Dealing with Aggression and Violence

REGULATIONS AND STANDARDS

The Positive Relationships Standard
Regulation 11

SCOPE OF THIS CHAPTER

This chapter gives guidance on responding to aggressive and violent behaviour.

RELEVANT CHAPTERS

This chapter should be read in conjunction with Measures of Control, Restraint and Discipline Procedure and The Offending and Anti-Social Behaviour – guidance on when to involve the Police Procedure


Contents


1. Introduction
2. Referral and Admission
  2.1 Risk Assessments
3. Reporting and Recording
4. Follow up After an Incident
5. Level of Risk
6. Actions for Staff following a Violent Incident


1. Introduction

Children who have suffered abuse and neglect may display difficult, risk taking or challenging behaviours, including violence and / or aggression. A child’s challenging behaviour should not be viewed in isolation.

Children who have a history of violence or aggressive behaviour, should be placed in settings which promote and support positive behaviour. The placing authority must ensure that the home has strategies to deal with challenging behaviour, and that staff are trained in encouraging positive behaviour through de-escalation of conflicts and confrontations.

Staff working with children who display aggressive and violent behaviour should be supported and trained to manage their own feelings and responses.


2. Referral and Admission

For many children, acts of aggression and violence may have been evident prior to coming to us.

Before a child is admitted to the home, the placing authority should provide information on:

  • Any previous challenging behaviour (including violence and aggression);
  • A description of the behaviour, including any triggers so staff can assess whether there are any patterns of behaviour.

At the point of admission staff should also ascertain the following:

  • What intervention strategies have been used to manage the behaviour?
  • What interventions had positive outcomes?
  • What interventions triggered further acts of aggression or violence?

2.1 Risk Assessments

With this level of understanding, Registered Managers should then:

  • Undertake a written risk assessment and develop a strategy for managing any challenging behaviour;
  • Ensure all staff are provided with training on how to de-escalate conflict and confrontation and manage aggression and violence.

The child’s Placement Plan should outline strategies for managing and promoting positive behaviour. If necessary, there should be a separate detailed Behaviour Management Plan.


3. Reporting and Recording

In any recording or reporting, Registered Managers must make clear the behaviour to which they expect staff to apply the term violent and/or aggressive.

The terms "violence" and "aggression" have many definitions. It is likely that if staff were asked individually what acts they felt constituted violence or aggression that these would differ considerably across the group. Similarly, if the question was asked of children it is likely that their interpretation and views would differ widely.

Registered Manager should ensure that:

  • Staff discuss what behaviours they feel describe the terms aggressive and violent;
  • Children are asked what behaviour they feel describe the terms aggressive and violent;
  • It is essential that Registered Managers agree with their staff what constitutes acts of aggression and violence;
  • Where reasonable to do so, staff and children should participate in discussions together;
  • Staff are made aware that discussions with children are a constructive way to ensure that they understand how others perceive behaviours.
The document used to record acts of violence or aggression is the CR16

Reports on aggressive and violent behaviour should provide the following information:

  • What was happening at the time;
  • Who was present;
  • What happened?

Staff and managers should consider the following before reporting an act of aggression or violence:

  • Staff should question their own behaviour and responses;
  • Has the child responded inappropriately to a feeling or act against them where the right to be angry was acceptable, but their response/behaviour was not?
  • Did this occur with a specific person with whom it is known they have difficulty?
  • Had the child received visitors or contact from family / friends at the time of the incident or shortly before or after?

Registered managers and staff should explore all of the above and look for any triggers before they label a child as aggressive or violent.

Accurate and descriptive records are important as they allow evaluation to take place and help identify any triggers or patterns in behaviour. This critical assessment of a situation will ensure that future reports of behaviours, which can 'label' a child aggressive or violent will be based on factual and evaluative reporting.

Each young person will have an Individual Crisis Management Plan (ICMP) This document offers insight into a young persons baseline, escalation and outburst, offering assessed observation on how best to manage and de-escalate difficult behaviours presented.

The CR16 report should be sent to the child’s social worker, the Therapeutic Crisis Intervention Instructor and the Residential Services Manager.

All CR16 reports are analysed in the Critical Incident Monitoring Group


4. Follow up After an Incident

Whenever an act or violence or aggression has occurred, the Registered Manager should ensure that both staff and child concerned, are allowed to discuss the incident and its impact on themselves and others in the group.

Registered Managers should:

  • Undertake a review and make necessary changes to internal policies, routines and children’s Placement Plans to help with reducing or preventing incidents from occurring in the future;
  • Discuss with staff how they dealt with the situation and, if required, how they could deal with the situation differently in the future.

The Critical Incident Monitoring Group collate data emanating from incidents and periodically undertake a review with a view to amending the Home’s policies, training strategies, routines and methods for promoting positive behaviour amongst children.


5. Level of Risk

Registered Managers need to ensure that procedures are in place for responding to incidents and that they match the level of risk.

Workers who are exposed to the risk of violence and aggression need training on the procedures to follow in the event of an incident. It is important that they are aware of the criteria for initiating procedures and are free to do so when they feel under threat.

If the level of risk is such that the continuing placement of the child is threatened, or may be at risk of coming to an end, the home’s manager must draw this to the attention of the child’s social worker and Independent Reviewing Officer (IRO), who may decide to convene a Looked After Review.


6. Actions for Staff following a Violent Incident

A decision should be made between the staff member, the manager and young person about whether to report matters to the Police, see Offending and Anti-Social Behaviour – guidance on when to involve the Police Procedure.