4.4. Explain actions to take in response to challenging behaviour

This guide will help you answer 4.4. Explain actions to take in response to challenging behaviour.

Challenging behaviour is behaviour that can cause harm to the person showing it, to others, or that disrupts the care setting. It can be verbal, physical, or a refusal to follow reasonable requests. Examples include shouting, swearing, hitting, throwing items, or refusing to participate in care activities.

This behaviour can be a way of expressing feelings or needs that the person is unable to communicate effectively. It may come from frustration, fear, confusion, pain, or changes in routine.

Recognising the reasons behind the behaviour can help in deciding on the most suitable response.

Staying Calm and Professional

The first action in response to challenging behaviour is to remain calm. Showing frustration or anger can make the situation worse. The worker should maintain an even tone of voice and keep movements steady.

Key points include:

• Maintain a safe body position
• Use language that is clear and simple
• Avoid shouting or arguing
• Keep facial expressions neutral and non-threatening

Professional behaviour helps reduce tension and shows that the worker is in control of the situation.

Assessing Safety

Safety is the priority. The worker needs to quickly check if the person or anyone nearby is at risk.

Actions include:

• Moving other people away from danger
• Keeping a safe distance from the person showing challenging behaviour
• Looking for potential hazards such as furniture or objects that could be thrown
• Using agreed organisational procedures for safe intervention

If there is an immediate threat of serious harm, emergency services may need to be called.

Using De-escalation Techniques

De-escalation means reducing the intensity of the behaviour before it gets worse. This is often done through calm, respectful communication and body language.

Methods include:

• Speaking slowly and clearly
• Offering choices to help the person feel in control
• Listening actively to show the person they are being heard
• Avoiding sudden movements
• Giving the person space and time to calm down

These techniques work best when staff have established a positive relationship with the person beforehand.

Following Individual Care Plans

Many people with a history of challenging behaviour will have an individual care plan or behaviour support plan. This will outline known triggers, preferred communication methods, and strategies that work for that person.

Actions include:

• Applying the agreed strategies in the plan
• Using preferred activities or topics to distract and engage the person
• Avoiding known triggers
• Recording changes in behaviour so the plan can be updated

Following the care plan keeps responses consistent and supports best practice.

Using Positive Behaviour Support

Positive Behaviour Support (PBS) focuses on understanding the causes of behaviour and using proactive methods to improve quality of life. In response to challenging behaviour, PBS involves:

• Identifying what the person wants or needs at that moment
• Providing appropriate alternatives for expressing those needs
• Reinforcing positive behaviour when it happens

PBS aims to reduce challenging incidents over time by meeting needs in a positive way.

Physical Intervention

Physical intervention should only be used when there is no other way to prevent harm. It must be proportionate, reasonable, and in line with training and organisational policy.

Actions for safe practice include:

• Using approved holds or restraints only if trained to do so
• Working with another trained colleague if possible
• Minimising the length of time physical intervention is used
• Recording and reporting the incident immediately

Staff must understand that physical intervention carries risks and can cause distress. It should never be used as a punishment.

Communicating with the Person

Effective communication during challenging behaviour can help reduce its intensity. Important actions include:

• Speaking in a calm voice without raising the volume
• Using the person’s name to get their attention
• Offering reassurance without making false promises
• Asking open questions to understand their feelings
• Using non-verbal methods such as eye contact or hand gestures if these are helpful for the person

Good communication can help the person feel respected and understood.

Communicating with Colleagues

In a care setting, staff often need to work as a team during challenging incidents. This means:

• Calling for help if needed, using agreed signals or systems
• Explaining the situation clearly to colleagues who arrive to support
• Following clear roles to avoid confusion
• Debriefing after the incident to share what worked and what did not

This teamwork approach helps keep everyone safe and improves responses in future incidents.

Recording and Reporting

After an incident of challenging behaviour, it is important to record what happened in full detail. This should be done as soon as possible while events are fresh in the mind.

Key points to include are:

• Time, date, and place of the incident
• People involved and any witnesses
• Description of the behaviour and what happened before, during, and after
• Actions taken by staff
• Any injuries or damage that occurred

Reports should be passed to the appropriate manager and stored according to organisational and legal requirements. Records help in spotting patterns and planning better support.

Involving External Support

After serious incidents or repeated challenging behaviour, it may be helpful to involve other professionals. This could include:

• Mental health specialists
• Behavioural therapists
• Social workers
• Medical professionals

They can offer assessments, change medication if needed, or review care plans to improve support.

Supporting Wellbeing After the Incident

Both the person who showed challenging behaviour and those affected by it may need emotional support afterwards. Actions can include:

• Giving the person quiet time to recover
• Talking calmly with them about what happened, using language they understand
• Providing reassurance that they are still valued and supported
• Offering staff access to wellbeing resources or supervision time

This helps everyone to process the incident and reduces future distress.

Learning from Incidents

Each incident can provide useful information about triggers and effective responses. After an incident, teams can:

• Analyse what caused the behaviour and how it was managed
• Update care plans with what worked or did not work
• Share successful strategies with all staff working with the person
• Arrange staff training if gaps are identified

Learning from experience helps to reduce risks and improve responses.

Preventing Future Incidents

Preventing challenging behaviour is better than reacting to it. Actions to reduce incidents include:

• Maintaining consistent routines for the person
• Offering meaningful activities to reduce boredom
• Building positive relationships through respect and patience
• Noticing early warning signs and acting before behaviour escalates
• Providing regular staff training on behaviour management

Prevention supports a calmer, safer environment for everyone.

Legal and Organisational Requirements

Workers must act within the law and follow organisational policy. Key laws include:

• The Health and Safety at Work Act 1974 – duty to protect staff and service users from harm
• The Care Act 2014 – duty to promote wellbeing and protect from abuse or neglect
• The Mental Capacity Act 2005 – protects the rights of people who may lack capacity to make certain decisions

Organisations will also have their own behaviour management policies. Workers need to know these and follow them at all times.

Training and Support for Staff

Staff should have regular training in responding to challenging behaviour. This may cover:

• De-escalation skills
• Communication methods
• Safe physical intervention
• Recording and reporting procedures
• Understanding mental health conditions or learning disabilities

Ongoing training keeps skills up to date and gives staff confidence in their responses.

Final Thoughts

Responding to challenging behaviour in health and social care requires patience, skill, and a focus on safety. The main aim is to protect everyone involved, while treating the person with dignity and respect. Acting calmly, using de-escalation, and following agreed procedures can reduce risks and bring the situation under control.

Every incident is an opportunity to learn more about the person’s needs. By recording and reviewing each event, teams can improve care plans and prevent similar situations. Over time, this can lead to fewer incidents, better relationships, and improved wellbeing for both service users and staff.