The Positive Relationships Standard
Regulation 11
The Protection of Children Standard
Regulation 19 – Behaviour Management and Discipline
Regulation 20 – Restraint and Deprivation of Liberty
Guidance: Positive Environments Where Children Can Flourish (Ofsted)
This chapter has been given a refresh in May 2022.
The assessment and planning process for all children in residential care must consider whether the child is likely to behave in ways which may place him/herself or others at risk of Injury or may cause damage to property. The impact of the child's arrival on the group of children/young people living in the home should also be considered.
If any risks exist, strategies should be agreed to prevent or reduce the risk. These Strategies may include Physical Intervention. Staff in the children's home should continually review any risk assessments.
Where Physical Intervention is likely to be necessary, for example, if it has been used in the recent past or there is an indication from a risk assessment that it may be necessary, the circumstances that give rise to such risks and the strategies for managing it should be outlined in the child's Placement Plan.
In developing the Placement Plan, consideration must be given to whether there are any medical conditions which mean particular techniques or methods of physical intervention should be avoided. If so, any health care professional currently involved with the child be consulted regarding appropriate strategies and this must be drawn to the attention of those working with or looking after the child and it must be stated in the Placement Plan. If in doubt, medical advice must be sought.
NOTE The absence of a strategy in the Placement Plan or other behaviour management plan does not prevent staff from acting as they see fit in the management of highly confrontational or potentially harmful behaviour. However, staff may only deviate from agreed plans where they are able to demonstrate that that it was not sufficient to prevent injury or damage to property. Any deviation from an agreed plan or must be reported to the Home Manager and child's social worker without delay. |
There are four broad categories of Physical Intervention:
The significant distinction between the first category, Restraint, and the others (Holding, Touch and Presence), is that Restraint is defined as the positive application of force with the intention of overpowering a child. The intention is to overpower the child, completely restricting the child's mobility. The other categories of Physical Intervention provide the child with varying degrees of freedom and mobility;
Trained staff should only use techniques that are approved by the home. Approved techniques should comply with the following principles:
All staff must be trained in methods of behaviour management, including the use of physical intervention and restraint that are agreed by the Home.
This training must ensure that staff are able to:
There are different criteria for the use of Restraint and other forms of Physical Intervention, such as Holding, Touching and Physical Presence:
This restriction of a young person's liberty should be for the minimum amount of time possible and in response to immediate danger. Staff will need to ensure that in the recording of any incident they clearly outline all the steps taken to prevent the need to restrict the child's liberty using physical means.
If a young person continually requires this level of intervention to help them to remain safe, a planning meeting should held with the placing authority to consider the appropriateness of the placement.
When strategies to manage behaviour are agreed in placement plans, they should be recognised that this is a process of ‘testing’, and as such the effectiveness of any strategies will need to be reviewed in conjunction with the local authority. The review should be clearly documented and any agreement must not conflict with regulations regarding 'Deprivation of Liberty'.
It is acceptable to use electronic mechanisms or other modifications which are necessary for security, for example on external exits or windows, so long as this does not restrict children's mobility or ability to leave the premises if they wish to do so.
Locking of external doors, or doors to hazardous materials, may be acceptable as a security precaution if applied within the normal routine of the home.
If Physical Intervention is used upon a child, the Home Manager and child's social worker must be notified within one working day.
If a serious incident or the police/emergency services are called, the relevant senior manager must be notified and consideration given to whether a Notifiable Event has occurred, if so, see Notification of Serious Events Procedure.
The social worker should make a decision about whether to inform the child's parent(s) and, if so, who should do so.
A children's home cannot routinely deprive a child of their liberty without a court order, such as a section 25 order to place a child in a licensed secure children's home or in the case of young people aged 16 who lack mental capacity, a deprivation of liberty may be authorised by the court of protection following an application under the Mental Capacity Act 2005.
Where Physical Intervention has been used, the child, staff and others involved must be able to call on medical assistance and children must always be given the opportunity to see a Registered Nurse or Medical Practitioner, even if there are no apparent injuries.
If a Registered Nurse or Medical Practitioner is seen, they must be informed that any injuries may have been caused from an incident involving Physical Intervention.
Whether or not the child or others decide to see a Registered Nurse or Medical Practitioner it must be recorded, together with the outcome.
The Registered person should regularly review the effectiveness and check the medical assessment of the system remains up to date.
If a child has an Education Health and Care plan in which a specific type of restraint is used as part of the day to day child's routine, the home is exempted from the recording requirement. Where these plans provide for a specific type of restraint that is not for day to day us, the restraint used must be recorded. Any other restraint used must always be recorded.
All forms of Physical Interventions should be recorded in the Restraint Log and an Incident Report must be completed.
The incident should be recorded in the Home's Daily Log and on the Daily Record for the individual Child(ren).
The child's Placement Plan should be reviewed to incorporate strategies for reducing or preventing future incidents. The child must be encouraged to contribute to this review and, if a health care professional is involved with the child, any new strategies must be approved by that person.
The Manager of the Home should regularly review incidents and examine trends and issues emerging from this to enable staff to reflect, learn and inform future practice and, where necessary, should ensure that procedures and training are updated.
Ideally within 24 hours (and no more than 5 days) the child involved in the restraint should be able to express their feelings about this experience and should be encouraged to record their views to the record of restraint.
Within 48 Hours the use of intervention, staff should have discussed the incident with a senior member of the team. This is to ensure that any issues can be identified and any learning be acted upon to prevent, where possible, the need for further instances.