A summary of the key policy principles on physical interventions
1. Any physical intervention should be consistent with the legal obligations
and responsibilities of care agencies and their staff and the rights and
protection afforded to people with learning disabilities under law.
2. Working within the "legal framework", services are responsible for the
provision of care, including physical interventions, which are in a person's
best interest.
Values
3. Physical interventions should only be used in the best interests of the
service user.
4. Service users should be treated fairly and with courtesy and respect.
5. Service users should be helped to make choices and be involved in making
decisions which affect their lives.
6. There should be experiences and opportunities for learning which are
appropriate to the person's interests and abilities.
Prevention of Challenging Behaviour
7. Challenging behaviours can often be prevented by the careful management of
setting conditions.
8. The interaction between environmental setting conditions and personal setting
conditions should be explored for each service user who presents a challenge.
Setting conditions should be modified to reduce the likelihood of challenging
behaviour occurring (primary prevention).
9. Secondary prevention procedures should be developed to ensure that
problematic episodes are properly managed with non-physical interventions before
service users become violent.
10. For each service user who presents a challenge there should be
individualised strategies for responding to incidents of violence and reckless
behaviour. Where appropriate, the strategy should include directions for using
physical interventions.
11. Individualised procedures should be established for responding to service
users who are likely to present violent or reckless behaviour. The procedures
should enable care staff to respond effectively to violent or reckless
behaviours while ensuring the safety of all concerned.
Promoting the best interests of service users
12. Physical interventions should only be used in conjunction with other
strategies designed to help service users learn alternative non-challenging
behaviours.
13. Planned physical interventions should be justified in respect of: what is
known of the client from a formal multidisciplinary assessment; alternative
approaches which have been tried; an evaluation of the potential risks involved;
reference to a body of expert knowledge and established good practice.
14. The use of physical interventions should be subject to regular review.
Physical intervention and risk assessment
15. The potential hazards associated with the use of physical interventions
should be systematically explored using a risk assessment procedure. Physical
interventions should not involve unreasonable risk.
Minimising risk and promoting the well-being of service users
16. Physical interventions should be employed using the minimum reasonable
force.
17. Any single physical intervention should be employed for the minimum duration
of time.
18. For individual service users, physical interventions should be sanctioned
for the shortest period of time consistent with his or her best interests.
19. Physical interventions should not cause pain.
20. Service users should have individual assessments to identify
contra-indications of physical interventions before they are approved.
21. Service users who receive a physical intervention should be routinely
assessed for signs of injury or psychological distress.
Management responsibilities
22. Service managers are responsible for developing and implementing policies on
the use of physical interventions.
23. The use of any procedure should be clearly set out in the form of written
guidance for staff
24. Service managers are responsible for ensuring that all incidents which
involve the use of physical interventions are clearly, comprehensively and
promptly recorded
25. All service users and their families and representatives should have ready
access to an effective complaints procedure
26. Careful consideration should be given to the impact of resource management
on the use of physical interventions
Employers' responsibility towards staff
27. Employers and managers are responsible for the safety and well-being of
staff
28. Staff should be encouraged to monitor all physical interventions and to
report any incidents which give cause for concern.
Staff Training
29. Staff who may be required to use physical interventions should receive
regular training on knowledge, skills and values.
30. Training should be provided by an instructor with appropriate experience and
qualifications
31. Staff should only employ physical interventions which they have been trained
to use.
32. Staff deployment should be organised to ensure that appropriately trained
staff are available to respond to any incident which requires physical
intervention.
From: Physical Interventions: A Policy Framework, Harris et al, 1996, published by BILD/NAS
See this and other books on challenging behaviour
Page ref: '03behaviour_pi_pp Owned by: l.howells@bild.org.uk Last updated: 06/08/2008