Overview:
To better support a person within a care setting, it is critical to understand who they are individually and why someone may be reacting to a situation in a certain way. With a full behaviour support process in place, it ensures carers can learn what a person’s triggers are and proactively respond in a positive way.
The Behaviour details form provides a detailed analysis of why a person as reacted in a certain way and allows you to capture how better to support them going forward. The behaviour chart enables you to track trends over time to see patterns and spot common triggers.
The Behaviour (ABC) Chart can be accessed by going into the Charts menu and clicking Behaviour (ABC) Chart under the Emotional Support section.
Within the chart there are two views available a list view, which will be the default when opening the chart and an analysis view.
There is also a link to the Chart from within the Service User’s record. This will pre-filter the ABC Chart to the Service User.
The list view of the chart is grouped by month and service user and displays details from both the care note and the behaviour form. It also provides a link to the behaviour form to fill out and view additional information.
The list view chart will contain the following columns:
• Date – the date and time the care note was recorded
• Duration – the length of time recorded on the care note
• Location – the location recorded on the care note
• Care note – the original care note details
• Antecedent – the details leading up to the distressed reaction, taken from the care note. This information will be updated with any additional details added to the behaviour form
• Behaviour – The details of the distressed reaction, taken from the care note. This information will be updated with any additional details added to the behaviour form
• Consequence – The details of the outcome of the distressed reaction, taken from the care note. This information will be updated with any additional details added to the behaviour form
• Worker involved – Any worker(s) listed in the behaviour form as being present at the time of the event
• Service user involved – Any service user(s) listed in the behaviour form as being present at the time of the event
• New behaviour – will display either Yes or No depending on what has been selected on the form
• Behaviour category – The category of the behaviour selected on the care note. This will be updated if overwritten on the form
• Intervention used – Detail of the type of intervention used
• Restrictive practice authorised – recording Yes or No for whether the restrictive practice was authorised
• Adverse incident – recording Yes or No to indicate whether the care note was flagged as an accident or incident
• Link to Behaviour/Incident Form – A link to take you through to the form capturing details of the event
It will be possible to filter the chart if wanting to view or evidence a particular type of event or distressed reaction.
The filters are:
• Analysis view – Toggle button to switch between list view and analysis view
• Date from – date selector (defaults to 28 days prior to the current date)
• Date to (inclusive) – date selector (defaults to today’s date)
• Select service user – drop-down list of all service user in the selected care site
• Filter by worker – drop-down list
• New/Existing behaviour – drop-down list
• All (default) • New • Existing
• Search for – free text search field
• Behaviour category – drop-down list of all behaviour categories. Defaults to ‘All’
• Restrictive practice type – Drop-down list of the restrictive practice types
• Positive intervention type – Drop-down list of the positive intervention types
• Adverse incident – tick box, when selected only show those which are part of an incident/accident. Defaults to unticked
• People on emotional watch only – tick box, when selected only show those which are on an emotional watch. Defaults to unticked.
It is also possible to select within the Care note column to view the details of the original care note.
When setting the Analysis view toggle to on, the report will change to a graph view in order to perform trend analysis of recorded events.
The Chart will have the following filters:
• Date from – date selector (default to 28 days prior to the current date)
• Date to (inclusive) – date selector (default to today’s date)
• Select service user – drop-down list
• Filter by worker – drop-down list • Group by – drop-down list (categories below)
• Analyse by – drop-down list (categories below)
• Analysis view – Toggle button to switch between list view and analysis view
It will be possible to click on a section of the graph to view the related care note.
From the Behaviour Chart, click on the Behaviour details link and you will be taken to the Behaviour form. In this form there are several sections which can be completed to detail what has been done before, during and after the event. The form can be used as a standalone process to capture important details of the event and interventions used if appropriate. It is not mandatory to fill out the form nor are any of the fields within the form mandatory. Some of the fields within the form will be pre-populated from the care note and can be added to or updated as needed.
If the care note has been flagged as an accident or an incident, the behaviour form will be displayed as a section within the accident or incident form. If the behaviour form has started to be filled out and the decision is made to escalate the event to an incident or accident, the existing details will not be lost and will move across.
The first section of the form will display the care note information, when the care note was reported and by whom. It will also be possible to link related care notes which can help report anything which occurred before or after the even which may provide supporting evidence.
The event details section allows you to capture information such as where the event happened, the time occurred and any other people who were involved.
The behaviour details section focuses on detailing basic information about the behaviour, allowing you to adjust any information that was captured by the care note and add additional important evidence that may be important to understanding the distressed reaction.
The Behaviour Details section has the following fields:
• How do you think they were feeling – a space to capture how the resident may have expressed how they were feeling at the time, or relevant information you may have witnessed that explained how they were feeling
• Warning signs – pre-populated from the care note, this can be updated as needed
• Antecedent - pre-populated from the care note, this can be updated as needed
• Behaviour - pre-populated from the care note, this can be updated as needed
• Consequence - pre-populated from the care note, this can be updated as needed
• Notes – Any additional notes
• Is this a new behaviour? – capturing whether this is a distressed reaction the person has expressed before, or this is new with potentially a new trigger
• Intensity - pre-populated from the care note, this can be updated as needed
• Behaviour Categories – pre-populated from the care note, this can be updated as needed
• Physical signs checked – evidencing that an assumption hasn’t been made the distressed reaction isn’t due to a potential illness or other physical concern, with an option to also evidence that there were no physical signs as a potential cause
• Was this an allegation? – detailing whether another person was alleged to have caused the distressed reaction. If you click ‘Yes’ an additional notes box will appear to record the details
• What worked to reduce the behaviour? - pre-populated from the care note, this can be updated as needed
• What did not work to reduce the behaviour? - pre-populated from the care note, this can be updated as needed
This section focuses more on the type of intervention(s) used during the event, allowing you to capture the level of intervention needed and if a PRN medication was prescribed.
At the top of the Intervention Details section, there is a link to the person’s most recent Personal Behaviour Support Plan to ensure the information can be easily accessed as needed.
The Intervention Details section has the following fields:
• Primary intervention – the initial intervention tried and whether this followed the behaviour support plan
• Secondary intervention – the second intervention tried and whether this followed the behaviour support plan
• Last resort – the intervention tried as a last resort and whether this followed the behaviour support plan
• Was a PRN medication used – if clicking yes, an additional box will appear to record the PRN medication details
• Positive intervention used – specific details on the intervention type(s) used if they fall under one of those categories – this is useful to complete for reporting purposes. • Positive intervention details – Any additional information on the positive intervention used
This section will be hidden by default and only displayed if clicking Yes on whether a restrictive practice was used.
Please note, this section is not to indicate what interventions are available and should only be filled out if a restrictive practice was used during the intervention.
The Restrictive Practice section has the following fields:
• Was the restrictive practice authorised
o If clicking yes – an additional text box will appear for Details of restrictive practice authorisation
o If clicking no – an additional text box will appear for Why was the restrictive practice not authorised
• Restrictive practice details – Any additional details of the restrictive practice
• What benefit did the restrictive practice have – useful to evidence any beneficial outcome to using a restrictive practice in that instance
• Restrictive practice used – tick the ones which are relevant to the restrictive practice used during the event
This section is important to complete to capture the outcome and any support provided during or after the event.
The Post event support and de-brief section has the following fields:
• Behaviour support plan reviewed? – evidence whether the BSP needed reviewing or whether it is not applicable
• Care plan reviewed? – evidence whether the care plan needed reviewing or whether it is not applicable
• Risk assessments reviewed? – evidence whether the risk assessments needed reviewing or whether it is not applicable
• Were clinical observations required? – useful to detail any clinical observations that may have been taken after the even. If clicking Yes an additional text box will appear to capture the details of the observations
• Support provided to service user – evidencing what help and support was provided to the individual during or after the event.
• How are they feeling post intervention? – evidencing how the individual has expressed or how you have observed they are feeling after the event
• Support provided to staff – detailing what help and support was provided to staff during or after the event
This section is helpful to capture what follow-up actions or lessons have been learnt from the behaviour. This can be used in future to inform the behaviour support plan and future interventions.
The Behaviour intervention de-brief section has the following fields:
• What has been learnt from the behaviour? – Has there been any outcomes from the interventions or events of the distressed reaction, what has been learnt that can be used in the future.
• Staff debrief – evidencing whether staff were debriefed about the event and what the outcome was
• Was the intervention effective? – capturing whether the intervention worked or if anything could be done differently in the future
• Notes – any additional notes
This section is similar to the incident form where a manager can confirm the details of the form and capture whether all actions and procedures were followed correctly.
There is an additional tick box in this section for No further details for this behaviour.
This is to ensure if only the boxes populated from the care note are required, that you are evidencing the form has been reviewed and no further information is needed before signing off.
If you have integration with Radar for accidents and incidents, you will be able to send the details of the accident or incident to Radar and populate the Behaviour Form in mCare.
The first section of the Accident/Incident form allows you to capture the brief overview of the accident/incident which will then be sent to Radar. This will continue to send based on your settings of either when the care note is created or when the form is saved.
Below the Details section, you will then see the rest of the Behaviour Form. There is an Edit details to be able to update the form. From here, the Behaviour Form remains the same as the previous pages in this guide.
Saving this section will be independent of the fields that will be sent to Radar so these can be populated at different times.
