Aggression Towards Staff and Appropriate Response (Wales) Policy

Aggression Towards Staff

This policy sets out the values, principles and procedures underpinning this care service’s approach to aggression and violence towards staff. It is in line with Regulation 29: The Appropriate Use of Control and Restraint of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017 and standards developed under the Health and Safety at Work Act 1974, setting out an employer’s duties to provide a safe working environment for their staff.

The service considers that staff should be safe at work and should not be exposed to undue or unreasonable risk. It believes 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. The service does all it can to minimise this risk still further and ensure that staff are as safe as possible. However, the service 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 relation to all policies and procedures relating to the safe use of restraint and to the safeguarding of people using services from abuse. This service 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 people using services are being appropriately protected.

Policy

This policy applies to all staff without exception.

Managers will assess the risk of violence or security risks during the initial needs assessment and implement or negotiate appropriate control measures. Where domiciliary support is being considered, the assessment will include the possible presence of potentially dangerous animals on the premises.
Managers will avoid the need for lone working whenever there are threats to care workers’ personal safety and identify people whose care and support needs should not be met by lone care workers.
Managers will improve information gathering and sharing with other agencies about clients or families with a history of violence.
Staff will work to minimise the risk of, and avoid the occurrence of, aggression and violence at all times.
Staff are expected to always adopt a confident, calm, professional approach that demonstrates understanding, empathy and respect.
Violence against staff will not be tolerated.
The service has systems in place to record incidents of violence against staff.
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.
Any person using services or other person who acts in a violent or abusive manner towards staff will be challenged as appropriate regarding their unacceptable behaviour.
In the case of a person who acts in a violent or abusive manner towards staff their personal plan will be reviewed and discussed with them so that any changes needed can be agreed.
Managers will ensure that supervisors of care workers always have details of their work schedules, which highlight any risks to personal safety and be available to help if needed.

Responding to Violent Situations

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

The first priority of staff must be their own safety and for the safety of other people present.
Staff should immediately try to summon help, preferably from their manager or person on call by using a mobile phone, call bell or alarm.
Staff should try to calm the situation wherever possible, talking to the potential aggressor calmly, trying to find out what is wrong — staff should try not to get angry and should never shout back.
Where the level of threat continues to increase and staff feel that they are in imminent danger then they should try to escape (with other people who also could be in danger) and get help.
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.
In the event of an actual physical assault, or if the incident involves an intruder to the home, then the police should be called as soon as possible.

Physical Intervention

Staff must always deal with behaviour that challenges them calmly and professionally. Physical and verbal aggression by a person using the services should be understood by staff and dealt with appropriately.

In the event of an aggressive incident staff should summon help or call the police immediately. They should try to de-escalate incidents, wherever possible, and their priority should be for their own safety and the safety of other people present.

Physical interventions should be used only as a last resort by trained staff, and in line with best practice guidance to protect the rights and best interests of the individual, and which are the minimum consistent with safety of all concerned.

If a member of staff is attacked they are permitted to use “minimum reasonable force” to defend themselves. Care should therefore be taken to ensure that minimum force is indeed used and that people using services who are acting in an aggressive or threatening manner are not subject to undue restraint.

The law gives protection to people from being abused or attacked and, if a member of staff is attacked, they can use “minimum reasonable force” to defend themselves. However, staff should remember that if they restrain a violent person and injure them because of the force they use, they could be charged for assault. Because of this risk, staff should always follow the established procedure.

Reporting and Support

Any violent or abusive incidents towards staff, no matter how minor, must be reported at once to the manager who should make a record in the incident book.
Staff involved should complete and submit an incident form.
Appropriate support will be offered by the manager to employees who are involved in violent or aggressive incidents.
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.
In extreme cases, the service understands that there may be a need for ongoing support and referral to occupational health services or professional counselling.
Where absence from work arises from a violent or aggressive incident, any such absence will be treated as special leave rather than sickness absence.
The service might need to notify the Health and Safety Executive under RIDDOR reporting procedures if the injuries meet their criteria, ie any injury from a physical assault that results in “death, major injury or incapacity for normal work for three or more consecutive days”.

Where the original incident did not involve the police, the management must decide in each case if it should report the incident to the CIW under its notification procedures and/or, where the protection of people using services is involved, to the appropriate Safeguarding and Protection Adults Board. The nature and severity of the incident will be carefully considered along with any criminal intent and assessment of future threat.

The service’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 service’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 people using services 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 line with the service’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 service would expect violent incidents to be rare and the appropriate use of restraint to be a last resort used only in exceptional circumstances. The service always requires the regular and proactive review of service delivery 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 calls for help.

Dealing with aggressive or potentially violent people using services is included in the induction training for all new staff, which is based on the All Wales Induction Framework for Health and Social Care. All training is refreshed annually or as required.

Further care staff training, where appropriate, includes guidance in the use of physical interventions and restraint. Where required, staff are trained in a range of intervention strategies that have developed in respect of socially inappropriate behaviour. This training includes:

de-escalation techniques
the concept and use of “minimum force”
approved and acceptable breakaway techniques
inappropriate or unacceptable techniques.

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

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}}

WCH11. Aggression Towards Staff and Appropriate Response

Aggression Towards Staff and Appropriate Response (Wales) Policy