We were all appalled and shocked by the revelations of abuse by staff at Winterbourne View, which prompted a national overhaul of the way we manage and support people with behaviour that challenges in care settings.
New guidance on use and reduction
This month, the Department of Health has launched guidance for health and social care services on how to reduce the use of so-called ‘restrictive interventions’ to safeguard the people in our care. The guidance aims to support a culture where restrictive interventions are only ever used as a last resort and only then for the shortest possible time.
It defines the type of restraint that should be prohibited, such as holding people face down and restricting their airway or circulation. It states that if a restrictive intervention is used, it should be the minimum and for the shortest amount of time. Interventions should be enshrined in agreed care plans and not include seclusion.
Governance and monitoring
The guidance also sets out mechanisms to ensure accountability for making improvements, including effective governance, transparency and monitoring by providers. The audience for this paper is not only providers of health and social care, but also the police and the prison service. It requires board-level governance of restrictive interventions in services, through policies which are available to Service Users and their families. Boards and providers will also be required to report to commissioners on the use of restrictive practices in their organisations.
In addition to reporting to commissioners, organisations monitored by CQC will be subject to scrutiny through the inspection process. The guidance will inform the way CQC monitors and reports on this area of practice and providers will be expected to show progress in the reduction or removal of restrictive intervention through their inspections.
Who is the intended audience?
It is essential that those managing and working in services caring for people who are exposed to restrictive interventions, should review this guidance and integrate it into their services. These includes services for people with autistic spectrum conditions and learning disabilities, but it also applies across any adult health and social care settings where people using services may, on occasion, present with behaviour that challenges but which cannot reasonably be individually predicted and planned for.
The full guidance document can be found at:
