Co-Producing PBS: Why Families and the People You Support Must Be Central

July 26, 2025

You can’t do Positive Behaviour Support to someone — it has to be done with them. That’s why co-production is a core principle of PBS. If the person and their family aren’t involved in shaping the support, it’s not PBS — it’s just behaviour management. The strongest services anchor this in clear PBS principles and values and apply it through real-world PBS ethical frameworks so involvement is rights-based, consistent, and measurable.

👥 What Co-Production in PBS Really Means

Co-production goes beyond asking for feedback after decisions have already been made. It means involving people from the start — with genuine shared power — in:

Designing support plans and routines
Reviewing goals and progress
Deciding what “quality of life” looks like to them
Shaping service culture, training, and policy

Families, advocates, and circles of support bring insights that professionals often miss. Their voices must be part of the picture — but always in a way that keeps the person at the centre and respects consent, capacity, privacy, and choice.

🧠 Why Co-Production Is Non-Negotiable in PBS

PBS is not a set of tools for controlling behaviour. It is an approach to understanding the function of distress and building support that improves quality of life. Without co-production, providers risk:

Misreading the function of behaviours of concern (because key context is missing)
Designing routines for staff convenience rather than the person’s life and preferences
Creating plans people do not recognise (and therefore do not engage with)
Escalating restriction when support fails to match what the person needs

Co-production is therefore both a rights-based requirement and a quality and safety strategy. It reduces misunderstandings, strengthens trust, and makes plans more likely to work in real life.

🏛️ The Ethical Backbone: Rights, Dignity, and Least Restrictive Practice

Co-production is also how services make “least restrictive” real. Ethical PBS requires that decisions about restriction, risk, and support are transparent and person-led. In practice, that means:

Explaining options in accessible ways (not just in professional language)
Seeking informed involvement wherever possible, not assuming “best interests” by default
Recording the person’s views, including what they do and do not agree with
Reviewing restrictions as time-limited, with an active reduction plan rather than an open-ended “control” approach

If a restriction exists, co-production helps services answer the hard questions: Is it necessary? Is it proportionate? Is it the least restrictive option? What would need to change for it to reduce?

👥 What Co-Production Looks Like Across the PBS Cycle

Co-production should show up at every step of the PBS journey, not just during plan sign-off.

1) Discovery and Understanding

Life story work, routines mapping, and “good day/bad day” exploration
Understanding sensory preferences, triggers, and calming strategies
Capturing what the person values most (relationships, activities, independence, privacy)

2) Functional Assessment and Hypothesis Building

Family and key supporters share early warning signs and patterns
Testing hypotheses collaboratively (“does this fit your experience?”)
Using multiple sources: the person, staff, family, records, and observation

3) Plan Design and Proactive Strategies

Agreeing routines that reflect the person’s real life, not service convenience
Co-designing communication supports (visuals, prompts, accessible scripts)
Making sure preferred activities are meaningful, available, and consistent

4) Teaching Skills and Building Independence

Setting goals that matter to the person (not generic “life skills”)
Agreeing the pace: what is achievable without creating distress
Celebrating progress in ways that feel right to the person

5) Review, Learning, and Refinement

Regular reviews that include the person in the way that works for them
Sharing what’s changed and why, in accessible language
Updating strategies based on lived feedback, not just incident summaries

🗣️ Co-Production When Communication Is Complex

Co-production is not limited to verbal discussion or formal meetings. Many people communicate preferences through behaviour, sensory responses, routine choices, and relationships. Practical options include:

Talking Mats or picture-based tools to explore preferences
Visual timelines and “now/next” structures to support understanding
Objects of reference for routines, activities, and transitions
Observation-led involvement (what the person shows you, consistently)
Supported decision-making with trusted people who know the person well

The key test is not “did we hold a meeting?” but “did we understand and reflect what this person wants, needs, and values — and can we evidence it?”

🏡 Benefits of Family and Individual Involvement

Fewer misunderstandings and breakdowns
Support plans that reflect the person’s actual life
Greater buy-in from the person and their network
Early warning signs spotted and responded to quicker

Involving people isn’t just respectful — it’s strategic. It leads to better outcomes, fewer restrictive interventions, and more sustainable support. It also strengthens continuity, because plans become easier for new staff to understand: they can see what matters, what helps, and what escalates distress.

⚖️ Balancing Family Involvement With the Person’s Rights

High-quality co-production keeps the person at the centre — even when family involvement is high. Good practice includes:

Checking consent: who does the person want involved, and in what way?
Respecting privacy: some topics are personal and should remain person-only
Avoiding “proxy control”: family perspectives matter, but they do not replace the person’s voice
Capacity-aware practice: where capacity is in question, use best-interests frameworks properly and document reasoning

This matters in PBS because restrictions can sometimes become “normalised” through fear, anxiety, or historical narratives. Co-production should surface those dynamics carefully and keep decision-making lawful, ethical, and least restrictive.

🧩 Turning Co-Production Into a Repeatable System

Commissioners and inspectors trust systems they can see and audit. To move co-production from “nice principle” to operational reality, embed:

Accessible planning standards: Easy Read templates, visuals, and clear language expectations
Named roles: who leads PBS co-production (e.g., PBS lead, keyworker, family liaison)
Review cadence: set frequencies (e.g., 4/12-week reviews after plan initiation, then quarterly)
Evidence prompts: required fields for “what the person said/showed”, “what changed”, and “impact”
Learning loops: “you said → we did” summaries shared with the person/family (where appropriate)

When co-production is a system, it becomes more resilient to staffing changes, turnover, and organisational growth.

📣 In Tenders and Inspections

Commissioners and CQC want to see evidence of meaningful co-production. That includes:

Clear processes for involving individuals and families
Accessible care planning tools (visual, Easy Read, etc.)
Examples of how feedback has changed practice
Joint training or learning events with people you support

It’s not enough to say “we involve families.” Show how, when, and with what impact. In tender responses, the most scoreable format is often: process → assurance → evidence → impact. For example, describe your co-production pathway, explain how you make it accessible, provide a brief anonymised example, then state what improved (quality of life, reduced incidents, reduced restriction, improved satisfaction).

🧪 Practical Evidence You Can Include (Without Overloading Word Count)

Even in tight word limits, you can add powerful proof points. Options include:

One-line metrics: “90% of PBS reviews include family/advocate input where consented.”
Short case vignette: a 3–4 sentence example showing co-produced change and impact
Audit outcome: “Quarterly audit checks: voice capture present in 95% of plans; actions completed in 88%.”
Feedback themes: “Top request was predictable routines; response was visual timetables across all homes.”

These prove that co-production is not just philosophy — it is measurable delivery.

For a deeper dive into applying PBS in day-to-day service delivery, visit the comprehensive PBS hub on behaviour, rights and proactive support.

🏁 The Bottom Line

Co-production is not an “add-on” to PBS — it is the foundation that makes PBS ethical, effective, and sustainable. When people and families shape the plan, the plan is more accurate, more likely to work, and less likely to drift into restrictive practice. In a competitive environment, providers who can evidence co-production clearly — grounded in PBS values and ethics — stand out to commissioners and reassure inspectors.