Understanding Restraint, Care and Control

Protecting the vulnerable people in our care and clearly balancing both safety and independence for individuals are increasingly important issues.

Understandably, many managers and professionals in our field feel sensitive when discussing the many aspects of restraint practice.   This undeniably an emotive issue and needs careful consideration. 

The regulatory guidance for the care of older people requires care homes to have a policy in place regarding restraint, and requires sufficient and able staff to be available to deal with situations appropriately. 

Building on our experience in delivering Edexcel-accredited BTEC certificate awards in physical restraint, dynamis delivers a training course which specifically addresses the rights, responsibilities and risks which staff must be aware of so that they may minimise the need for and - when the circumstances call for them - the positive use of appropriate restraint methods.

Incorporating a fundamental understanding of the legal and ethical principles which help your staff to make good decisions, our training also ensures that organisations and managers have the information and clarity they need to reduce risk and liability for all concerned.

We must acknowledge the vulnerability of staff in some exceptional circumstances and support their rights, under health and safety law, to work in an environment which respects their wellbeing while also safeguarding their often vulnerable clients. 

Under Health and Safety statute and the principles of Duty of Care, staff must be enabled with the available and appropriate methods to minimise any risk of harm.

Even in positive environments, where the risk of aggression or harmful behaviour is low, there may be times when staff must make crucial decisions about restricting liberty.    

Wherever our staff might potentially need to restrict an older person’s liberty, they should feel confident that they know when, how and why restraint is appropriate.  Only educated staff can use informed judgement to act appropriately and in the best interests of their clients.

There are few more sensitive areas in the field of care than that of the purpose, time and place for physical intervention with service users.  Management have duty of care for both staff and service users.  Care professionals must balance care with risk.  Its not easy, and we recognise this.

Our training in this area seeks to wash away much of the confusion and misconception which abounds, while ensuring that staff have the confidence to act appropriately if and when they ever need to physically intervene with a service user.

Of course, the professional directive is to avoid the need for physical restraint wherever possible, however in exceptional circumstances, the need for competency and skill is paramount.

Our Physical Restraint course has been developed by leading specialists in the field, NFPS Ltd, who have rigourously deeloped the course to Edexcel-accredited BTEC standard, ensuring the highest levels of occupational relevance and due diligence.

Primarily, it is clear that the staff who are called upon to carry out these duties need to be enabled, supported and trained to recognise how the law applies to their work and how it governs the appropriate responses they should make when faced with a given scenario.

Being a competency-based skill, physical intervention requires the acquisition of appropriate physical capability, enablement of sound decision-making, knowledge of risk factors relating to the employment of those skills, and a clear unambiguous understanding of the Law.

To carry the highest relevance to those who need these skills, holding methods, whether restrictive or non-restrictive, should be hierarchical by design and in practice, allow the application of force at a level which is appropriate and necessary to the scenario.  This ensures that staff have a complete “incident management toolbox” when they approach a situation, especially when coupled with sound communication strategies.

Restraint methods need to be easy-to-learn and retain and should be applicable to as many situations in which they may be needed as possible.  They also need to take into consideration that in applying force to a person, the principles and advice relevant to manual handling also apply.

Due to inherent risks of serious injury and even death which can occur when ill-designed or inappropriate methods are used by staff attempting to control and restrain a subject, there must be careful consideration of the contributory factors which can heighten those risks.  Measures should then be taken to reduce them - most critically by educating staff to recognise and act on them.

In summary, the use of force in order to protect service users is a unique demand of the caring profession and requires competent, recognised training to minimise the risks involved.

Knowledge, Skill and Judgement

Our restraint training, regardless of the setting, ensures that staff develop competent judgement.  To adequately manage risk, staff must:

1. •Understand what restraint is
   

1. •Provide person-centred care that minimises the need for restraint
   

1. •Understand the legal and ethical frameworks relevant to restraint
   

1. •Know what to do if they suspect inappropriate or abusive use of restraint
   

1. •Understand the circumstances in which restraint may be legally or ethically required
   

1. •Understand how to minimise the risks if restraint is used.