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Aggression Towards Care Home Staff (Wales) Policy

Policy Statement

This policy is intended to set out the values, principles and policies underpinning {{org_field_name}}’s approach to aggression and violence towards staff. It is written to achieve compliance with the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017 and accompanying statutory guidance, particularly Regulation 58: Health and Safety.

{{org_field_name}} considers that staff should be safe at work and should not be exposed to undue or unreasonable risk. It recognises that staff must be able to work safely, free from the threat of injury or upset through acts of aggression and violence.

Attacks on staff at work are, fortunately, very rare and the home does all it can to minimise this risk still further and ensure that staff are as safe as possible. However, {{org_field_name}} recognises that such events do unfortunately occur and where even a small risk exists then it understands that it has a duty to ensure that staff are properly trained and supported to deal with such incidents.

This policy should be read in conjunction with all policies and procedures relating to the safe use of restraint and to the safeguarding of service users from abuse. {{org_field_name}} will not tolerate abuse in any shape or form and will carefully monitor all incident reports relating to violence or the use of restraint to ensure that both staff and service users are being appropriately protected.

Guidance

{{org_field_name}} will comply fully with the following Health and Safety Executive COSHH guidance:

• HSG220 (2nd edition) Health and Safety in Care Homes
• INDG69 Violence at Work: A Guide for Employers.

Policy

This policy applies to all staff without exception.

1. Staff will work to minimise the risk of, and avoid the occurrence of, aggression and violence.
2. Staff are expected to always adopt a confident, calm, professional approach that demonstrates understanding, empathy and respect.
3. All risks of workplace violence are comprehensively assessed and any identified risks are systematically managed.
4. Violence against staff will not be tolerated.
5. The home has in place systems to record incidents of violence against staff.
6. All violent incidents, no matter how minor, will be reported by staff to their managers at the time they occur or as soon as possible thereafter.
7. Any service user or visitor who acts in a violent or abusive manner towards staff will be challenged as appropriate regarding their unacceptable behaviour.
8. In the case of a service user who acts in a violent or abusive manner towards staff their plan of care will be reviewed and discussed with them and changes agreed.
9. Visitors who act in a violent or abusive manner towards staff will be asked to leave and told that they could be prevented from visiting the home if their behaviour and attitude does not alter.

Responding to Violent Situations

In the event of a violent or aggressive incident, staff should adhere to the following procedure.

1. The priority of staff must be for their own safety and for the safety of other staff and service users.
2. Staff should immediately try to summon help, preferably from {{org_field_name}} manager or duty manager — help can be summoned by asking another member of staff to fetch assistance, by using a “panic” alarm if available, by making a telephone call to {{org_field_name}} manager, or merely by calling for help.
3. Staff should try to calm the situation wherever possible, talking to the potential aggressor calmly, trying to find out what is wrong and pointing out how their behaviour is affecting people — staff should try not to get angry and should never shout back.
4. Where the level of threat continues to increase and staff feel that they are in imminent danger then they should try to escape and remove any residents from the situation immediately and get assistance.
5. Where a member of staff is actually attacked then they are permitted to defend themselves but they must use only the “minimum reasonable force” to do this.
6. In the event of an actual physical assault, or if the incident involves an intruder, then the police should be called as soon as possible.

Where the “attacker” in a violent situation is a service user and the situation requires some form of restraint then action should be taken in line with the physical intervention by staff and rights, risks and restraint policies.

Reporting and Support

1. Any violent or abusive incidents towards staff or volunteers, no matter how minor, must be reported at once to the manager who should make a record in the incident book.
2. Staff involved should complete and submit an incident form.
3. Appropriate support will be offered by the manager to employees who are involved in violent or aggressive incidents.
4. Violent or aggressive incidents, even if they just amount to being shouted at, can be very upsetting for a member of staff and, in extreme cases, can lead to them suffering psychological trauma or illness — staff should therefore be given the opportunity to discuss their experience.
5. In extreme cases, the home understands that there may be a need for ongoing support and referral to occupational health services or professional counselling.
6. Where absence from work arises from a violent or aggressive incident, any such absence will be treated as special leave rather than sickness absence.

Where the original incident did not involve the police, the management must make a decision in each case about whether or not to report the incident to the CSSIW under its notification procedures and/or, where the protection of service users is involved, the local safeguarding adults’ authority. The nature and severity of the incident will be carefully considered along with any criminal intent and assessment of future threat.

The home’s management will always seek the approval and consent of the member of staff attacked before making any decision about reporting the incident to the police or other authorities. However, it will report the matter without the victim’s consent where it deems this to be the correct action to take in the public interest or to protect other people from possible abuse.

Monitoring

The appropriate manager will review all reports of aggression and violence or potential aggression and violence and look for any trends or patterns or lessons to be learned. This is done with reference to the home’s security policy and might require a review of security procedures and precautions.

Managers will carefully monitor all incident reports relating to violence or the use of restraint to ensure that both staff and service users are being appropriately protected. Any suspicion of abuse by staff or by others, or any whistleblowing by other staff, will be investigated and acted upon in accordance with the home’s safeguarding policies.

This policy, and policies on restraint and abuse, should be regularly reviewed. If its policies and procedures are working adequately and are being properly applied the home would expect violent incidents to be rare and the appropriate use of restraint to be a last resort used only in exceptional circumstances. The home at all times requires the regular and proactive review of service user care plans to ensure that the most appropriate level of care is being provided and the use of restraint avoided.

Training

All staff are trained to recognise the early warning signs of potential aggression and in responding to panic alarms and pleas for assistance.

Dealing with aggressive or potentially violent service users is included in the induction training for all new staff in line with the Social Care Induction Framework for Wales’ requirements.

In-house training sessions are conducted at least annually and all relevant staff attend. These sessions include guidance on where panic buttons are installed and cover the drill of how staff should act in an emergency situation.

Care staff training includes guidance in the use of physical interventions and restraint in the care of service users.

Managers are trained in the management of violent or emergency situations and in appropriate post-incident follow-up.

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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}}

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