12th March 2014

Restrictive intervention / restraint

People with different conditions and in different settings may need care and support that involves both positive support (such as positive behaviour support (PBS), as a specific model of support), and some form of restrictive practice or intervention; this could be physical restraint or use of devices, medication or seclusion.

Image: Restrictive Practices.Any restrictive intervention must be legally and ethically justified; broadly it must be absolutely necessary to prevent serious harm and it must be the least restrictive option.  Workers should always aim to meet an individual’s needs with dignity and respect - in a way that minimises the risk of harm to the person being supported and the person implementing the intervention.

A positive and proactive workforce; A guide to workforce development for commissioners and employers seeking to minimise the use of restrictive practices in health and social care

Skills for Health are working with Skills for Care to co-produce guidance on commissioning or delivering workforce development for adult social care workers and health workers in England who may need to carry out restrictive practices or interventions as part of positive support for people with social care needs who can display or are at risk of displaying behaviour that challenges or are resisting essential care.

The new guidance will improve commissioner and provider decision making when planning, purchasing or providing learning and development about supporting people positively and carrying out restrictive practices and interventions as part of that. A clear framework for workforce development decisions in this area will also help to rationalise the investment needed in learning and development.

Commissioners and providers will have a mechanism that they can use to improve skills and knowledge and expertise of workers needing to understand the role of a personalised approach to support. This new guidance will also be useful to employers in the housing and other sectors.

Skills for Health and Skills for Care have been working in partnership with co-production focus groups representing experts in PBS, people with learning disabilities, mental health problems, autism, older people, family carers, commissioners, social care employers and learning providers to draw up a draft framework. The framework is being tested in action by a broad range of partners in a variety of environments.

The framework will form part of the new guidance which will be published at the launch of ‘Positive and Safe’, the Department of Health’s two-year programme, to end the use of outdated and damaging restrictive practices, including physical restraint, in health and care services at an event in London on 3 April 2014.

Launch event

The Positive and Safe launch event is being hosted by the Royal College of Nursing (RCN), Skills for Health and Skills for Care and will bring together people in need of care and support, and carers, health and care practitioners, academics and policy makers. It includes the launch of the Department of Health guidance on minimising the use of restrictive practices in health and social care and the Skills for Health and Skills for Care workforce development guidance for commissioners and employers, seeking to minimise the use of restrictive practices in health and social care.

Confirmed speakers include Minister of State for Care Services, Norman Lamb and Department of Health Director General for Social Care, Local Government, Care Partnerships, Jon Rouse.

This event  will be followed up with events in the North West and South West which are open to people from across the country, in late April and early may.  These events will recognise the contributions that the focus groups have made to this work and will allow people to consider how the guidance can be implemented in their local area. Dates to be confirmed soon.

For further details please see our Projects page: Physical intervention/restraint