Behind Closed Doors: The Real Impact of Challenging Behaviour in Care

Posted by Chris Turnbull

A Divisive Topic in Social Care

Few topics in social care are as controversial as "Challenging Behaviour." The term alone can spark division among staff groups, but let’s pause for a moment to consider who is truly affected.

Defining Challenging Behaviour

For clarity, in this article we are talking about verbal outbursts, physical aggression and self-injurious actions. Oftentimes the focus is on the person displaying the behaviour. Considerable effort and time is spent trying to understand the causes, triggers and trauma that lead to what we have just observed or been subjected to. Equally important, however, is to acknowledge, accept and understand the broader implications for those around the behaviour, staff, peers and families alike.

Psychological & Physical Impact on Staff

The psychological impacts on those working in environments where such behaviour is common can be profound. However, there is an often unspoken acceptance and minimising of verbally and physically damaging behaviour; a comradery borne of adversity. According to H&SE a staggering 40% of “workplace stress” in the UK is attributed to challenging behaviour. This alarming statistic highlights how these interactions can lead to heightened anxiety, emotional strain and the eventual burn-out among invested staff.

The impacts don’t stop at mental health. The physical toll is just as concerning with an average of 4.5 sick days being taken annually due to stress related health conditions (H&SE). This underscores the persistent and relentless strain these behaviours put people through and the need for effective management strategies to listen, identify and support.

Staff Retention: A Critical Concern

Staff retention is another issue linked to challenging behaviour. NHS research reveals that approximately 30% of healthcare professionals consider leaving their positions due to the stress of managing challenging behaviour. This raises a significant challenge: how can a sector, increasingly in demand, continue to staff packages and support individuals with such precarious retention?

The effects of high turnover can be damaging for care providers and those being supported. Where experienced and skilled staff leave, they take knowledge and stability with them, disrupting service provision. Obviously, this creates a gap in training, skills and mentoring for new staff. Many hard-learned lessons may never be passed-on, contributing to a cycle of stress and dissatisfaction among remaining staff. Individuals who feel unsupported or ill-equipped to effectively and pro-actively manage challenging behaviour will likely be unable to consistently and proficiently deliver the high-quality care every service-user deserves.

Impact on Service Users

In residential and peer settings such behaviour can significantly affect the morale and well-being of other service users. In care settings, individuals who witness aggressive or disruptive behaviours experience increased anxiety and fear. The Journal of Applied Research in Intellectual Disabilities found that around 25% of individuals with disabilities reported feeling unsafe due to the behaviours of their peers. This highlights the wider social impact and disruption, raising concerns about the sense of safety necessary for personal growth, development and meaningful relationships.

What Can Be Done?

To mitigate the impacts of challenging behaviour, support staff need regular, high-quality training that is relevant to their roles. Equipping professionals with the understanding, skills and resilience to proactively manage and de-escalate situations through communication with confidence.

Challenging behaviour is a complex multi-layered puzzle. Tools such as Positive Behavioural Support, person-centred care plans and guides to "good days" can bring consistency and progress to the person displaying challenging behaviours. These tools help support and offer more efficient ways of conveying their needs, describing emotions and achieving their aims.

Fostering a Supportive Culture

As a sector, we must foster a culture of open, honest discussion. Regular, meaningful conversations about what staff experience and how they are impacted are essential. Through regular supervisions and peer support, we can empower each other to express, share and develop coping strategies while offering mentorship.

Building a genuine culture of understanding, with a focus on staff well-being and pastoral support, not only benefits staff but also improves consistency and understanding for the individuals we support.

Open dialogue and ongoing support are crucial. Keep listening. Start Talking.

Downloadable Resource: Guide to a Good Day

As mentioned earlier, one effective tool in managing challenging behaviour is the "Guide to a Good Day," which helps bring consistency and understanding to both staff and service users. To support your efforts in fostering positive environments, we’ve created a downloadable PDF version of this guide. This practical tool provides clear strategies for enhancing communication, identifying triggers, and promoting emotional well-being.

Click the button below to download your copy of the Guide to a Good Day and begin implementing these steps in your care approach today.

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