SL132-Restrictive Practices and Physical Interventions Policy

Registration Number: {{org_field_registration_no}}

Restrictive Practices and Physical Interventions Policy

1. Purpose

The purpose of this policy is to ensure that {{org_field_name}} adheres to CQC regulations, the Mental Capacity Act 2005, the Human Rights Act 1998, and other relevant legislation when implementing restrictive practices and physical interventions. This policy aims to:

Minimise the use of restrictive practices and ensure they are only used as a last resort.
Protect the dignity, rights, and safety of service users and staff.
Ensure compliance with CQC’s fundamental standards, particularly regarding safeguarding and safe care.
Promote positive behaviour support (PBS) and non-restrictive approaches to managing challenging behaviours.
Provide clear guidance on lawful and ethical decision-making when restrictive practices are deemed necessary.

2. Scope

This policy applies to:

All staff members, including permanent, temporary, agency, and volunteer workers.
All service users who may require restrictive interventions.
Families, advocates, and external professionals involved in the care of service users.
Visitors and external stakeholders who may be impacted by the implementation of restrictive practices.

3. Legal and Regulatory Framework

This policy aligns with:

Health and Social Care Act 2008 (Regulated Activities) Regulations 2014:
- Regulation 9 – Person-Centred Care
- Regulation 10 – Dignity and Respect
- Regulation 11 – Need for Consent
- Regulation 12 – Safe Care and Treatment
- Regulation 13 – Safeguarding Service Users from Abuse and Improper Treatment
Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS)
Human Rights Act 1998 (Article 3 – Freedom from degrading treatment, Article 5 – Right to liberty)
Equality Act 2010 (Protection against discrimination)
The Restraint Reduction Network Standards
Positive Behavioural Support (PBS) Framework

4. Principles of Restrictive Practices

4.1 Least Restrictive Approach

Restrictive practices must only be used:

As a last resort, when all other non-restrictive interventions have failed.
In proportion to the level of risk to the service user or others.
For the shortest time necessary.
With full documentation and justification.

4.2 Positive Behaviour Support (PBS)

{{org_field_name}} promotes PBS as a primary strategy for reducing restrictive interventions by:

Identifying triggers for challenging behaviours.
Implementing proactive interventions to prevent distress.
Providing staff training on de-escalation techniques.
Encouraging service user engagement in behaviour management strategies.

4.3 Consent and Capacity

Service users must be involved in decisions regarding their care whenever possible.
The Mental Capacity Act 2005 must be followed when assessing whether a service user can consent to restrictive practices.
Where a service user lacks capacity, best interest decisions must be made following consultation with families, advocates, and professionals.

4.4 Deprivation of Liberty Safeguards (DoLS)

Where a restrictive practice amounts to a deprivation of liberty, DoLS authorisation must be sought from the local authority. This applies where:

A service user is not free to leave.
Continuous supervision and control are exercised.
There are no less restrictive alternatives available.

5. Types of Restrictive Practices

5.1 Physical Interventions

Physical interventions should only be used when:

There is an immediate risk of harm to the service user or others.
Staff have received specialist training in accredited restraint techniques.
All incidents are recorded, reviewed, and reported.

5.2 Mechanical Restraint

Mechanical restraints (e.g., arm splints, lap belts) must only be used if prescribed by a qualified professional.
Their use must be regularly reviewed to ensure continued necessity.

5.3 Chemical Restraint

Medication must not be used to control behaviour unless clinically justified.
Any use of PRN (as-needed) medication must be documented with a clear rationale and review plan.

5.4 Environmental Restrictions

Locked doors, restricted access to areas, and controlled routines must be risk-assessed.
These restrictions must be justified, proportionate, and regularly reviewed.

5.5 Seclusion

Seclusion is not permitted in {{org_field_name}}’s supported living service. If a situation requires a time-out approach, this must be fully documented and alternative de-escalation strategies explored.

6. Training and Competency

All staff must receive mandatory training in:
- De-escalation and conflict resolution techniques.
- The lawful application of restrictive interventions.
- Person-centred approaches to behaviour management.
Training must be updated annually.

7. Incident Reporting and Review

7.1 Documentation

Every restrictive practice must be recorded in an Incident Report.
Reports must include:
- Triggers and de-escalation attempts.
- The type of intervention used.
- Duration and impact on the service user.
- Service user’s post-incident wellbeing.
- Follow-up actions to reduce recurrence.

7.2 Post-Incident Review

Debriefing sessions should be provided to staff and service users involved.
Lessons learned should inform care planning and policy updates.
Multi-disciplinary reviews should assess alternative, less restrictive approaches.

7.3 Safeguarding and External Reporting

Incidents of restraint or seclusion must be reported to CQC where required.
Families and advocates must be informed where appropriate.
Any concerns regarding misuse or overuse of restrictive practices must be escalated through safeguarding procedures.

8. Governance and Oversight

8.1 Monitoring and Auditing

Regular audits will be conducted to ensure compliance.
Trends in restrictive practice use will be analysed to inform training and policy improvements.

8.2 Service User Involvement

Service users must be consulted on their behaviour management plans.
Advocacy support must be offered to ensure their voices are heard.

9. Related Policies

Safeguarding Adults from Abuse and Improper Treatment Policy
Mental Capacity and Deprivation of Liberty Safeguards Policy
Safe Care and Treatment Policy
Staff Supervision, Training, and Development Policy
Incident Reporting and Investigation Policy

10. Policy Review

This policy will be reviewed annually or sooner if changes in legislation, best practice, or operational needs arise. All staff will be informed of updates and provided with training and guidance as 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.