Care Agency’s Learning Disability Services recognised for excellence in Positive Behaviour Support

The Care Agency’s Learning Disability Services in Gibraltar has been recognised by the British Institute of Learning Disabilities (BILD) for its excellence and innovation in Positive Behaviour Support (PBS), reflecting over 15 years of person-centred, evidence-based approaches to enhancing care for individuals with learning disabilities.

The Service has aimed to promote effective, person-centred support strategies, helping individuals with learning disabilities navigate challenging situations with dignity and respect, over these past 15 years.

Specialist Occupational Therapist/Strategy Coordinator, Rachel Tobelem initially spearheaded the integration of PBS into Learning Disability Services’ framework by integrating BILD resources into training programmes for our support workers.

“These early efforts set the foundation for a structured approach to PBS, equipping our staff with strategies to better support individuals in managing behaviours of concern that may arise in stressful or difficult situations,” said a statement from the Care Agency.

“Over the years, this approach evolved significantly, guided by the values of person-centred care and active engagement, as we incorporated insights from occupational therapy, behavioural support, and established frameworks such as the PERMA model (focuses on enhancing well-being and resilience).”

“By 2009, a Behaviour Consultant introduced Rachel and the Learning Disability Services (LDS) team to the PBS approach, setting the stage for transformative practice shifts.”

This period also marked the Care Agency’s initial membership with BILD in 2010, ensuring continuous access to up to-date research, guidelines, and educational resources.

In 2014, the Care Agency established specialist review weeks consisting of a multi-disciplinary team. These reviews, occurring quarterly until 2019, reinforced the structured use of PBS and supervision practices.

By 2017, the addition of our Behaviour Support Officer/Counsellor, Ashleigh Coombes enriched the team further. This role brought significant expertise in behaviour planning/reviews, data analysis, debriefing and contributing to the overall resilience and skill set of the support staff.

The Care Agency's practice progressed from commissioning external specialists to cultivating internal leadership in PBS. This shift led to establishing multi-agency service development meetings initiated to enhance communication and develop collaborative strategies, including advocating for a National PBS Strategy within Gibraltar.

Ms Tobelem and the team’s work on updating the Care Agency’s Learning and Development Policy in 2021 included making PBS training mandatory and embedding trauma-informed care as a core aspect of staff training.

This holistic focus on well-being aligned with modern support practices, emphasising the integration of Person-Centred Active Support.

She has also extended PBS teachings to departments, including the Department of Education and to the Nursing Degree Students at the University of Gibraltar.

By 2022, Ms Tobelem and Ms Coombes and eight other team members, earned certificates as PBS coaches and functional assessors from BILD.

“This milestone enabled the Care Agency to reinforce a supportive structure where PBS training and functional assessments are embedded in service delivery. Internally, new care plans and review processes were implemented, incorporating Occupational Therapy and PBS frameworks to streamline approaches and promote consistency across practices,” said the Care Agency statement.

“These enhancements unified various methodologies and included video presentations to showcase service user progress, providing a visual tool for measuring and evidencing outcomes.”

“Currently, our work with the BILD Partnership Improvement Programme has been a cornerstone of service evolution. This programme provides a framework for organisations to assess and enhance our PBS performance in line with best practices outlined by BILD.”

“We continue to gather evidence and work on strategic tools, such as the Centre for the Advancement of Positive Behaviour Support (CAPBS) Self-Assessment.”

“Through this initiative, we have not only measured and refined our approaches but also solidified our role in creating an inclusive, supportive environment.”

“The Care Agency remains dedicated to excellence in PBS, drawing on decades of growth and the unwavering commitment of Rachel, Ashleigh and their colleagues.”

“This recognition marks not only past achievements but a firm commitment to future innovation and holistic support for individuals with learning disabilities.”

CEO of the Care Agency, Carlos Banderas, said that the recognition by BILD is a testament to the dedication and hard work of the team over the years. Integrating Positive Behaviour Support into practices has transformed how it support individuals with learning disabilities, ensuring they receive the best care tailored to their needs.

“We remain dedicated to building on this foundation and pioneering further advancements in PBS for the benefit of our community.”

The Minister for Health and Care, Gemma Arias-Vazquez, said that The Care Agency’s dedication to refining Positive Behaviour Support exemplifies the commitment government has towards enhancing services for individuals with learning disabilities.

“This recognition from BILD highlights the outstanding work done by our professionals, ensuring that Gibraltar remains at the forefront of compassionate and effective care practices. We are proud of this achievement and support continued progress in this vital area.”