A Qualitative Investigation of a Setting-Wide PBS Workforce Development Programme in an Adult Disability Setting

The presence of distressed behaviours can amplify the difficulties experienced by people with intellectual disabilities (ID), and place pressure on the provision of effective support by organisations and direct support personnel. Setting-wide positive behaviour support (PBS) is an evidence-based framework aimed at enhancing quality of life and reducing distressed behaviour for people with intellectual disabilities through systemic change. Implementation science offers a route to better understand how we can support organisations to adopt best practice into routine procedures. This study employed a qualitative research design to examine the facilitators and barriers of a workforce development programme in setting-wide PBS in a disability service organisation through semi-structured interviews with staff (n=14). Two conceptual models of implementation science, the theoretical domain framework and the Capability, Opportunity, and Motivation (COM-B) Behaviour change model were adopted to code and analyse participant responses. Positive relationships with adults with ID, effective leadership and supervision and the systemic components of the PBS framework were highlighted as important enablers for behaviour change among participants. Workload, staff turnover, limited resources including lack of investment in workforce development and lack of mentorship were among the barriers identified. Systemic concerns with staff wellbeing, retention and capacity development continue to be prevalent in disability service provision. Outcomes indicate a need for significant investment in widespread, mandatory evidence-based training programmes in quality support for direct support staff, first line managers and service leaders