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CHW132-Restrictive Practices and Physical Interventions Policy

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Restrictive Practices and Physical Interventions Policy

1. Purpose

The purpose of this policy is to set out the arrangements at {{org_field_name}} for preventing, reducing, authorising, using, recording, reporting, monitoring and reviewing restrictive practices and physical interventions. The service is committed to providing care and support in a person-centred, rights-based and least restrictive manner and to reducing the use of restrictive practices wherever possible.

Restrictive practices must not be used routinely, for convenience, as a substitute for appropriate staffing, because of resource difficulties, as a punishment, to humiliate or degrade an individual, or as a means of securing compliance where there is no lawful justification for the restriction.

Any act intended to control or restrain an individual must comply with Regulation 29 of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended. Control or restraint may only be used where:

This policy must be read and applied in accordance with:

For adults in care homes, the Deprivation of Liberty Safeguards remain the applicable statutory authorisation process where care arrangements amount, or may amount, to a deprivation of liberty and the relevant legal requirements are met. Liberty Protection Safeguards must not be treated as the operative authorisation system unless and until they are brought into force and replace the existing arrangements.

The service will ensure that restrictive practices are reduced as far as reasonably possible through person-centred planning, positive approaches to behaviour, trauma-informed practice where appropriate, effective communication, environmental adjustments, meaningful engagement, positive risk management and appropriate de-escalation.

The aims of this policy are to:

2. Scope

This policy applies to all employees, agency staff, and volunteers at {{org_field_name}}, service users receiving care and support, visitors, including family members, advocates, and external professionals, and management and safeguarding leads responsible for oversight and reporting.

This policy covers the definition of restrictive practices, positive behaviour support strategies, risk assessments and individual care planning, authorised use of physical interventions, reporting and monitoring, and staff training and competency requirements.

3. Definition of Restrictive Practices

For the purposes of this policy, a restrictive practice is any action, arrangement or intervention that restricts an individual’s rights, freedom of movement, autonomy, choice or control over their daily life.

Under Regulation 29 of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, a person controls or restrains an individual where that person:

Restrictive practices may include, but are not limited to:

Practices described by other terms, including “time out”, “quiet time”, “safe space”, “observation”, “monitoring”, “guidance” or “support”, must be treated as restrictive practices where their actual purpose or effect is to prevent an individual from doing something they wish to do, require them to do something they do not wish to do, or restrict their freedom of movement or autonomy.

The name given to an intervention does not determine whether it is restrictive. Staff must consider its actual purpose, effect and impact on the individual.

Restrictive practices must never be used:

4. Preventing and Reducing Restrictive Practices

{{org_field_name}} will adopt a proactive, person-centred and rights-based approach designed to prevent and reduce the circumstances in which restrictive practices may become necessary.

Staff must seek to understand the reasons for an individual’s distress, behaviour or communication and must not assume that behaviour which challenges the service is, in itself, justification for restriction.

Preventative approaches will include, where relevant:

Restrictive practices may only be used where they are lawful, necessary to prevent a risk of harm to the individual or another individual, and proportionate to that risk. The least restrictive effective intervention must be used for no longer than necessary.

Restrictive practices must not be used simply because other approaches have not produced the outcome preferred by staff. The justification must always relate to the prevention of harm and must meet the applicable legal requirements.

5. Risk Assessment, Consent, Mental Capacity and Individual Planning

Where there is a foreseeable possibility that restrictive practice may be required, the service must undertake and document an individualised assessment before planned restrictive practice is used.

The assessment must consider:

Any intended or foreseeable restrictive practice must be clearly described in the individual’s personal plan and, where relevant, their behaviour support plan. The plan must identify the circumstances in which the intervention may be used, preventative and de-escalation strategies, the least restrictive response, relevant risks, monitoring requirements and the arrangements for reducing the restriction.

Restrictive practices must not be authorised through generic statements such as “restraint as required” or “physical intervention if necessary”. The personal plan must contain sufficient individualised detail to guide staff safely and lawfully.

Any use of restrictive practice which was not anticipated or provided for in the individual’s existing plan must result in an appropriate and timely review of the incident, the risks, the individual’s needs and the personal plan.

The personal plan must be reviewed in accordance with Regulation 16 of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, including whenever required and at least every three months. Where applicable, that review must take account of the most recent records relating to control, restraint and restrictive practice.

5.1 Mental Capacity, Consent and Best Interests

Staff must comply with the principles and requirements of the Mental Capacity Act 2005 whenever an individual’s capacity is relevant to a proposed restriction or care arrangement.

Capacity must be considered in relation to the particular decision at the time it needs to be made. A person must not be treated as unable to make a decision merely because the decision appears unwise.

Where an individual lacks capacity to make the relevant decision, any act carried out under the Mental Capacity Act 2005 must be in the individual’s best interests and must comply with the statutory requirements concerning restraint, including necessity and proportionality where applicable.

A best-interests decision does not, by itself, provide authority for a deprivation of liberty. Where care arrangements amount or may amount to a deprivation of liberty, appropriate lawful authorisation must be obtained.

5.2 Deprivation of Liberty

An individual must not be deprived of their liberty for the purpose of receiving care and support without lawful authority.

For adults aged 18 or over receiving care in a care home, the Deprivation of Liberty Safeguards remain the applicable statutory authorisation process where the arrangements amount to a deprivation of liberty and the relevant criteria are met.

Following the UK Supreme Court judgment of 2 June 2026, staff and managers must not rely solely on the former Cheshire West “acid test” when deciding whether care arrangements amount to a deprivation of liberty.

Whether an individual is deprived of their liberty must instead be assessed on the individual circumstances of the case. Relevant factors include:

No single factor is determinative.

The individual’s wishes and feelings must be actively established. Compliance must not automatically be treated as consent. Staff must consider verbal and non-verbal communication, behaviour, attempts to leave, resistance to care, distress and previously expressed wishes and feelings.

Where there is doubt about whether the individual is objecting, whether they can validly consent to the arrangements, or whether the restrictions amount to a deprivation of liberty, the matter must be escalated promptly to the Registered Manager and referred to the relevant local authority or other appropriate legal route for consideration.

6. Use of Physical Interventions

6.1 Circumstances in Which Physical Intervention May Be Used

A physical intervention or other form of control or restraint may only be used where:

Where the situation allows, staff must use preventative, de-escalation and less restrictive approaches before physical intervention.

Staff must continually assess whether the intervention remains necessary. The intervention must cease as soon as the justification for using it no longer exists.

Physical intervention must never be used:

6.2 Methods of Physical Intervention

{{org_field_name}} does not give blanket authorisation through this policy for particular holds or restraint techniques.

Where the foreseeable use of a specific physical intervention forms part of an individual’s support arrangements:

Staff must not improvise restraint techniques or use techniques in which they have not been appropriately trained.

The following are prohibited:

Any physical intervention that causes or may have caused injury, breathing difficulty, loss of consciousness, significant distress or an unexpected deterioration in the individual’s condition must be stopped as soon as safely possible and appropriate medical assistance obtained without delay.

7. Recording, Reporting, Notification and Post-Incident Review

7.1 Immediate Actions Following Restrictive Practice

Following any restrictive intervention, staff must:

The individual must be offered appropriate support following the incident. This must take account of their communication needs, wishes, emotional state, possible trauma and ability to participate.

7.2 Recording Requirements

Every incident in which control or restraint is used must be recorded. A record of the incident must be made within 24 hours, as required by Regulation 29(4).

The fact that a restrictive practice is already authorised or anticipated within an individual’s personal plan does not remove the requirement to record its actual use.

The record must provide sufficient information to enable review of the individual’s care and support and organisational monitoring. It must include, as applicable:

The service must also maintain the records required by Regulation 59 and Schedule 2, including the date and circumstances of measures of control or restraint used on an individual.

7.3 Safeguarding

Where restrictive practice may constitute abuse, neglect, improper treatment, unlawful restraint or inappropriate deprivation of liberty, staff must act immediately in accordance with the service’s safeguarding policy and the Wales Safeguarding Procedures.

Any indication that restrictive practice has been used inappropriately must be treated as a safeguarding concern and referred in accordance with applicable safeguarding procedures.

Any injury sustained as a result of restrictive practice must be considered and reported in accordance with the service’s safeguarding procedures and current Welsh Government requirements.

Where there is an allegation or evidence of abuse, neglect or improper treatment, the service provider must:

This mirrors Regulation 27.

7.4 Notifications to Care Inspectorate Wales

Restrictive practice is not automatically notifiable to CIW simply because it has occurred. The Registered Manager must consider whether the circumstances fall within a prescribed notifiable event under the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended.

Where a prescribed event has occurred, the service provider must notify CIW without delay and in writing unless a different timescale is specifically prescribed, using CIW Online and the form or process required by CIW.

Relevant circumstances may include:

Every DoLS request/application which falls within the applicable CIW notification requirement must be notified through CIW Online. This applies whether the application is subsequently authorised or not.

CIW currently confirms that registered adult care homes must notify it of each DoLS application and that notifications are made through CIW Online.

7.5 Post-Incident Support and Review

Following restrictive practice, the individual must be offered person-centred post-incident support appropriate to their needs and circumstances.

Post-incident support must be distinguished from the subsequent learning review. Immediate support should focus on physical and emotional well-being and restoring safety.

A learning review must consider, as appropriate:

Where an unplanned restrictive intervention has occurred, the individual’s assessment and personal plan must be reviewed promptly to determine whether changes are required.

The individual must be involved in the review as far as possible. Relevant representatives and professionals must also be involved where appropriate and lawful.

8. Staff Training, Competence and Responsibilities

8.1 Training and Competence

All staff must receive training appropriate to their role which enables them to understand the service’s approach to preventing and reducing restrictive practices.

Relevant induction and ongoing learning must include, according to role:

Staff must not receive physical-intervention training merely as a blanket requirement where their role and the assessed needs of individuals do not indicate that they may need to use such interventions.

Where staff may reasonably be expected to use a particular restrictive physical intervention as a last resort, they must receive appropriate competence-based training in that method before using it. Prevention and de-escalation training must form part of the overall training approach.

The service provider must ensure that:

Staff must never use a planned restrictive intervention for which they have not been appropriately trained and assessed as competent.

8.2 Staff Responsibilities

All staff must:

9. Governance, Audit and Reduction of Restrictive Practices

The Registered Manager and Responsible Individual must ensure that effective systems are in place to monitor, review and reduce the use of restrictive practices within the service.

The service must maintain sufficient information to enable patterns, trends, risks and areas for improvement to be identified.

Monitoring must include, as applicable:

The Registered Manager must ensure that restrictive-practice records are audited regularly and that concerns are acted upon without delay.

The Responsible Individual must ensure that records relating to control, restraint and restrictive practice are considered as part of the service’s systems for monitoring, reviewing and improving the quality and safety of care and support.

Aggregated information concerning restrictive practices must inform the quality-of-care review required by Regulation 80, including identification of patterns, trends, safeguarding risks, lessons learned and opportunities to reduce restrictive practice.

Where monitoring identifies repeated or increasing restrictive practice for an individual, the Registered Manager must ensure that the individual’s needs, risks, personal plan and behaviour support arrangements are reviewed and that specialist advice is sought where appropriate.

Where monitoring identifies organisational practices, blanket restrictions, environmental factors, staffing arrangements or other systemic issues contributing to restrictive practice, corrective action must be taken.

The service’s objective must be demonstrable reduction of unnecessary restrictive practices while maintaining the safety and well-being of individuals and others.

10. Related Policies

This policy must be read alongside, where applicable:

Where there is any conflict between a local procedure and current legislation or statutory requirements, the applicable legal requirement must take precedence and the policy must be reviewed without delay.

11. Policy Review

This policy will be reviewed at least annually and sooner where required because of:

The Responsible Individual must ensure that suitable arrangements are in place to keep this policy up to date and to ensure that staff and volunteers have access to, understand and follow the policy.

Where the policy is amended, relevant staff must be informed of the changes and additional training or competency assessment must be provided where necessary.

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.

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