ࡱ> ]_\` %bjbjss J(((((((<ddd8<4<6j.DDD 6666666$7h_:^26(1"1126((DDG61(D(D 61 6*h((0,D  `?-Sd\+ 6]606l+:: 0,:(0, vcTD62626X61111<<<d<<<<<<((((((  British Institute of Learning Disabilities Campion House Green Street Kidderminster DY10 1JL Telephone 01562 723010 enquiries@bild.org.uk www.bild.org.uk Factsheet on physical interventions Summary 50% of people with intellectual disabilities and challenging behaviour will have physical interventions used on them at some point in their life. Physical Interventions should be used in the light of clear policies and procedures, in the context of other strategies for the individual. Staff training and support is essential to ensure good practice in the use of physical interventions The BILD Physical Interventions project is working to develop an Accreditation Scheme for trainers in Physical Interventions with funding made available by the Department of Health and the Department for Education and Science Skills DoH DfES Guidance on restrictive physical intervention now published. 1. General Introduction The behavioural challenges presented by a small number of adults and children with learning disabilities and/or autism, special educational needs or emotional and behavioural difficulties mean that the use of some form of physical intervention may be unavoidable. There is a need to ensure that such interventions are carried out within a legal and ethical framework that sets out explicit safeguards for the person with a learning disability and for staff. It has also been identified that training in physical interventions must be commissioned, delivered and planned within a strategic approach and to a set of desired standards. The inappropriate use of Physical Interventions increases the risk of injury to both staff and service users. 2. Numbers Challenging behaviour is very common in people with learning disability, estimates suggesting about 20% of children and 15% of adults exhibit some form of challenging behaviour. (Harris 1993). There is currently no systematically recorded evidence of the extent to which physical interventions are used in services for people with learning disability and/or autism. Recent research has suggested that 50% of people with intellectual disabilities and challenging behaviour will have physical interventions used on them at some point in their Life. 3. The Issues What are Physical Interventions? Physical interventions have been defined in the BILD guidance as: "A method of responding to the challenging behaviour of people with learning disability and/or autism which involves some degree of direct physical force which limits or restricts the movement or mobility of the person concerned." Categories of Physical Intervention The BILD policy framework for physical interventions sets out three broad categories of physical intervention Direct physical contact between a member of staff and a service user e.g. holding a person's arms and legs to stop them attacking someone The use of barriers, such as locked doors, to limit freedom of movement e.g. placing door catches or bolts beyond the reach of service users Materials or equipment which restrict or prevent movement e.g. placing splints on a person's arms to restrict movement The Legal Framework This brief factsheet cannot set out the full extent of the legal framework, however, some brief points can be made. Professionals working with vulnerable people have a duty of care to ensure that in this context means a need to avoid actions that may harm others, and that the agencies they work for act always in the best interest of the service user. Also, the framework provided by criminal and civil law should ensure that people can live without 'interference from others' including for example assault or false imprisonment. There is further discussion and clear guidance about the legal framework to be found in BILD Physical Interventions Policy Framework. WHERE SERVICES HAVE A CONCERN ABOUT THE LEGAL STATUS OF PROCEDURES EMPLOYED TO RESPOND TO CHALLENGING BEHAVIOURS, THEY ARE ADVISED TO CONSULT A LAWYER WITH RELEVANT EXPERIENCE. When to Use Physical Interventions? The guidance on the use of physical interventions sets out the circumstances in which they can be used. Some key principles are that physical interventions should be used in the context of other strategies for the individual, after other less intrusive methods have been tried and found to be ineffective, and as a part of individual support plans. The Role of Management in Policy and Procedure Service Managers have a number of responsibilities around the appropriate use of Physical Interventions. Ensuring that Care staff always work in ways that are consistent with the law. Ensuring the needs of service users are properly met. Discharging responsibility for health and safety in the workplace. Developing Policy Managers in services have a responsibility for the development of policies on the use of physical interventions, and for ensuring that staff are appropriately trained. There is further guidance on the development of policy and procedure in the BILD guidance. Some key points about policy development are that: staff record the use of physical interventions fully and honestly emergency responses to behaviours and follow up process required are clearly laid out service users as fully involved as possible in developing the Physical Interventions policy Training must make explicit reference to the values that underpin the use of Physical Interventions. Training in the use of Physical Interventions is not a one off event. In successful services, where good strategies for prevention of challenging behaviour are used, it could be that PI is used minimally, or that incidences of its use are few and far between. Because of this staff skills and competences in this area will need to be regularly updated. The BILD Physical Interventions project is working to develop an Accreditation Scheme for trainers in Physical Interventions with funding made available by the Department of Health and the Department for Education and Science Skills. References Harris P (1993); The nature and extent of aggressive behaviour amongst people with learning difficulties (mental handicap) in a single health district, in Journal of Intellectual Disability Research, 37, 221-242 Harris J. Allen D. Cornick M. Jefferson A. and Mills R. 1996, Physical Interventions a Policy Framework. Kidderminster (BILD Publications) Department of Health, 2001,A Safer Place: Combating Violence against Social Care Staff - Report of the National Task Force and National Action Plan. ( Pavilion) Department of Education and Employment, 1998, Section 550a of the Education Act 1996: The use of Force to Control or Restrain Pupils. Circular 10/98. London(HMSO) Department of Health, 1993, Guide on the Permissible Forms of Control in Children's Residential Care, DoH. Department of Health 1991, The Children Act (1989) Guidance and Regulations, Volume 4 Residential Care. London (HMSO). Treatment and Management of Challenging Behaviour in Residential Settings JARID Vol 13, No4, 197 - 215 British Institute of Learning Disabilities (2001), BILD Code of Practice for Trainers in the Use of Physical Interventions: learning disability, autism and pupils with special educational needs, (BILD Publications). More information can be found 0n BILDs website  HYPERLINK "http://www.bild.org.uk" www.bild.org.uk Authors: Sharon Powell and John Northfield Date: 20 February 2002 BILD has made every effort to ensure the accuracy of the information contained within its factsheets, but cannot be held liable for any actions taken based on the information provided.      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