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5.10.4 Physical Intervention: Practice Guidance for Social Workers

AMENDMENT

This chapter was updated in July 2017. Any restraint should be made within the parameters of the child’s Behaviour Management Plan and when a child places themselves or others In direct danger. The subsequent report together with any report from others on shift should then be shared immediately with the Registered Manager and Responsible Individual.


Children in residential Children’s Home at times have to be restrained in respect of managing their safety and being a risk to themselves or to others. No restraint should be used unless outlined and detailed in a risk/behaviour management plan and or the child is placing themselves and or others in direct danger. All children’s homes have restraint procedures and staff must be experienced and fully trained with recognised positive approaches as well as physical intervention techniques.

Restraint also includes restricting the child’s liberty of movement. Restriction on liberty of movement can involve adaptations to the environment such as using high door handles or removing physical aids, but it also refers to behaviour support strategies such a requiring a child to take ‘time out’ in a specific area of the home, asking a child to spend time away from the group to regain control of their behaviour (i.e. if a child is struggling to maintain a socially acceptable level of behaviour at the meal table, asking them to move away from the group to another area, can be defined as restricting their liberty of movement). Where there is no need to use restrictive physical intervention (i.e. the child goes willingly once instructed to do so) a record of the incident must still be recorded (see recording and reporting). This is to ensure the intervention can be monitored and to ensure that children are not be scapegoated or unduly being isolated from the group.

Where the likely application of this strategy is a reasonable assumption due to a child’s previous behaviour or level of emotional needs, this should be included in the ECH Plan/Care Plan. This should be monitored as part of the normal review process. This strategy should be clearly recorded on the child’s Individual Behaviour Support Plan. In this instance, there is no requirement to complete an incident report, unless the behaviour displayed is new, unusual or falls under any other category of incident.

There are recognised restraint techniques which trained staff must apply and adhere to in respect of regulatory requirements and good practice. All Knowsley staff and the majority of children’s homes’ staff are trained in PRICE: Protecting Rights in a Caring Environment, under the principles of which the child/young person should experience minimal restriction or discomfort for a minimal amount of time. All staff undertaking restraint must be trained and must have annual refresher training.

Positive approaches to challenging behaviour must always be exercised first and as such physical restraint should only be used as a LAST RESORT when: other more positive interventions have not worked or there or if there is an immediate; real risk of harm to the young person; others are at risk or there is a risk of significant damage to property.

When a restraint does take place, it is the responsibility of the Children’s Home to bring this to the attention of the social worker immediately, during office hours by telephone in the first instance and then with a written incident form. In addition we are asking the Children’s homes to also inform ART in writing (incident form) of any restraint that takes place in addition to the allocated social worker.

All staff members should ensure a report is written following an incident and within the same shift if a restraint is used of any type.

The Registered Manager for the home is responsible to make all notifications to Ofsted in line with the regulations and this should include the actions and plans going forward to reduce any risk of restraint. The notification will be shared with the Head of Service.

Social workers and Independent Visitors are responsible to undertake the following duties, when conducting a visit to a child/young person placed in a residential children’s home:

  • When undertaking statutory visits, all social workers and independent visitors must review the daily log and any restraints that take place. This record should indicate that the child has been spoken following the restraint with their views about the incident and actions taken ascertained;
  • The independent Reviewing Officer will review any restraints and raise this at the next Looked After Children (LAC) Reviews;
  • Patterns of restraints should be considered at all LAC reviews;
  • Following contact in respect of a restraint or when a restraint rises cause of concern; such as bruising to a child/young person or the Police being called - this must be immediately addressed with both the child/young person and the Children’s home manager or senior officer on duty. The purpose of this is to ascertain directly from the child/young person their welfare and to be given a written record from the Children’s Home to support the verbal account given;
  • The matter must be escalated to the Team Manager or Head of Service (if manager is not available). A visit to the child/young person by a social worker should also be considered;
  • Consideration will be given as to the incident, circumstances and restraint procedures being applied and adhered to by the responsible team manager or Head of Service. At any time, in-house children’s home Registered Managers are also available for consultation re: the restraint incident itself and relevant practice responsibilities;
  • Social workers should be aware that the physical restraint is only one form of restriction of liberty which is governed by clear behavioural standards, techniques and training. Other forms of physical intervention which are generally not permitted include the locking of doors both internal and external.

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