PBS and Human Rights: Reducing Restrictive Practices in Social Care
Positive Behaviour Support (PBS) isn’t just about reducing behaviours — it’s about upholding rights. At its core, PBS is a human rights-based approach that aims to reduce or eliminate the use of restrictive practices wherever possible.
🛑 What Are Restrictive Practices?
Restrictive practices include any action that limits a person’s freedom of movement, decision-making, or access to the community. This may include:
- Physical restraint
- PRN (as-needed) medication for behavioural reasons
- Locked doors or controlled access
- Limited choices or over-structured routines
Sometimes restrictions are legally justifiable — but PBS challenges us to ask: Is there a better, less restrictive way?
⚖️ The Human Rights Foundation of PBS
PBS is aligned with key human rights principles, including:
- Dignity and respect — seeing the person first
- Autonomy — supporting choice, not just safety
- Proportionality — using the least restriction for the shortest time
- Accountability — recording, reviewing, and justifying any restrictions
By embedding these values into practice, providers reduce reliance on restrictive interventions and demonstrate ethical, high-quality care.
📝 What to Show in Tenders and Inspections
When discussing PBS and restrictions, commissioners and inspectors want to see:
- Clear policies for monitoring and reducing restrictions
- Staff training on rights-based approaches and de-escalation
- Data showing reduced use of restraint or PRN medication
- Service user and family involvement in planning and review
It’s not just about compliance — it’s about building a culture where restriction is a last resort, not a routine.
🌱 The Future of PBS Is Rights-Based
Services that embed PBS with a human rights lens don’t just deliver safer care — they deliver more empowering care. And that’s exactly what commissioners and the CQC want to see.
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Updated for Procurement Act 2023 • CQC-aligned • BASE-aligned (where relevant)