Restrictive Interventions Information Sheet

INFORMATION SHEET

Restrictive Physical Interventions (Restraint) at Iris Care Group What is restrictive Physical Intervention?

Restrictive physical intervention is also known as restraint or physical restraint. It is something that is only ever used when all other attempts to keep a person safe have failed. At Iris Care Group we spend a lot of time and resource trying to reduce the use of restraint.

Restraint involves physically limiting or restricting a person’s movement in order to keep them safe and to keep other people safe in the event of an incident involving serious physical aggression or a serious attempt at selfharm. We may also sometimes be required to use restrictive physical intervention to provide personal care, to preserve the dignity and safety of people who cannot consent to or undertake their own personal care.

What kinds of restrictive physical interventions do we use at Iris Care Group?

At Iris Care Group we use three kinds of physical restraint:

Escorting . This is when two members of staff will hold a person in order to direct them to a calming area or lead them from an environment where they may come to harm or where they are likely to cause harm to others.

Update Date: April 2024

Seated safeholds. This is when two members of staff, with sometimes an additional member of staff used to prevent the person from banging their head, restrict a person to a seated position on a sofa or other safe seating area.

Supine Safeholds . This is when a minimum of three and a maximum of seven people secure a person while they are laying on their back on the floor. It is only used to prevent serious harm. Staff do not exert any of their body weight on joints or the chest area. Sometimes a larger number of staff are needed because of the importance of not placing physical pressure on the person while they are laying on the floor.

People who require support for personal care will all have their own care plan. Staff are required to make referrals to our physical intervention team to help them put together a care plan to fit the needs of the person. For this purpose, we have a specific policy that sets out the rules for using restraint to deliver personal care.

Everyone who is admitted to Iris Care Group has a risk assessment that checks if there are any safety issues around the potential use of any restrictive physical intervention (e.g., history of certain surgery, or any underlying health concern). This is compulsory for everyone.

Everyone admitted to any Iris Care Group site has an individualised behaviour support plan. This helps them and staff avoid the use of restraint. Staff are expected to feedback on the effectiveness of this plan every month. Everyone we support also has to be offered the chance to provide feedback on and suggest changes to their plan.

How often do you use Restrictive Physical Intervention at Iris Care Group?

We use restrictive physical intervention at Iris Care group as little as we possibly can. If you would like to see our data on how often we use restrictive intervention we can give you this information for the period of time you wish to see. Over the last 8 years Iris Care Group has been implementing a formal ‘restraint reduction strategy’ and have been Update Date: April 2024

involved in the development of a number of policy documents aimed at reducing the uses of restraint. Restraint use at Iris Care group has fallen between 75% and 100% over this period.

What laws govern the use of restrictive physical intervention?

The main laws that tell us how restrictive physical intervention must be used are the Mental Capacity Act, Mental Health Act, and the Human Rights Act. At Iris Care Group our policies are all written with these laws in mind and are compliant with them.

How is the use of restrictive physical interventions monitored at Iris Care Group?

At Iris Care Group, all restraints are recorded and monitored by senior clinical and management staff. After each restraint staff are required to engage in a ‘learning debrief’ where the incident is examined, and staff are asked to think about ways that they use of restraint might have been avoided.

After each restraint we require staff to ask the person who has been restrained to give feedback on the restraint to make sure that they have the opportunity to raise any concerns about how the incident was managed. There are special communication systems in place in different Iris Care Group sites to support people with communication difficulties to take part in this process.

Staff do not have a choice as to whether to engage in a learning debrief and they must ask people we support if they wish to give their feedback.

This is checked every month to make sure that staff are doing it. We have noticed over the years that making debrief compulsory has played a big part in reducing restraint.

The amount of restraint used at all Iris Care Group sites is reviewed by senior management and clinical teams in ‘clinical governance’ meetings at

Update Date: April 2024

each site, each month. This information is then reviewed by Director at a monthly clinical governance meeting that covers the entire organisation.

If any individual has three or more restraints during a calendar month, Iris Care Group uses its own ‘Restrictive Intervention Review’ process. This is over and above the legal requirements regarding debrief. We have been using this for 6 years and have fond it adds another level of oversight over the use of restraint which is helpful for ensuring we provide the best possible care.

Every three months, Iris Care Group publishes a thematic review of all restraints, post incident debriefs with staff and people we support, and special restrictive intervention reviews for all sites. This is then reviewed in board meetings and shared across the organisation. It ensures that best practices for reducing restraint are distributed widely.

If any site in Iris Care group has an increase of 10% or more in the use of restraint in a calendar month, then senior teams are required to evidence consideration of a ‘whole service review’. This is an in-depth quality review process, using a standard format, which checks whether there are any problems in the way that the service is being run that has caused restraint use to increase.

How can I find out more about how restraint is used at Iris Care Group?

Anyone – service users, families, and carers, is welcome to arrange a meeting or discussion with the people at Iris Care Group that are involved in the oversight of the use of physical restraint or to see any of our polices and processes that have been referred to in this guide. Anyone can see the training materials we use. These have been approved by the ‘Restraint Reduction Network.’ This is an organisation that approves all physical restrictive intervention training in the UK. We are also happy for people to observe staff members demonstrating any physical intervention technique, on request.

We are always happy to receive feedback on our policies and processes.

Update Date: April 2024