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Behavioural & Mental Health

The behavioural 4-tier model will be utilised by Keystone Care when providing participants with
Positive Behaviour Support Services. This model focus’ on the management and prevention of
behaviour and outlines specific ways in which Keystone Care can assist in preventing negative
occurrences that may significantly impact the participant or other individuals.
Keystone Care recognises and understands that restrictive practices may only be used under certain
circumstances, and will ensure to do so in a lawful, respectful, and compliant way. Workers must
always consider the ethical and moral principles when utilising any method to manage difficult
behaviour. Keystone Care will not, under any circumstances utilise restrictive methods on individuals
where it is not necessary or approved by the NDIS Commission. Keystone Care will always aim to utilise
a more appropriate method and utilise restrictive methods as a last alternative.
CEO/Director Responsibilities—
➢ Ensure no unauthorised persons without the necessary qualifications are offering behavioural
support to participants.
➢ To ensure all practices are in accordance with relevant legislation and standards.
➢ Ensure restrictive practices are only used when the appropriate measures have been taken.
(Appropriate measures meaning obtaining approval form the NDIS Commission)
➢ Enforce this policy and procedure equally across all persons within Keystone Care
➢ Perform regular audits to see areas for improvement
➢ Implement the necessary measures for improvement.
➢ Assess improvement and document in accordance with the Continuous Improvement Plan.
Management Responsibilities—
➢ To ensure the practices implemented are adhered to and followed by all.
➢ Ensure workers have the ability to access resources that improve their professionalism when
managing difficult or inappropriate behaviour.
➢ Ensure Workers are encouraging participantsto partake in activities that improve their quality
of life.
➢ To ensure participants have the opportunity to access external support services (such as
counselling services).
➢ To frequently access the behaviour interventions implemented.
➢ To promote productive interactions between participants.
➢ To ensure professionally accredited persons can be accessed for their service, in supporting
participants with difficult behaviours.
➢ To ensure the participant’s related personnel are welcomed to the discussion of the
participant’s needs and requirements.
➢ To ensure participants with a history of complex behaviour are prioritised in the management
of behaviour.
➢ Conduct annual reviews to keep up to date with relevant legislation and regulations.
Workers Responsibilities—
➢ Acknowledge room for improvement.
➢ Make suggestions to the Management or CEO/Director on ways to improve the delivery of
quality care.
➢ Make suggestions regarding new policies and procedures.
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➢ Ensure to enforce quick responsive measures in the event of an incident or if a participant
appears to be subject to any form of harm or injury.
➢ To aim to minimise the use of restrictive methods.
➢ Take reasonable measures to protect themselves from harm.
➢ Take reasonable measures to prevent damage to the facility of Keystone Care.
Positive Behaviour Support
Management of Keystone Care is inclusive of monitoring participant behaviours and ensuring there
are methods developed to combat any negative behaviour, with positive behaviour support.
Keystone Care will ensure efficient communication is had between workers, participants, and their
advocates/family, to discuss any negative behaviours and how they can support the participant,
aiming to improve their behaviour. This discussion should be as sensitive and professional as possible,
ensuring not to hinder the participant’s rights. As Keystone Care promotes and implements a personcentred approach, it is against policy to use any form of restraint to manage participant behaviour.
This policy and procedure will be used in conjunction with the Assessment, Planning and Review Policy
and Procedure.
The 4-Tier Positive Behaviour Support Model
Another method used to implement positive behaviour support is the 4-tier model. The stages of this
model are as followed:
Step 1
• Implementation of prevention strategies (universal strategy)
•- used when participants have a minor behavioural issue
•- negative behaviours are identified and a basic prevention strategy implemented
Step 2
• Risk and response to potential harm (primary response)
•- used with vulnerable participants, who may be a danger to themselves/others
•- requires case management to correct their negative behaviour
Step 3
• Response to harm (secondary response)
•- used with participants who have previously harmed themselves/others
•- workers must be trained with emergency interventions, management and response
Step 4
•Response to serious harm
•- used with participants who reguarly harm themselves/others
•- workers will have speciality training in intensive support, case management, emergency intervention
and accommodation to decrease potential for negative behaviour


see images on policy manual..