Positive behaviour support plan template for adult social care (with example)

A good support plan should help staff respond consistently, reduce avoidable crises, and improve day-to-day quality of life. In adult social care, that means a plan that is practical on a night shift, clear for agency staff, and grounded in what matters to the person.

This guide gives you a ready-to-use template and a worked example you can adapt. It also includes a simple review routine so the plan stays a live document, not a folder on a shelf.

If you want support to build consistent practice across a service, our positive behaviour support training covers the core principles and how to apply them in real settings.

What a PBS-style support plan is (and what it is not)

In adult social care, support planning often includes many documents: care plans, risk assessments, capacity and consent notes, health action plans, and more. A PBS-style support plan sits across these and focuses on one thing: helping staff understand why distressed behaviour is happening, and what to do before, during, and after difficult moments.

Skills for Care describes positive behavioural support as a way of supporting people that involves understanding reasons behind behaviour, including a person’s life history, physical health and emotional needs (Skills for Care).

NICE guidance on supporting people with a learning disability and distressed behaviour emphasises understanding the cause of the behaviour, carrying out thorough assessment, and using psychological and environmental approaches as key parts of support (NICE NG11).

What this plan should help you achieve

• Shared understanding of what the person is communicating through their behaviour
• Practical proactive strategies that reduce triggers and increase safety
• Clear, least restrictive responses when risk rises
• Consistent recording and review so you learn what works

Before you start: gather the right information

Most plans fail because they are written without the day-to-day details that staff actually need. Before drafting, gather:

• The person’s perspective: what feels hard, what helps, preferred routines, and how they want staff to support them.
• Communication profile: how they show pain, anxiety, overwhelm, and what “yes” and “no” look like.
• Health context: pain indicators, sleep, constipation, medication changes, sensory needs, seizure patterns, and anything else relevant.
• Baseline patterns: when incidents happen, where, with whom, and what typically changes the trajectory.
• Risk and safeguarding: known hazards, past trauma triggers (handled sensitively), and any restrictions already in place.

CTA: If you are reviewing how staff respond to higher-risk situations, pair this work with restraint reduction training to build a consistent approach to reducing restrictive practice.

Template: sections to include in a PBS-style support plan

You can copy and paste the headings below into your own format. If your organisation uses an electronic care planning system, keep the same headings so staff can find information quickly.

1) Person summary (one page)

• Name, preferred name, pronouns
• What matters to me (values, routines, relationships, activities)
• How I communicate (what to look for)
• What helps me feel calm and safe
• Things that tend to make my day harder

2) What the behaviour is communicating

Describe the behaviour clearly and neutrally. Avoid labels and assumptions. Focus on what staff might observe.

• What it looks like (topographies)
• Early signs (low-level cues)
• Escalation signs (mid-level cues)
• Crisis indicators (high-risk cues)
• Recovery signs (what helps the person return to baseline)

3) Likely functions and maintaining factors

This is the heart of the plan. Use evidence from records and team observations. Common functions include: escaping demands, gaining attention or support, accessing preferred items, avoiding sensory overload, or communicating pain.

• What seems to happen right before incidents (antecedents)
• What staff responses might accidentally reinforce the behaviour
• What needs are not being met in the moment (pain, predictability, choice, privacy)

4) Proactive strategies (what staff do every day)

List specific actions that reduce triggers and increase coping. Proactive strategies should make up the majority of the plan.

• Routine and predictability: visuals, advance warning, clear start/finish, planned breaks.
• Choice and control: offer choices that are real and manageable.
• Communication supports: scripts, symbols, agreed phrases, supported decision-making.
• Health and wellbeing checks: pain check prompts, hydration, regular movement, sleep routine.
• Skills teaching: a small number of teachable skills that replace the need for distressed behaviour (for example, requesting a break).

5) Skills teaching plan (simple, teachable, trackable)

Write this as a mini-programme. Keep it realistic: one or two skills first, practised in calm moments.

• Skill(s) to teach
• When to practise (daily opportunities)
• How staff will prompt and reinforce
• How you will record progress

6) Environmental adjustments

• Noise, lighting, crowding, and space
• Transitions (travel, meals, personal care)
• Staff approach (tone of voice, pacing, personal space, consistency)
• Meaningful activity and engagement

7) Reactive strategies (what to do when risk rises)

Reactive strategies are about reducing escalation and harm. They are not “punishments”, and they are not a substitute for proactive planning.

• What to do at early signs (low intensity)
• What to do at escalation (medium intensity)
• What to do in crisis (high intensity, safety-critical)
• What not to do (known escalation triggers)
• When to call for additional support

Where physical safety interventions are part of your organisation’s risk framework, make sure staff are trained and that the plan describes the least restrictive options available, with clear thresholds and aftercare. This should align with your incident reporting and governance. physical intervention training can help teams standardise safe practice and reduce variability.

8) Post-incident support and learning

• Immediate aftercare for the person (privacy, hydration, medical checks if needed)
• Support for staff (debrief, wellbeing)
• What gets recorded (facts, not judgement)
• What you will review (triggers, responses, injuries, missed opportunities)

9) Review schedule and responsibilities

• Named plan owner (role, not just a person)
• How often the plan is reviewed (for example, every 4-6 weeks)
• What triggers an early review (health change, placement change, incident spike)
• How changes are communicated to staff (handover notes, supervisions)

Worked example (adult social care)

Important: This is an anonymised, fictional example to show structure and level of detail. Adapt it to your setting and the person’s preferences.

Person summary

• Preferred name: “Sam”
• What matters: Quiet mornings, walking to the local shop, listening to the same playlist, and having predictable staffing.
• How Sam communicates: Limited spoken words; points, takes staff by the hand, uses a picture card for “break”.
• What helps: Being offered two clear choices; calm tone; knowing what happens next; time to process.

Behaviour description and early signs

• Early signs: pacing, rubbing hands, repeating a phrase, avoiding eye contact.
• Escalation: shouting, pushing objects away, moving rapidly towards the front door.
• High risk: attempts to run from the home, or pushing past staff into a road environment.

Working hypothesis (what the behaviour may be doing)

Incidents are most likely after unexpected changes (agency staff, cancelled community activity) or when Sam is asked to switch tasks quickly. The behaviour appears to function as an escape from overwhelming demands or uncertainty, and sometimes as a way to access the preferred walk routine.

Proactive strategies

• Predictable morning plan: Display a simple visual sequence: breakfast, music, walk, then choice of activity.
• Processing time: After giving an instruction, count to ten silently before repeating.
• Two-choice offers: “Walk now or in 10 minutes?” “Shower before or after music?”
• Planned access: Build the daily walk into the rota when possible, and give advance notice if it cannot happen.
• Health check prompts: If pacing increases, offer water and check for signs of discomfort (especially constipation and tooth pain indicators noted in health plan).

Skills teaching

• Skill: Requesting a break using the “break” card.
• Practice: 3 short practice moments daily in calm times (before meals and before leaving the home).
• Prompting: Staff model the card and phrase “break please”, then immediately offer a short break space.
• Reinforcement: Praise and quick access to the break space. Record each independent use.

Reactive strategies

• Early signs: Reduce language, offer the break card, guide to a quieter space, and remove non-essential demands.
• Escalation: Increase distance, keep exits clear where safe, ask one staff member to lead communication, and avoid blocking.
• High risk (road safety): Call for additional support immediately; follow the agreed community safety protocol; prioritise de-escalation and safe positioning without crowding.
• What not to do: Do not argue, threaten consequences, or rush physical prompts that reduce Sam’s sense of control.

Post-incident learning

• Complete an incident record within the shift, focusing on triggers, what helped, and what escalated.
• Hold a short debrief within 24 hours with the key staff involved.
• Review whether there was a missed opportunity for choice, predictability, or an earlier break.

CTA: If your service wants a consistent way to debrief incidents and reduce repeat crises, consider aligning your processes with restraint reduction training so learning turns into practical changes on the floor.

How to make the template work in real services

Keep it specific enough for agency staff

A plan that says “use a calm approach” is not enough. Instead, describe what a calm approach looks like for this person: where to stand, what tone to use, how many words, and what to offer first.

Build in measurement without making it burdensome

You do not need complex charts to start improving. Decide on 2-3 measures your team can collect consistently, such as:

• Number of incidents per week
• Number of times the person used the new skill
• Use of reactive strategies (and which ones were needed)

Link behaviour support to quality of life

Plans are strongest when they are not only about reducing risk, but also about increasing good days. Ask: what will the person be doing more of if the plan is working? More community access, more choice, better sleep, more meaningful relationships?

Make review routine, not reactive

Set a short, scheduled review meeting. Even 20 minutes every 4-6 weeks can prevent drift. Use the same agenda each time: what has improved, what has got harder, what changes should we trial next, and how will we know?

CTA: If you support a mixed provision and want a joined-up approach across ages, you may also want to explore our support for children's services resources.

FAQ

Who should write the plan in adult social care?

Ideally it is written with the person (as far as possible) and those who know them best, then reviewed by a clinician or specialist where the risk and complexity call for it. What matters most is that the people delivering support every day understand and own the plan.

How long should a PBS-style support plan be?

Aim for a one-page summary plus detail that staff can use. Many teams do well with 6-12 pages, depending on complexity. If it is longer, include a clear front page that covers “what to do first”.

How often should the plan be reviewed?

Review on a routine cycle (for example every 4-6 weeks) and sooner if there is a significant change in health, placement, staffing, or incident frequency.

What if the plan includes restrictive interventions?

Keep the focus on prevention and least restrictive options. Describe thresholds, responsibilities, recording, and aftercare clearly, and make sure staff competence and training match what the plan expects.

How do we show that the plan is working?

Track a small number of measures consistently and look for trends. Pair incident data with quality-of-life indicators (such as community access or sleep) so progress is not reduced to “fewer incidents” alone.

Simple checklist you can use in supervision

• Can the staff member explain what the behaviour is communicating, without blaming language?
• Can they name the top three proactive strategies and when to use them?
• Do they know early signs and the first response steps?
• Are recordings factual and complete, with enough detail to learn from?
• Has anything changed in health or routine that should trigger a review?