Reducing Restrictive Practices in Supported Living: A PBS-Led Approach
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Reducing restrictive practices is a core expectation in Supported Living, aligned with PBS values, CQC regulation and human rights principles. For further context, explore Restrictive Practices & Human Rights and PBS in Tenders.
Why restrictive practice reduction matters
Restrictive practices often develop because environments or responses are not meeting a person’s needs. PBS helps teams understand the underlying drivers and build alternatives that increase safety, dignity and autonomy.
1. Start with data and function
- Identify when, why and how restrictions are being used.
- Link restrictive moments to behavioural function — escape, sensory regulation, communication, access.
- Use this insight to design proactive alternatives.
2. Replace restrictions with supportive strategies
- Swap physical prompts for visual cues or paced communication.
- Replace locked doors with agreed traffic-light access plans.
- Introduce sensory-based alternatives instead of PRN usage for regulation.
3. Improve team confidence and skill
- Ensure all staff are trained in low-arousal approaches.
- Rehearse proactive strategies in supervision and team meetings.
- Use reflective practice to analyse difficult situations safely.
4. Involve the person and family
- Agree shared expectations and co-produce escalation plans.
- Discuss human rights implications openly and simply.
- Ensure families understand why restrictive practices are being reduced and how safety will be maintained.
5. Work with commissioners transparently
- Share data trends showing reductions in incidents or PRN use.
- Explain step-down plans for staffing or enhanced support.
- Demonstrate how outcomes are improving alongside reduced restriction.
6. Monitor and sustain change
- Review restrictive practice logs weekly or monthly.
- Update PBS plans dynamically as the person grows in confidence.
- Celebrate reductions — they represent meaningful life changes.
Ultimately, restrictive practice reduction is not just a regulatory requirement — it is a measure of how well a service enables choice, dignity and meaningful autonomy.
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