, and the concept of banning restraint, physical intervention, safe holds (insert preferred term here). Why is that? Isn’t finding an alternative to restraining an individual, whether it is a child or adult a much better outcome for all? Well, in an ideal world yes.
Never having situations where restraint is the only viable option to keep an individual or other people safe would be fantastic. Service users would benefit as not many people like to be restrained. Staff would benefit as they would no longer have to put themselves in danger of physical injury by restraining a service user. Unfortunately in the real world, this simply isn’t the case, and here is why.
Before we go any further, for the purposes of this article and the ease of writing, all physical intervention methods that involve the direct application of force to restrict the movement of an individual will be referred to as ‘restraint’.
What about the risk assessment?
Firstly, if an organisation, school, care facility has a restraint policy it should be informed by a risk assessment. That assessment will be a measurement of known and likely risks that an individual, or groups of individuals may pose to themselves or others. If that risk is present the organisation must, by law, implement all reasonable actions and measures to eliminate or reduce that risk. If the identified risks include violence, aggression, self-harm or any threat to the physical welfare of a service user or others, then appropriate measures must be put in place to prevent or reduce those risks.
Secondly, if a risk assessment has been carried out and the risk of violence, aggression, self-harm etc. has been identified, but the organisation only goes so far in its reduction of risk to the point where those measures are not fit for purpose, the organisation is at risk of breaking the law. Low level strategies will only go so far in the management of aggression, and removing the option of reasonable force will raise the risk of harm to all. You can read more about
risk assessments and risks to employees here.
Would restraint reduction strategies work better?
At COVIC Training Solutions, we are known as a leading training provider for restraint and personal safety training. That is a given. However, the bulk of what we actually teach could be described as ‘restraint reduction’ strategies such as conflict management, positive behaviour support, and effective communication techniques. Why? Because it has been proven time after time that strategies such as these significantly reduce the number of incidents an organisation may experience. Furthermore, the ethos of any given organisation has a huge impact on the mind-set of its staff.
Ultimately it is right that we do all in our power to NOT use force. With that said, we must also prepare to have to use force if a particular situation makes it a necessary option.
Does the Care Review raise important issues?
The report from the Care Review raises some very salient points, particularly around the use of restraint as a form of abuse and/or punishment. I completely and unreservedly agree with the Care Review on this. Restraint should NEVER be used as such, and should only be used in the prevention of harm. The Care Review also highlights a few techniques that potentially increase the risk of harm during an incident. Again, I completely agree with their findings.
So should restraint be completely banned?
Absolutely not! There are many restraint packages available, and some are better than others, but those that are worth their weight in gold are those that work and are safe. A simple analogy that works for me is ‘cars have killed many people so we should ban all cars’. Is this a reasonable measure? Of course it isn’t. The need for transport is still there. The need for people and businesses to get around the country hasn’t gone away, and the same can most certainly be said about the risks some service users pose. Banning restraint doesn’t reduce the risk.
Is the Care Review keeping people safe?
In short, if the Care Review can guarantee carers, and anyone working with service users will not be put at risk by aggression and violence from service users, and never have to manage incidents of self-harm, then I will be at the forefront of having restraint banned in all organisations, and will then have to find another job. Until then, I will continue to train staff in safe, appropriate, and effective methods of restraint alongside actively promoting methods of how to minimise the need for it.
A final thought…
Let’s consider the ramifications on the carer/teacher/someone in charge of a young person. If a
service user physically attacks a carer, teacher, member of staff and that
staff member fears for their life
and uses reasonable physical force to stop the assault from continuing, should that carer be punished? Should they lose their job? I’ll take that thought further. The carer has been told restraint is no longer an option so the carer decides their only option to protect themselves is to strike the service user. Again, should the carer be punished? Should they lose their job? Are the Human Rights of the carer not as important as those of the service user? Should carers just expect that their
life is put on the line
when giving care?