This chapter was updated in March 2016 in accordance with the Children`s Homes Ordinances, including Quality Standards (2015) – in particular „Restraint“. (See Section 2, Definition of Physical Interventions, and Section 4, Criteria for Using Physical Interventions.) Similarly, chemical restraint (medications that are not prescribed to treat a formally identified physical or mental illness, but are prescribed „as needed“ or „PRN – pro re nata“) should always be administered only in accordance with recognized, evidence-based best practices. The home should employ staff with the appropriate qualifications, skills and experience to manage this type of restraint in accordance with the NICE guidelines for handling medicines in care homes and the joint CQC/Ofsted guidelines on health care registration in children`s homes. Any use of restraints involves risks. These include physical injuries, psychological trauma or emotional disturbances. When determining whether restraint is warranted, employees should consider the following: Ideally, the child involved in the restraint should be able to express feelings about this experience within 24 hours and should be encouraged to record their views on the restraint file. Within 48 hours, employees should have discussed the incident with a senior team member. This is to ensure that all problems can be identified and that all findings can be implemented in order to avoid having other instances where possible. Trained staff should only use techniques approved by the home. Approved techniques must adhere to the following principles: If you have concerns about the use of restraint or segregation, seek independent advice. For example, mechanical restraint may be necessary to limit self-destructive behaviours of extremely high frequency and intensity, such as in a small number of children with severe cognitive impairment, where measures such as orthotics or padded helmets may be necessary to protect children from the dangerous consequences of their behaviour. Such devices should be installed by persons with the requisite qualifications, skills and experience. Restraint approaches should recognize that children develop both physically and emotionally.

Any application of restraints must be adapted to the needs of each child. The context in which restraint is applied should also take into account that, based on previous experiences, children have a unique understanding of their situation that will influence their response to the reluctance of adults responsible for their care. Ways of not intervening in behaviours such as distraction, diversion, and space for the person should be considered prior to restraint and seclusion, as they are a less restrictive way of responding to the behaviour. Information page on how to get legal advice and/or a lawyer on behalf of a parent with a learning disability and how to fund legal advice. When developing the mediation plan, it is necessary to take into account whether there are medical conditions that make it necessary to avoid certain techniques or methods of physical intervention. If this is the case, any health professional currently caring for the child should be consulted on appropriate strategies and this should be brought to the attention of those working with or caring for the child, and this should be stated in the placement plan. In case of doubt, medical advice should be sought. Any child who has been restrained should have the opportunity to express feelings about their restraining experiences as soon as possible, ideally within 24 hours of the restraint incident, taking into account the age of the child and the circumstances of the restraint.

In some cases, children take longer to process their feelings, so a recording that the child has spoken about their feelings should not be made more than 5 days after the restraint incident. Children should be encouraged to add their views and comments to the restraint record. Children should have the opportunity to access advocacy support to help them do so. See Advocacy, Independent Visitors and Independent Review Officer Procedure. Those ordering restraint training for staff must be assured that the training is consistent with their approach to restraint or the existing restraint system and meets the needs of the children for whom the home has been set up. They should see evidence that all restraint techniques advocated by the training have been medically evaluated to demonstrate their safety in the context of caring for children who are still developing, physically and emotionally. The notifier should regularly verify the effectiveness of a restraint system put into service. In particular, they should verify that the medical assessment of the system remains up to date. If a youth consistently needs this level of intervention to stay safe, there must be clear evidence for a planning interview with the housing authority to assess the appropriateness of the placement. It can be recognised that this is a testing process and that an agreement on strategies is drawn up and revised in cooperation with the local authority, this must be clearly documented and any agreement must not conflict with the rules on „deprivation of liberty“. „Restricting a child`s freedom of movement“ includes, for example, changes to the physical environment of the home (e.g., using high door handles) and removing physical aids (e.g., turning off a child`s electric wheelchair).

Some children, perhaps because of impairments or disabilities, may not resist, but such measures should always be a limitation. The techniques used shall comply with the principles and procedures set out in this chapter and its guidelines. See Section 3, Who can use physical interventions? under. The absence or existence of such a plan shall not prevent staff/carers from acting as they see fit in the event of unforeseen injury or probable property damage, provided that the measures taken are in accordance with the principles and procedures set out in this chapter. Employees/caregivers can only use the physical intervention if they have completed approved training. Children`s home staff may only use restraint techniques approved by the home where they work. Staff should be trained in proven home techniques before starting to work with children. In all cases, the use of force must reflect the values and principles set out in this chapter and related guidelines (see Behaviour Management Guidelines). „Use of force“ includes techniques of physical servitude that involve the use of force, namely: the positive use of violence with the intention of dominating a child. In practice, this refers to any measure or technique aimed at completely restricting a child`s mobility or preventing a child from abandoning him, for example: this restriction of a young person`s freedom should be as short as possible and respond to immediate dangers. Employees must ensure that, when recording this incident, they clearly describe all measures taken to ensure that the child`s liberty does not have to be restricted by physical means. Restraint also includes restricting the child`s freedom of movement.

This may include changes to the physical environment of the home or removal of physical aids. All this should be recorded as a constraint. It is the registrant`s responsibility to ensure that all staff have received adequate training in restraint principles and all restraint techniques that meet the needs of the children for whom the home has been established, as defined in the institution`s letter of intent.