increase social contact between the person and their carers and important others  
• Ensure physically pleasing and spacious environments (though there is recognition that families may not always have the resources to ensure this)
• Offer structured programmes of activity that increase people’s opportunities to participate fully in their own homes
• Provide non-contingent access to things that people enjoy 

7.6   When a person is attending one of the council’s short break homes or day centres, staff will record any concerns about behaviours and how we worked with the person with preventative strategies to restore calm.  

7.7   If staff believe a person’s behaviour may be due to abuse or neglect, they will follow Gloucestershire’s Multi-agency safeguarding policy and procedures. 

Secondary prevention 

7.8   There may be times when the proactive primary prevention doesn’t work, and a person may display early signs of agitation, irritation, anger and aggression.  

7.9   Secondary prevention is a group of agreed strategies to calm the person before behaviours escalate: These strategies may be used when subtle observational signs indicate a person’s feelings are escalating. They may be best understood through working together with the person during their behavioural support plan. 

7.10   When early signs of distress are recognised, we will use responses that effectively deescalated the person’s feelings, for example by: 

• Inviting the person to another activity, particularly something they enjoy or to another part of the building where the environment is more supportive of the person’s immediate needs
• Removing the cause of the person’s distress
• Prompting and supporting the person to use their coping skills / respond in other ways 
• Providing what the person is trying to achieve and communicate through their behaviour