The Department for Health and Department for Education have published a consultation on new draft guidance to reduce the need for restraint and restrictive intervention for children and young people with learning disabilities, autistic spectrum disorder and mental health needs.
You can read the draft guidance and submit a response here.
We welcome this long anticipated guidance from the Department of Health and Department for Education and having congruent messages from both departments is really helpful. However we are disappointed that the guidance doesn’t also apply to mainstream schools and PRU’s where many children with learning disabilities, autism and mental health problems are having difficulties and are vulnerable to the overuse of restrictive practices such as physical restraint and seclusion.
We are very pleased to see the focus on de-escalation throughout the guidance but would like to see more focus on preventative strategies so that needs are understood and met before behaviour that challenge occur and de-escalation is needed.
We think there could be even more emphasis in this guidance on physical restraint as the last response in an emergency and we would also like to see some very clear definitions of important key terms and concepts in the final guidance. For example we are pleased to see the guidance includes positive behaviour support (PBS), but it does not define clearly enough what PBS is and what its essential components are. These essential components have been set out clearly in other guidance such as Ensuring Quality Services and the key messages document.
Behaviour support plans should be evidence based and developmental for the young person. They should contain preventative and proactive strategies so children and young people can build skills and develop alternative behaviours. A behaviour support plan may contain some reactive strategies but these should not be the main part of the plan. It would be very positive if the Department of Health and the Department for Education could emphasise this important aspect in this guidance.
We support the emphasis on participation throughout the guidance but we think the key actions could be made stronger overall and more outcomes focused.
We were pleased to see that there is a recommendation for an organisational lead for restraint reduction that can monitor organisational and individual progress of reduction plans.
Successful restraint reduction needs whole organisational commitment, outcome monitoring and partnership working. There also needs to be careful attention to the individual support provided to children and young people who are mostly likely to be at risk of being physically restrained or put in seclusion.
We would like to see the principles in the private members bill Seni’s law Mental Health Units (Use of Force) Bill, that requires publication of data on the of physical force and better training being applied apply to all learning disability and children’s services as well as adult mental health.
We will be submitting a full response to the draft guidelines and the consultation period is open until 24 January.
19 December, 2017