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New restraint training standards launched to support staff to minimise use of force

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A new set of training standards for restraint have been launched today in a bid to reduce the use of restrictive practice and to provide a national “benchmark” for supporting vulnerable people.

The new guidance will “support staff in health and social care services to understand and apply the principles of minimising use of force” and promote human rights and person-centred care, according to a leader in mental health at the Care Quality Commission.

“The standards will support staff in health and social care services to understand and apply the principles of minimising use of force”

Paul Lellilott

The new standards, produced by the Restraint Reduction Network, will be mandatory for restraint training delivered in NHS-commissioned services for people with mental health conditions, learning disabilities, people with autism and people living with dementia in the UK.

The independent body behind the standards, brings together government departments, professional bodies, people with lived experience, practitioners and academics to work together to help reduce the use of restrictive practice.

It said it hoped that the latest guidance would provide a national and international benchmark for training in supporting people who are distressed in health and social care and education settings.

According to the network, the standards are designed to:

  • Protect people’s fundamental human rights and promote person centred best interest and therapeutic approaches to supporting people when they are distressed
  • Reduce reliance on restrictive practices by promoting positive culture and practice that focuses on prevention, de-escalation and reflective practice to minimise use of restrictive practices
  • Increase focus on prevention, understanding of the root causes of behaviour and recognition that many behaviours are the result of distress due to unmet needs
  • Improve staff skills and confidence in how to keep people safe in crisis and to better understand how to meet people’s needs in order to prevent crisis situations
  • Improve the quality of life and protect the fundamental human rights of people at risk of being restrained and those supporting them
  • Where required, focus on the safe use of restrictive interventions including physical restraint

The system regulator the CQC is one of the organisations under the umbrella of those that have committed to the Restraint Reduction Network.

Dr Paul Lellilott, deputy chief inspector of hospitals and lead for mental health at the CQC, said the health watchdog had been “concerned about the use of restrictive practices for some time” and so are now pleased to see the launch of the new Restraint Reduction Network Training Standards.

“The standards will support staff in health and social care services to understand and apply the principles of minimising use of force with the aim of promoting human rights and person-centred care of the people they are caring for,” he said.

Mr Lellilott added that the CQC was looking forward to seeing the standards rolled out, which are due to be implemented via commissioning requirements and inspection frameworks from April 2020.

“We hope that the standards will provide a national and international benchmark for training and supporting people”

James Ridley

A university lecturer and nurse who spent his career caring for people with learning disabilities, helped co-write the guidance.

James Ridley, a senior lecturer in pre-registration nursing (learning disability) at Edge Hill University, said: “Having worked for over 25 years in the social care sector I am very aware of the use of restrictive practices and how distressing this can be both for the individual involved and the person doing the restraining.

Mr Ridley explained how the authors of the standards wanted to approach restraint from a human rights perspective, noting the rights of the staff, carers and parents involved, as well as the individual.

“Essentially the standards focus on a move towards understanding why somebody gets in a distressed state, in the hope that an alternative mode of behaviour might help support them and thereby minimise the use of restraint,” he said.

“There will be times when a form of restraint will need to be used and, in these cases, we want the member of staff, carer, or family member to be informed about what they should do and what they should be considering,” said Mr Ridley.

He added: “While there are a number of organisations providing training these vary greatly and staff can be trained to use restrictive interventions which may not be appropriate.

“We hope that the standards will provide a national and international benchmark for training and supporting people across the health, educations and social care sectors,” he said.

Nursing Times attended a conference about the standards in February where chair of the network and professor of mental health at Manchester Metropolitan University, Joy Duxbury, noted that the guidance “will weed out some trainers” who may be overwhelmed by the standards and what is now required.



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