Understanding Behaviour Through Sensory Smell and Taste in PBS: Recognising Hidden Triggers in Daily Routines

May 12, 2026

Positive Behaviour Support requires services to understand how smell and taste can affect behaviour. The Positive Behaviour Support knowledge hub supports providers to connect behaviour, communication, proactive support, rights and reduction of restrictive practice.

In specialist services, understanding behaviour through PBS means looking beyond visible routines and asking what the person is smelling, tasting or anticipating. Food smells, cleaning products, perfumes, medication taste, oral care products, communal kitchens and public spaces can all influence behaviour.

This reflects PBS principles and values, because support should adapt around the person’s sensory experience. Strong services do not treat refusal or avoidance as oppositional before checking whether smell or taste has made the situation difficult.

Concept Explained Clearly

Smell and taste are powerful sensory experiences. They can affect appetite, comfort, nausea, anxiety, memory, tolerance of personal care and willingness to enter particular spaces. Some people may be highly sensitive to specific smells or tastes, while others may seek strong flavours or scents for regulation.

Behaviour linked to smell or taste may include refusal of meals, leaving rooms, gagging, shouting, pushing items away, covering the face, avoiding personal care, rejecting medication or becoming distressed in kitchens, bathrooms or vehicles. In PBS, these behaviours should be understood as possible communication that the sensory environment is uncomfortable or overwhelming.

Why It Matters in Real Services

When smell and taste are missed, staff may focus on the wrong explanation. A person may be recorded as refusing food when the smell of the meal is the issue. They may be described as avoiding oral care when the toothpaste taste is intolerable. They may leave a room because of cleaning products rather than social interaction.

This can lead to unnecessary pressure, reduced choice, poor nutrition, missed medication, personal care difficulties and reduced community access. Commissioners and CQC will expect providers to evidence that sensory needs are understood and that reasonable adjustments are made before restrictive or task-led responses are used.

What Good Looks Like

Strong services demonstrate that smell and taste preferences are known, recorded and reviewed. Staff understand which smells the person avoids, which tastes they prefer, how they show discomfort and what substitutions or adjustments help.

Good PBS practice adapts routines before distress builds. Staff may change cleaning times, offer alternative products, separate food smells, provide choice around flavours, prepare the person for unavoidable smells and record whether adjustments improve outcomes. This creates a clear line of sight from behaviour to sensory trigger, from sensory trigger to support action, and from action to outcome.

Operational Example 1: Mealtime Refusal Linked to Cooking Smells

Step 1 – Situation identified: A person in supported living often refused dinner before seeing the meal. They left the kitchen area, covered their nose and later asked for plain snacks.

Step 2 – Sensory pattern reviewed: The provider compared refusals with meal preparation notes. Refusals were more likely when strong-smelling foods such as onions, fish or spiced sauces were cooked in the open-plan kitchen.

Step 3 – Support approach: Staff adjusted meal planning so stronger-smelling food was prepared with better ventilation and advance notice. The person was offered a choice of a milder alternative without being pressured to remain in the kitchen.

Step 4 – Day-to-day delivery detail: Staff showed the person the meal options visually before cooking began. Where a strong smell was unavoidable, the person used a quieter room during preparation and returned when the smell had reduced.

Step 5 – How effectiveness was evidenced: Meal refusal reduced, intake improved and staff records showed fewer distress signs around dinner preparation. The provider evidenced that behaviour was linked to smell sensitivity, not simple food refusal.

Deepening the Understanding: Smell and Taste Can Trigger Memory and Emotion

Smell and taste can connect strongly with memory, emotion and physical response. A smell may remind someone of a previous unpleasant experience. A taste may create nausea or anxiety before the person can explain why. Strong PBS services treat these responses as valid information, even when the trigger seems minor to staff.

Providers should be able to evidence how sensory information is gathered from the person, family, staff observation and routine review. Sensory triggers should not remain informal knowledge held by one staff member. They should be built into PBS plans and daily support guidance.

The related article on seeing behaviour as communication in PBS reinforces why sensory avoidance should be understood as meaningful communication before staff decide how to respond.

Operational Example 2: Oral Care Distress and Toothpaste Taste

Step 1 – Practice concern: In a residential service, a person pushed away the toothbrush and became distressed during oral care. Staff initially believed the person disliked toothbrushing itself.

Step 2 – Detail checked: The team reviewed the routine and found the person tolerated the toothbrush when no toothpaste was used. Distress increased when strong mint toothpaste was introduced.

Step 3 – Support adjusted: Staff trialled a milder flavour with dental advice and gave the person control over holding the toothbrush. The routine was shortened while trust was rebuilt.

Step 4 – Consistency secured: The oral care plan specified the accepted toothpaste, amount used, staff wording and pause signal. New staff were briefed before supporting the routine.

Step 5 – Outcome evidence: Oral care tolerance improved, distress reduced and dental hygiene records became more consistent. The provider evidenced that taste sensitivity had been a key factor in behaviour.

Systems, Workforce and Consistency

Sensory smell and taste support must be consistent across the workforce. If one staff member uses accepted products and another changes them without warning, distress may return quickly. Strong services include sensory guidance in PBS plans, care plans, mealtime records, shopping lists, handovers and supervision.

Managers should review whether products, menus and environments are changed without considering sensory impact. Supervision should explore whether staff dismiss sensory responses because they personally find the smell or taste acceptable. Handovers should include any new reactions to food, products, medication or environments.

Operational Example 3: Cleaning Product Smell and Room Avoidance

Step 1 – Access issue: A person began refusing to enter the communal lounge after morning cleaning. Staff thought they were avoiding other residents, but refusal happened before the lounge became busy.

Step 2 – Environment reviewed: Observation showed that a strong disinfectant smell remained after cleaning. The person covered their face and backed away from the doorway.

Step 3 – Support response: The provider changed cleaning timing, improved ventilation and trialled a less intrusive product that still met infection control requirements.

Step 4 – Practical delivery: Staff checked the lounge before inviting the person in and offered an alternative space until the smell reduced. Cleaning changes were recorded so all shifts followed the same approach.

Step 5 – Evidence reviewed: Lounge access improved, refusal reduced and the person spent more time in shared space. The provider evidenced that environmental smell, not social avoidance alone, was affecting behaviour.

Governance and Evidence

Governance should show how smell and taste triggers are identified, recorded and reviewed. Providers should be able to evidence sensory profiles, PBS plan updates, mealtime records, product reviews, incident analysis, staff briefings, supervision notes and outcome monitoring.

Strong governance connects sensory experience to daily outcomes. Records should show what smell or taste was present, how the person responded, what staff changed and whether the outcome improved. This creates a clear line of sight from behaviour to sensory need, from sensory need to practical adjustment, and from adjustment to outcome.

Commissioner and CQC Expectations

Commissioners expect providers to understand sensory needs because they affect nutrition, personal care, community access and quality of life. They need assurance that providers adapt support before behaviour escalates or opportunities are reduced.

CQC will expect care to be person-centred, responsive and respectful. Inspectors may review whether staff understand sensory preferences, whether care plans are followed, whether health needs such as nutrition and oral care are supported, and whether restrictions are proportionate. Strong services demonstrate that sensory support is practical, recorded and evidence-led.

Common Pitfalls

Recording food refusal without checking smell, taste, texture or preparation environment.
Changing toothpaste, soap, detergent or cleaning products without reviewing sensory impact.
Assuming a smell is acceptable because staff do not find it strong.
Using pressure when the person is showing sensory discomfort.
Failing to link oral care distress with flavour, pain or product tolerance.
Keeping sensory knowledge informal instead of adding it to PBS guidance.

Conclusion

Understanding behaviour through smell and taste helps PBS teams recognise hidden sensory triggers in ordinary routines. Behaviour may communicate discomfort, nausea, memory, anxiety or sensory overload before the person can explain it in words.

Strong providers adapt products, environments, meals and staff responses so support becomes more tolerable and respectful. They evidence how sensory adjustments improve care, participation and quality of life. This gives commissioners and CQC confidence that PBS is detailed, practical and person-centred.