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{{org_field_name}}

Registration Number: {{org_field_registration_no}}

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Positive Risk-Taking and Risk Enablement Policy

1. Purpose

The purpose of this policy is to set out {{org_field_name}}’s approach to enabling positive behaviour, positive risk-taking, and the careful management of restrictive practices, including restraint, in line with the core principles of autonomy, dignity, rights, safety, and safeguarding.

{{org_field_name}} recognises that taking positive risks is an essential part of living a meaningful life. At the same time, we acknowledge that there may be rare occasions where restrictive practices or restraint may be necessary to protect people from harm. These situations must always be carefully assessed, proportionate, lawful, time-limited, and fully accountable.

This policy fully reflects:

• The Health and Social Care Standards: My Support, My Life (2017).
• The Mental Welfare Commission’s ‘Rights, Risks and Limits to Freedom’ (updated 2021).
• The Adults with Incapacity (Scotland) Act 2000.
• The Adult Support and Protection (Scotland) Act 2007.
• The Equality Act 2010.
• The Human Rights Act 1998.
• The SSSC Codes of Practice (2024).

2. Scope

This policy applies to:

• All staff employed by {{org_field_name}} at every level.
• All people we support, regardless of age, condition, or communication needs.
• Family members, legal representatives, and advocates.
• External professionals involved in care planning and safeguarding.
• All forms of risk-taking, restrictive practices, and positive behaviour support.

3. Related Policies

This policy should be read in conjunction with:

• Safeguarding Adults and Children Policy
• Personal Planning and Support Policy
• Equality, Diversity and Human Rights Policy
• Incident and Accident Reporting Policy
• Health and Safety Policy
• Capacity and Consent Policy
• Complaints Policy
• Staff Supervision and Training Policy

4. Policy Statement

{{org_field_name}} is committed to enabling people we support to:

• Live full and meaningful lives.
• Exercise as much control and autonomy as possible.
• Make informed choices, even when those choices involve positive risks.
• Be protected from unnecessary or inappropriate restriction.
• Have their human rights upheld at all times.

We recognise that restrictive practices must always be used as a last resort, for the minimum necessary time, and only when lawful, proportionate, and fully risk-assessed.

5. Links to Health and Social Care Standards

This policy fully reflects the following principles and Standards:

• 1.2: My human rights are protected and promoted.
• 1.3: If my independence, control and choice are restricted, this complies with relevant legislation and is justified, transparent and kept to a minimum.
• 1.6: I get the most out of life because the people and organisation who support and care for me have an enabling attitude.
• 2.24: I am supported to understand and uphold my rights.
• 2.25: I can live my life in the way that I choose and experience as much control and independence as possible.
• 2.26: If I have restrictive practices used, these are the minimum necessary, involve me and are reviewed regularly.
• 4.1: My care and support is provided in a planned and safe way.
• 4.11: My care and support is based on relevant evidence, guidance and best practice.

6. Understanding Positive Risk-Taking

6.1 What is Positive Risk-Taking?

Positive risk-taking involves supporting individuals to pursue meaningful life choices that may involve risks, while minimising potential harm through robust planning and support.

• Risk is part of life and contributes to self-esteem, growth, confidence and independence.
• Avoiding all risks may lead to harm through social isolation, boredom, loss of skills, or institutionalisation.
• The goal is not to eliminate risk but to enable people to weigh options, understand consequences, and make informed choices.

6.2 Legal and Ethical Basis for Positive Risk

• Adults with Incapacity (Scotland) Act 2000: decisions made on behalf of someone lacking capacity must promote their welfare and least restrictive option.
• Adult Support and Protection (Scotland) Act 2007: protects adults at risk of harm.
• Human Rights Act 1998: upholds autonomy, privacy, dignity, and proportionality in all care decisions.

7. Restrictive Practices

7.1 Definition

Restrictive practice refers to any intervention or action that limits a person’s rights, freedom, choices, movement or ability to live as independently as possible. Restrictive practices are only ever used as a last resort, and only:

• To prevent immediate or serious harm to the person or others.
• When absolutely necessary and proportionate.
• When lawful, properly consented, authorised and regularly reviewed.
• When no less restrictive alternatives are available.

Restrictive practices are not part of routine care and should be avoided wherever possible by promoting positive behaviour support, de-escalation, and preventative care planning.

The main types of restrictive practices are described in detail below, along with how {{org_field_name}} handles each:

7.2 Physical Restraint

Description:
Physical restraint involves any use of force, hands-on technique, or physical hold to limit a person’s movement or prevent them from causing harm. Examples may include holding someone’s arm to stop self-injury, guiding someone away from danger, or preventing a physical assault.

Management at {{org_field_name}}:

• Physical restraint is used only in emergency, life-threatening situations where there is immediate risk of harm.
• Staff receive training in de-escalation, conflict resolution, and safe handling techniques where risk assessments indicate this may ever be required.
• Any physical intervention must be:
  • The least forceful necessary.
  • For the shortest possible time.
  • Stopped as soon as the risk reduces.
• Restraint must never be used for punishment, compliance, or staff convenience.
• All incidents are fully recorded, reviewed, and reported to management.
• Post-incident reviews involve the person supported, their representatives and relevant professionals.

7.3 Mechanical Restraint

Description:
Mechanical restraint involves the use of equipment or devices to restrict freedom of movement. Examples include:

• Lap belts, harnesses or wheelchair straps.
• Bed rails.
• Protective helmets or mittens.
• Safety vests or chair inserts.

Management at {{org_field_name}}:

• Mechanical restraint is only considered following multidisciplinary assessment and where the intervention reduces a specific, clearly identified risk (e.g. risk of falls, seizures, head injury).
• Use must always be prescribed, authorised, documented, and reviewed in partnership with health professionals (OTs, GPs, physiotherapists).
• Informed consent from the person (or legally appointed representative) is required wherever possible.
• Each item of equipment is regularly checked for safety, proper use and effectiveness.
• Mechanical restraint is never used for staff convenience or to replace proper staffing or supervision.

7.4 Environmental Restraint

Description:
Environmental restraint refers to modifications or controls in a person’s environment that limit access or movement. Examples include:

• Locked external doors.
• Internal door locks or coded keypads.
• Physical barriers preventing access to certain rooms or objects.
• Restricting access to kitchens or medication storage.

Management at {{org_field_name}}:

• Environmental restraint is only used where necessary to protect safety (e.g. risk of wandering, fire, or access to hazardous substances).
• Proportionate restrictions are based on individual risk assessments and regularly reviewed.
• Least restrictive alternatives (e.g. supervision, staff support) are always explored first.
• Individuals are supported to understand any environmental restrictions and their purpose.
• The principle of “access where safe” applies, ensuring freedoms are maximised wherever possible.

7.5 Chemical Restraint

Description:
Chemical restraint refers to the use of medication primarily to control behaviour or restrict freedom, rather than for therapeutic treatment of a medical condition. This includes:

• Over-sedation.
• PRN (as required) medication given primarily to manage behaviour or agitation.

Management at {{org_field_name}}:

• Chemical restraint is only used under strict medical supervision and review.
• Prescribing decisions remain the responsibility of qualified health professionals (GP, psychiatrist).
• Medication is never administered by care staff for behavioural control unless:
  • Authorised on the care plan.
  • Prescribed by the responsible clinician.
  • Administered safely and recorded appropriately.
• All use of PRN or sedative medication is monitored, logged, and reviewed regularly.
• Wherever possible, non-pharmacological interventions are prioritised.
• Any potential chemical restraint triggers a formal multidisciplinary review.

7.6 Psychological Restraint

Description:
Psychological restraint includes the use of language, communication, or interaction styles that seek to control through:

• Threats, coercion or intimidation.
• Constant discouragement from independent decision-making.
• Withholding of privileges, access, or support.
• Indirect pressure or emotional manipulation.

Management at {{org_field_name}}:

• Psychological restraint is never acceptable under any circumstances.
• Staff are trained in positive, respectful communication, promoting informed choice and person-centred decision-making.
• Any instances of coercive practice are treated as safeguarding concerns and fully investigated.
• Staff reflect regularly through supervision to ensure they do not unintentionally exert psychological restraint.

7.7 Technological Restraint

Description:
Technological restraint refers to the use of devices that monitor or limit movement or behaviour, including:

• Bed or chair alarms.
• Electronic door monitors.
• Video surveillance.
• GPS or tracking devices.

Management at {{org_field_name}}:

• Technological restraint is only considered where it demonstrably prevents serious harm.
• All technological interventions require:
  • Risk assessment.
  • Consent.
  • Multi-agency discussion.
  • Documentation of proportionality and necessity.
• Surveillance equipment is only used where legally permitted, fully consented, and with full privacy safeguards.
• The least intrusive technology is always selected.
• Regular reviews ensure ongoing necessity and appropriateness.

7.8 Overarching Principles for All Restrictive Practices

At {{org_field_name}}, all restrictive practices must:

• Comply with legislation including the Adults with Incapacity (Scotland) Act 2000, Adult Support and Protection (Scotland) Act 2007, Human Rights Act 1998 and Mental Welfare Commission good practice guidance Rights, Risks and Limits to Freedom (2021).
• Be person-centred, lawful, respectful, and transparent.
• Be authorised, recorded and regularly reviewed by a multi-agency team.
• Have clear, documented consent processes involving the person, their family or legal representative.
• Always consider whether less restrictive options are available.
• Be used only as part of a broader, proactive Positive Behaviour Support approach aiming to reduce future restrictive practice.

8. Our Approach to Minimising Restrictive Practices

8.1 Positive Behaviour Support (PBS)

PBS is a person-centred approach that seeks to reduce behaviours of concern by:

• Understanding the root causes of behaviour.
• Adjusting the environment or triggers.
• Teaching alternative coping skills.
• Promoting communication, autonomy, and self-control.

Restrictive practice should never be the first response to behaviours of concern.

8.2 Least Restrictive Principle

We are committed to:

• Always using the least restrictive intervention possible.
• Exhausting all alternatives before considering restraint.
• Using restraint only in exceptional, urgent situations.

This reflects the Mental Welfare Commission’s ‘Rights, Risks and Limits to Freedom’ guidance, which we fully endorse and implement.

9. Assessment, Planning and Decision-Making

9.1 Risk Assessment

Whenever there is a possibility of restrictive intervention, a full multi-disciplinary risk assessment must be undertaken considering:

• The risks involved in both using and not using restraint.
• The person’s rights, capacity, and preferences.
• The views of family members, legal proxies or advocates.
• Input from healthcare professionals (GP, psychiatrist, psychologist, SALT, OT etc.).
• The necessity, proportionality, and legality of any proposed restriction.

9.2 Informed Consent

• Informed consent must always be sought prior to using any restrictive practice.
• Where a person lacks capacity, decisions must be made in line with the Adults with Incapacity (Scotland) Act 2000, involving welfare guardians or attorneys.
• Decisions should always promote the person’s wellbeing, safety, and dignity.

9.3 Multi-Agency Involvement

Consultation must involve:

• The person we support.
• Family members and/or legal representatives.
• Care Managers or Social Workers.
• Community health professionals.
• The Care Inspectorate (where significant restrictions are proposed).
• Independent advocacy services where appropriate.

All discussions and decisions are fully documented and reviewed regularly.

10. Procedures for Use of Restrictive Practices

10.1 Authorisation and Recording

• Any authorised restrictive practice must be clearly documented in the person’s support plan.
• Documentation must include:
  • Reason for the restriction.
  • Evidence of multi-agency consultation.
  • The least restrictive alternative explored.
  • Consent and legal authority details.
  • Staff authorised and trained to apply the measure.
  • Review and monitoring arrangements.
• Risk assessments and support plans are reviewed at least every 6 months, or sooner if required.

10.2 Emergency Situations

• Emergency restraint may only be used where there is immediate and serious risk to safety.
• Staff must:
  • Apply restraint only to the extent necessary.
  • Ensure the person’s dignity is maintained.
  • Report the incident immediately to the Manager.
  • Complete full incident reports.
  • Initiate post-incident debrief and review.

11. Training and Competence

All staff at {{org_field_name}} will receive training in:

• Positive behaviour support.
• Understanding restrictive practices.
• Rights, Risks and Limits to Freedom guidance.
• Legal duties under Adults with Incapacity Act and Adult Support and Protection Act.
• De-escalation techniques and conflict resolution.
• Safe physical intervention techniques (only where risk assessments identify staff require this skill).

Ongoing competency is monitored through:

• Supervision.
• Observation.
• Post-incident reviews.
• External training updates.

Staff are expected to promote people’s autonomy at all times and avoid restrictive practice unless absolutely necessary.

12. Involving Families, Representatives and Professionals

We recognise the critical role of families, legal representatives, and professionals in decisions relating to restrictive practices. Therefore:

• Families will be involved from the outset in discussions about positive risk, safety and restrictive practices.
• All meetings will be fully documented.
• In cases of disagreement, we will seek independent advocacy or legal guidance.
• Welfare Guardians/Attorneys will be consulted where they hold relevant legal authority.
• External professionals (Care Managers, Consultants, Community Learning Disability Teams, SALT, Occupational Therapists) will contribute to assessments and reviews.
• Any restrictive practice will not be implemented unless all relevant legal authorisations are in place.

13. Monitoring, Review, and Governance

• All restrictive practices are subject to ongoing audit and senior management review.
• Records will be maintained for inspection by the Care Inspectorate.
• Any incident involving restraint will trigger a formal review.
• The Registered Manager will ensure ongoing compliance with all legal and regulatory obligations.
• Quality assurance reports will review trends and aim to reduce restrictive practices wherever possible.

14. Safeguarding and Whistleblowing

• Improper or excessive use of restrictive practice constitutes abuse.
• Staff have a duty to report any misuse of restraint immediately under our Safeguarding and Whistleblowing Policies.
• All allegations will be fully investigated.

15. Roles and Responsibilities

Registered Manager

• Overall responsibility for safe, lawful, proportionate use of restrictive practices.
• Ensures full staff training.
• Authorises and monitors all restrictive practices.
• Reports serious incidents to Care Inspectorate where required.

Deputy Manager/Team Leaders

• Support development and review of support plans.
• Ensure all staff follow approved practices.
• Facilitate training, supervision, and reflective practice.

Care Staff

• Deliver person-centred care.
• Promote autonomy and reduce restrictions.
• Apply restrictive practice only where authorised and trained.
• Report any concerns or incidents promptly.

People We Support

• Are central to all decisions.
• Have their voice heard in planning, reviews, and consent.
• Have access to independent advocacy where appropriate.

16. Review of Policy

This policy will be reviewed annually, or sooner if:

• New legislation or guidance is issued.
• The Care Inspectorate issues new requirements.
• Audit or inspection identifies improvements.
• Organisational learning identifies policy development needs.

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Responsible Person: {{org_field_registered_manager_first_name}}{{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
Copyright © {{current_year}} – {{org_field_name}}. All rights reserved.