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3.4.1 Behaviour Management, Discipline/Sanctions and Physical Intervention for All Looked After Children

AMENDMENT

This chapter was updated in September 2011 to take account of Regulation 13 of the Fostering Services Regulations 2011 and associated guidance and Standard 3 of the National Minimum Standards for Fostering 2011. In particular Sections 9 to 12 of this chapter, which previously referred to staff in residential care, has been revised to include foster carers.


Contents

  1. Introduction
  2. Principles of Positive Care
  3. Rights and Responsibilities
  4. The Need for Discipline
  5. Care Management and Discipline
  6. Permitted Disciplinary Measures
  7. Prohibited Disciplinary Measures
  8. Managing a Potential Incident
  9. Managing a Violent Incident- Use of Restraint
  10. Follow-up Action to Incidents of Restraint
  11. Recording Incidents
  12. Training and Staff Development


1. Introduction

This policy sets out a framework for the behaviour management of all Looked After children and is based on a need to provide a safe and caring environment in which the rights and responsibilities of both children and staff/carers are respected. It complies with Standard 3 of the National Minimum Standards for Fostering 2011 and Children’s Homes 2011.

It affirms certain key principles and establishes a framework for good care practices and clarifies the support and training necessary to assist staff/carers in this task.

At the same time it acknowledges the challenge of the task of residential staff and foster carers and the fact that children sometimes behave unacceptably. We therefore have a responsibility to establish clear boundaries and to provide guidance on ways of addressing this behaviour. This may include appropriate use of sanctions and as a last resort physical Restraint.


2. Principles of Positive Care

1. Each children’s home and foster home needs to have clear rules for conduct and behaviour. Children must understand what is unacceptable and what disciplinary measures may arise as a consequence.
2. Each child is a unique individual who is entitled to have his or her own needs addressed and a Care Plan developed for him or her. Children who are looked after and their families should be involved in shaping the Care Plan whenever possible.
3. Residential staff/carers should aim to create an environment, which provides consistent care practices based on constructive relationships between the children in the placements and the staff/carers. It should be openly acknowledged that children have a right to be protected from abuse and ill treatment.
4. Children need to be cared for with due regard to their gender, sexual orientation, race, religion, language, culture, diet and to any disability. Appropriate leisure activities should be provided and high priority given to health, education, stimulation and play.
5. Children have a right to be consulted and to raise concerns about their care. These concerns should be seriously listened to and all children should be made familiar with the borough’s complaints procedure. This right to consultation extends also to those with Parental Responsibility.
6. Account must be taken of a child’s background and experiences. Many will have suffered physical and sexual abuse. Unaccompanied asylum seekers may have suffered extremes of physically violent and oppressive behaviour. Some children may have a learning disability or physical disability. All factors may influence a child’s reaction to authority and the exercise of power.
7. The care of children is a complex and demanding task. Relationships between staff/carers and children are subject to similar tensions as in a family but with additional factors.
  • The children are not being cared for by their parents;
  • They all have different life experiences prior to their being in care;
  • They may be living in a group setting.
8. It is clearly the responsibility of Education and Children’s Services to provide appropriate staffing for our residential homes and to provide the support and training necessary for staff/carers. Staff/carers needs to be trained, supported and valued in order to create a safe, sensitive environment in which children can grow, learn, develop and feel safe.


3. Rights and Responsibilities

All rights and responsibilities go hand in hand. Everyone should be afforded basic human rights, but need to be aware that, in order to have their rights respected, they must exercise responsibility for their actions towards others.

Staff/carers have to right to

  • Clear information on the expectations of them in relation to the behaviour management of children in the placement having regard to the child’s individual problems and needs and the permitted forms of discipline;
  • Understanding of their task and the effects of being exposed to abusive and violent behaviour from children;
  • Support and training to help in their task and in dealing with issues of care and discipline;
  • Protection from violence and harm.

Staff/carers have a responsibility to

  • Safeguard and promote the welfare of children at all times;
  • Participate in training and develop skills, which promote good care and diminish the need for disciplinary measures;
  • Only use Restraint as provided for in this procedure;
  • Recognise and support children’s rights to make representations and complaints;
  • Work together with other professionals involved in the task of protecting children and be open and honest when giving accounts of the actions they have taken;
  • Offer assistance to children to help them communicate concerns e.g.: through an interpreter, signer, and advocate as appropriate.

Children have a right to   

  • Be protected from harm, violence and the risk of exploitation;
  • Safe and consistent care that promotes their welfare and development;
  • Not to be punished cruelly or in a way that belittles them;
  • Express an opinion about their care and the management of their behaviour;
  • Complain if they feel they have been treated in a manner, which is incorrect, harmful, and abusive or infringes their basic human rights;
  • Respect from adults, even if behaving unacceptably;
  • Unconditional support from adults in pursuit of the above rights.

Children have a responsibility to

  • Be responsible for their own behaviour and actions;
  • Treat other children and adults with respect and not behave in a bullying or violent way towards them;
  • Respect other people’s property;
  • Accept the need for external control if they are unable to exercise self-control;
  • Respect the rights of other children in the placement, staff/carers or visitors;
  • Give an honest account of their behaviour;
  • Report any action in which they have been harmed.

All these responsibilities are dependent on the age, level of understanding and ability.


4. The Need for Discipline

There is a clear need for good order and discipline within a residential home or foster home for various reasons.

Individual development: Part of growing up is learning how to live within reasonable limits. External controls may be necessary at first to help a child feel able to develop inner controls. Some children we care for may come from environments where external controls are absent, or excessively punitive.

Group needs: Harmful or disruptive behaviour will have an obvious effect on others in the children in the placement - this includes staff/carers - who have a right to be protected from verbal or physical violence.

Safety: Any behaviour is unacceptable if it puts the child or others at risk of injury or other harm.

Effects on staff/carers: Frequent incidents of abusive or violent behaviour can have negative effect on staff/carers. It can be de-skilling and isolating and at worst can cause injury and illness.

Maintenance of a homely environment: Damage to property affects the quality of physical care within the home.


5. Care Management and Discipline

  1. The emphasis should be on effective discipline based on a framework of approval, praise and negotiation. The establishment of boundaries is a way in which adults demonstrate care and by which children learn to socialise and become responsible adults. There should be a system of rewards (commendations, extensions of privileges, etc.) as well as consequences. In normal circumstances children should be encouraged to behave well by the frequent expression of approval by staff and the generous use of rewards rather than by the extensive imposition of disciplinary measures;
  2. This can only be done in an environment of good relationships between the children in the placement and staff/carers. Staff/carers should always demonstrate that they care for the child and are concerned about their wellbeing, even if they disapprove of the child’s behaviour. We should remember that this unconditional acceptance might have often been lacking in a child’s previous care;

    Children will tend to listen to and co-operate with staff/carers who are fair, honest, warm, willing to listen, firm, consistent, and able to stick to their word and establish open and friendly relationships;
  3. Good order and discipline can best be achieved when staff/carers work together as a team. Frequent and clear communication is therefore essential between staff/carers and disagreements should not be aired in front of the children;
  4. In residential care, this consistency of approach should extend to the management of the home, as this will enable staff/carers to feel supported in their approach.
  5. Group living in residential care is a very different experience from life in a family. There is a more apparent need for boundaries and behaviour has a greater impact on others. Children need a clear understanding of what the ground rules are and the reasons for this existence. They need the opportunity to participate in decision making about how the home operates and about rules and sanctions. They will have no respect for rules, which are seen as unfair or arbitrary.


6. Permitted Disciplinary Measures

1. There may be occasions when an external control or sanction has to be imposed on a child; Sanctions are likely to be most effective when
  • The child cares about what is being done;
  • The child cares about where he/she lives;
  • The child cares about their relationship with the person imposing the sanction. In many instances, if the above applies, a verbal reprimand will be all that is necessary.
2. In the case of more serious breaches of discipline, a more formal sanction may be considered. These should be used sparingly and not as a substitute for verbal discussion and negotiation.

Consideration should always be given to circumstances surrounding the behaviour and a specific behaviour should not necessarily earn a specific sanction as a matter of course. Before a sanction is imposed three factors should be considered

  • Does the child realise what he/she has done wrong?
  • Does he/she accept the need for a sanction?
  • Will the sanction be of benefit or will it just make the adult feel better.
3. Restitution: The aim should be to teach the child the value of property belonging to others. Restitution should be appropriate to “income” (i.e. no more than 2/3 pocket money allowance) age and degree of responsibility. It may also be appropriate to consider any sentimental value of property lost/damaged and any mitigating factors causing the incidents.
4. Reparation or “making amends” for negative behaviour: The aim of restorative justice is to address the needs of the victim, while helping the “offender” take responsibility for what they have done, and see things from another perspective. It could include such things as an apology or doing something for the person affected. For non-verbal children a hug or kiss may be appropriate.
5.

Withdrawal of privileges: Usually a curtailment of leisure activities. These are hard for a child to accept and could be unnecessarily stringent. An immediate sanction -e.g. no TV, or “grounded” for 1 night may be more enforceable and understandable than withdrawal from a trip one week later.

We should try and avoid stopping attendance on:

  • School trips;
  • Team events (e.g. school football team);
  • Regular and beneficial activities e.g. swimming, guides, cadets.
6. Additional chores: These should be beneficial activities, not pointless activities. Staff/carers should ideally be present or assist and should not be beneficiaries of the extra chores.
7. Increased supervision: This is appropriate if there is a danger to the child, or to others, or if they are likely to run away. This supervision is the responsibility of staff/carers, not the child. The supervision should be preventative, not punitive, and the need for it should be explained to the child. The extra attention could enable the child to talk through the issues and may diffuse the situation. 
8. Removal from the group (“Time out”): This may be necessary after an incident or to diffuse a difficult situation. The child should not be left alone or confined (i.e. behind locked doors.) It should be time limited and used as a cooling down period. The time should ideally be no more than 30 minutes and certainly no longer than an hour unless the child is in agreement.

Another option may be to remove the other children in the placement if the child refuses to leave or continues to misbehave.

Early bedtimes can be used as a sanction but should not be longer than one hour and it is advisable not to leave a child alone at this time!

9. Confiscation of articles from the child: This would include weapons and drugs. Clothing and footwear may only be removed if it has been used as a weapon. Toys, radios etc. may only be removed if used as weapons or being deliberately damaged.
10.

Refusal to accept a sanction.

This may always be an instant response in the heat of a situation. Staff/carers too may have heightened emotions and may feel a need to exert their authority for fear of losing face. It may be advisable to have a short delay to diffuse the situation and discuss with a colleague.

If the child still refuses the sanction should still be imposed and the child will be informed that the sanction will be waiting for them to carry it out.

This means that a sanction may have to be carried out by another member of staff/carer and it is important that staff/carers a) impose reasonable sanctions and b) support each other. On the other hand, improved behaviour can be rewarded by a reduced sanction as long as the reason is clearly communicated. Children must realise that a sanction can only be reduced by their good behaviour, not because of differences in attitude of staff/carers.

11.

Group sanctions: These should be avoided wherever possible, as they may include those who were not involved in the incident. They are likely to incite children against staff/carers and create a climate where there is a potential for bullying. Peer pressure can be a useful tool when used appropriately and sparingly but children should not be allowed to have too much power in this respect.

In children’s homes, residents’ meetings can be a good means of influencing the group, reinforcing rules and expectations and dealing with issues of bullying, stealing and other matters.

12. Recording: The child should be informed immediately of any sanction imposed and they should be fully recorded. The record should include the name of the child, details of the behaviour including the time of day, names of the staff/carers present, the date and nature of the sanction, the name of the person imposing the sanction and any follow-up action taken. The child should be given the opportunity to give their views regarding the sanction, and this should be included in the recording. For children in residential care the record should be seen by the residential manager within 24 hours. The residential manager should check that all sanctions are: -
  • Within the law;
  • Relevant to the child’s behaviour;
  • As time limited as possible;
  • Imposed as close in time as possible to the child’s behaviour;
  • Imposed with at least the child’s tacit agreement;
  • Enforceable;
  • Achievable by the child;
  • Not constantly resurrected.

Those with Parental Responsibility should be informed as soon as possible after the event. The Team Manager of the residential service should also monitor the sanctions book a minimum of monthly to review the effectiveness of the strategies employed. For foster carers, their use of sanctions should be monitored by the supervising social worker in supervision and as part of their annual review.


7. Prohibited Disciplinary Measures

7.1 Prohibited disciplinary measures include:

  1. Any form of corporal punishment;
  2. Any punishment relating to the consumption or deprivation of food or drink;
  3. Any restriction, other than one imposed by the court, on:-
    1. A child’s planned contact with his or her parents, relatives or friends;
    2. Visits by the child’s parents, relatives or friends;
    3. A child’s communications with his or her family, advocate or solicitor; or
    4. His or her access to any telephone helpline providing counselling for children;
  4. Any requirement that a child wear distinctive or inappropriate clothes;
  5. The use or withholding of medication or medical or dental treatment;
  6. The intentional deprivation of sleep;
  7. The imposition of any financial penalty, other than a requirement for the payment of a reasonable sum (which may be by instalments) by way of reparation;
  8. Any intimate physical examination of the child;
  9. The withholding of any aids or equipment needed by a disabled child;
  10. Any measure which involves:-
    1. Any child in the imposition of any measure against any other child; or
    2. The punishment of a group of children for the behaviour of an individual child.

7.2 Restriction of liberty

Children must not be kept in accommodation which physically restricts their liberty unless it is in compliance with the Placement in Secure Accommodation Procedure

The following therefore is not permitted:

  • Locking of a child or children in a room – even when accompanied by an adult;
  • Locking of internal doors to confine a child or children in a certain section of the building, even if accompanied by an adult.

The following do not count as Restriction of Liberty although should only be used as consistent Health and Safety requirements.

  • The locking of external doors at night;
  • The securing of windows;
  • The locking of external doors during the day to prevent intruders from gaining access, not to prevent residents from going out;
  • Any measures needed to prevent children from gaining access to unsafe areas or objects.

In some circumstances (e.g. younger children or children with disabilities who put themselves at risk of running away) it is permissible to lock the external door during the day time, if agreed in the Statement of Purpose and/or as part of the child’s Placement Plan.


8. Managing a Potential Incident

8.1 Diffusing an Incident

There are frequently occasions when all the usual methods of external control do not work! With many children, especially those under stress (which includes all those we look after) a very low-key problem can quickly escalate into aggression and violence. 

We can briefly define ‘aggression’ as a deliberate intention to cause hurt or harm to someone against his or her will. Violence is when this aggression or behaviour becomes an act that can cause harm to someone. The person at risk could be himself or herself, another child, a member of staff or the carer.

There are many reasons for aggressive and violent behaviour. These reasons are usually a combination or personal and environmental factors.

The personal factors may be physical (e.g. illness or injury) or due to current or past life experiences. These factors are not quickly changed.

We can however, change the environmental factors, bearing in mind that staff/carers are a vital part of the environment! We can try and create an environment where challenge does not lead to aggression and where aggression does not lead to violence. It is also important to remember that if one child is aggressive or violent towards another or towards a member of staff/carer, it should not be taken personally. They may be angry because a member of staff/carer has refused them something, or because they just happen to be there, although the anger may be actually directed towards someone or something else.

We need also to remember that a violent incident can be just as distressing to the perpetrator as to the person attacked and the other people present. Examination of incidents also demonstrates that there are triggers that indicate potential escalation and ways in which these can be diffused. 

Click here to view the Development of an Incident Over Time Diagram

The above diagram indicates the development of an incident over time. We should be aiming to spot the ‘triggers’ that indicate the potential for a situation to escalate out of control. During the build-up there are actions that can be taken that will prevent the situation from getting worse. However, if this fails, or is not spotted soon enough, then a violent incident may occur when all that can be done is to protect the child and all others as best one can. Afterwards it is important that time is allowed for all to recover.

Early Warning

Not all aggressive incidents can be avoided but some can by reading the early warning signs. These may be: -

Verbal
  • Negative phrases e.g. “I can’t, it doesn’t matter”;
  • Threats.
Non-verbal

e.g.

  • Raised tone of voice;
  • Body position;
  • Drumming of fingers, clenched fist etc.

At this time it is helpful to be aware of any unusual behaviour and to have information from other staff of any potential stressful occurrences for the child. They may need some individual time or may need to be left for a while. It is important to remain calm and be available if necessary – a lot will depend on relationship with and knowledge of the child. 

Build-up

Frequently these early warning signs are unnoticed and the first time staff may be aware of a problem is when a child starts to become abusive or aggressive. It may still be possible to diffuse the situation by keeping calm, talking to the child and avoiding confrontation if possible or avoiding a situation where the child feels threatened or likely to lose face.

If the situation continues to develop, other measures may need to be used e.g.

8.2 Restriction of Liberty

In the ordinary course of maintaining control over a child, an adult may tell them to do things, which they do not want to accept, including refusal of permission to leave the building. If a child complies with reasonable instructions, the question of restricting liberty by the use of accommodation does not normally arise. 

For a young child, the potential danger in leaving a home is real and obvious and the case for action to prevent this is clear. In addition to physically restraining such a child it may be necessary to hold or closely supervise him/her for a matter of hours to ensure he/she does not run off. However, for an adolescent who absence from home is judged unlikely to lead to injury or serious damage, physical Restraint would be inappropriate. Staff should recognise that there are practical limitations on their ability to prevent children from running away from a children’s home or foster home if they are determined to do so. The use of physical restraint in these circumstances cannot become substitute for secure accommodation. Where there is a need for “immediate action” - to prevent injury to any person or damage to property”, then consideration should be given to whether the criteria for placement in secure accommodation can be satisfied and legal advice should be sought.

The practice of not allowing children out (‘gating’ or ‘grounding’, as it is sometimes called) is common and acceptable provided the child is not prevented from leaving by being locked in or physically restrained. If however, staff or carers require a child to remain in a building or part of a building for an unreasonable length of time without relief, then this may constitute the use of accommodation to restrict liberty, even though no actual locking up is involved. This will depend upon circumstances including the space available to the child within whom she/he is restricted, their age, competence and physical and emotional well-being.

8.3 Methods of Care and Control of Children, which Fall Short of Physical Restraint or the Restriction of Liberty

In any situation where child’s behaviour provokes intervention talking to them is an essential response. However, staff/carers should feel able to reinforce dialogue with actions such as standing in the way of a child wishing to leave, placing a hand on the child’s arm, holding the child if he is highly distressed. These are acceptable, provided that their use is persuasive rather than coercive. The notion is developed in the following paragraphs, which identify two types of intervention that can be used in this manner, physical presence (e.g. standing in the doorway) and holding.

Physical Presence

This refers to actions, which reinforce a member of staff/carer’s authority or concern. It is an aspect of the staff member/carer’s role as a supervisor of children. As its simplest level, a staff member/carer’s presence in the room with children should be a deterrent to misbehaviour. A look or a gesture may send out signals to children, which help to keep behaviour within acceptable limits. This guidance suggests acceptable limits can include standing in the way of a child who is ignoring instructions or losing control and may be reinforced further, for example, by placing a hand on the child’s arm. The effect of this may be to restrict a child’s movement without the use of (forceful) physical Restraint. This is acceptable only as long as the duration of this restriction does not extend for example into hours. It may be counter-productive if the child’s anger or distress increases. Its effectiveness may depend upon the respect that the child has for the particular staff member.

The following principles apply to the use of an adult’s physical presence. It:

  1. Must be likely to be effective by virtue of the overall authority carried by the staff member and not simply his/her physical presence;
  2. Must be used in the context of trying to engage the child in discussion about the significance and implications of his/her behaviour;
  3. Should not be persisted in if the child physically resists. In this case a decision will need to be made about whether another form of intervention is justified.

Holding

There are occasions when control can be maintained by holding a child in a manner, which does not carry the force of physical restraint. A child may be successfully diverted from destructive or disruptive behaviour by being led away by the hand, arm, or by means of an arm around his/her shoulder. Again children having an argument or a fight, which in itself is not likely to cause serious harm, but is nonetheless disruptive and detrimental to the well being of other children, may be successfully separated by being held firmly and guided away. The main factor separating “holding” from “physical restraint” is the manner of intervention and degree of force applied. Physical restraint uses the degree of force necessary to prevent a child harming himself, others or property. Holding would discourage but in itself would not prevent such action. It is more likely to find application in those homes caring for younger children, particularly for those whose behaviour is unlikely to respond to verbal influence alone. However, even young adults may be successfully engaged by the hand placed firmly on the arm or shoulder to reinforce the attempts of staff or carers to reason with them, or to emphasise the concern felt for them.

Staff/carers should adopt the following principles when dealing with children this way:

  1. Whenever possible, staff/carers involved should have an established relationship with the child and should explain to the child what he/she is doing and why;
  2. Holding should not arouse sexual expectations or feelings and should be careful not to hold a child or child in such a way that involved contact with breast or genitals;
  3. If on any occasion the child forcibly resists or demonstrably objects then “holding” should no longer be used as a method of Restraint in the particular case. Consideration should be given to other means of intervention, in consultation with other staff on duty if circumstances at the time permit.


9. Managing a Violent Incident - Use of Restraint

The above measures may not be successful or an incident may escalate too quickly for staff/carers to be able to prevent a child becoming violent.

At this point the child has gone beyond the stage where they can be reasoned with. The aim should be to contain and calm them as quickly as possible in order that they can then be engaged in a resolution of the problem.

The difference between “restraint” and “holding” is the degree of force applied. “Holding” would discourage a child or child from harming himself or herself or others but would not in itself prevent such an action-taking place.

“Restraint” is defined as “the positive application of force with the intention of overpowering a child to protect the child from harming himself or others or seriously damaging property”; the force used should be the minimum necessary.

As well as the requirements of the Children Act 1989, any Restraint must also be within the general law, as any physical contact or Restriction of Liberty could be considered an assault. The law does recognise that there are some circumstances where legal justification exists for such actions.

These are: -

  • Self defence;
  • Protection of an individual child/child;
  • Protection of other children/adults;
  • Protection of property from serious damage.

Therefore under the Children Acts 1989 and 2004, child protection procedures and general law, reasonable application of the minimum force to deal with particular situation in order to protect oneself others or a particular child from significant injury or to prevent serious damage to property is permissible.

In Hillingdon the approved methods of Restraint in residential care are those techniques taught by Team Teach; residential staff must have received training in these methods before using them in their work.

9.1 Principles relating to the use of physical restraint

  1. Staff/carers should have good grounds for believing that immediate action is necessary to prevent a child from significantly injuring himself or others, or causing serious damage to property;
  2. Staff/carers should take steps in advance to avoid the need for physical Restraint e.g.: through dialogue and diversion; and the child should be warned orally that physical restraint may be used unless he/she stops;
  3. Only the minimum force necessary to prevent injury or damage should be applied; it should be reasonable in the circumstances and for the benefit of the child;
  4. Every effort should be made to secure the presence of other staff/carers before applying restraint. These staff/carers can act as assistants and witnesses. A member of staff/carer alone in a home should be extremely wary of using physical restraint;
  5. As soon as it is safe, restraint should be gradually relaxed to allow the child to regain self-control;
  6. Restraint should be an act of care and control, not punishment;
  7. Physical restraint should not be used purely to force compliance with the instructions of staff/carers when there is no immediate risk to people or property;
  8. Staff/carers should consider the risks to themselves particularly if the child is under the influence of alcohol, drugs or solvents;
  9. Restraint should be the exception, not the rule. It should be a “one off” intervention, not a regular regime;
  10. Escalation of a situation should be avoided wherever possible and the failure of a particular intervention to secure a child’s compliance should not automatically signal the immediate use of another, more forceful form of intervention;
  11. In developing individual Care Plans and Placement Plans, consideration should be given to approaches to control that would be appropriate to that child’s case.

9.2 Factors to bear in mind when considering restraint

The child

History    

  • Is there a past history of violence (either to or by the child)?
  • Does the child have phobias/fears?
  • Has the child been sexually or physically abused when the power dimension or the impact of body contact may be significant?     

Size

  • Big/small; weak/strong;
  • Size differential between the child and staff/carer.

Health           

  • Fit and healthy?
  • Strong or fragile?
  • Pregnant?                       

State of Mind    

  • Distress and anger give added strength;
  • May be under influence of drink, drugs, solvents;
  • May be very young or have severe learning disabilities and may not respond to instructions;
  • May have an impaired ability to recognise danger, Withdrawal from the group may be a more appropriate course of action;
  • Restraining an autistic child may cause major escalation.     

Communication    

  • If a child and member of staff or carer do not share a common language this will impair communication and may unnecessarily cause an escalation.           

The place

  • Can the situation be contained or isolated?
  • Are others in danger (real or potential)?
  • Is this environment a safe one in which to carry out Restraint?     

Staff/carer

  • Does this action have to be taken?
  • Is there an alternative?
  • Is help available?
  • Is there any other action, which will remove or end the problem?
  • What would the effects of Restraint be?
  • What is the likely result if I don’t restrain?
  • Can I restrain without injury to myself?

Other children

  • Can they be separated from the situation?
  • Is there a risk they will join in?
  • What would be the impact on them if I do/do not restrain?

All of the above need to be assessed very quickly at a time when opportunities for consultation are minimal.

9.3 Restraining action

If a decision is made to restrain staff/carers must:

  • Support each other and work as a team;
  • Allocate an observer if possible;
  • Talk to the child in a re-assuring manner throughout.

There will always be some risk of injury to the child or to staff/carers. That is why we must be sure that this is the only course of action possible in the situation and that measures taken are reasonable under the circumstances.

The information we have indicates the following: -

DO DON’T
Inform the child WHAT you are doing and WHY Keep Silent
Talk to them re-assuring throughout in a calm manner, giving short clear messages. Shout, argue or talk loudly
Hold the child firmly by arms and legs only, using your hands. Use “Bear Hugs”
If it is necessary to hold the child on the floor, lower them slowly and gently, whilst maintaining your own balance. Hold by wrists or ankles
Manually support the head and neck at all times. Use arm locks or force limbs against the joints.
Remove neckties and footwear only if you or child is at risk of injury. Use unnecessary pressure to the child’s back or abdomen.
Use as few people as possible Sit on the child or “straddle” them on the ground.
Be aware of your own and others’ safety Cover the head or airways or push the face into the floor
Call the police if the situation does not quickly come under control Touch breast or genital area.
Be aware of space available, as confined space can appear threatening. Remove Clothes

If the child has a disability, ensure eye to eye contact is maintained.

Staff/carers may therefore need to hold the child’s face towards them.

Cause pain if you can possibly avoid it.

Cause loss of dignity to the child.


10. Follow-up Action to Incidents of Restraint

It should be remembered that everyone is left feeling devastated by a major incident, and that time is needed for all to recover. The first priority should be to ensure that anyone who needs medical attention receives it immediately.

The child involved will almost certainly need immediate attention and reassurance. Now is not the time to discuss the incident that led to the Restraint but to reassure them that restraint was the protection, not punishment.

Other children will also need some discussion and reassurance and once some normality is restored, so will the staff/carer involved.

Some time after the incident but before the end of the shift, all involved should try and spend some time discussing the incident. It is important that staff teams in residential care are able to discuss the incident and decisions made in an atmosphere of support for each other, rather than blame. Foster carers should have the opportunity to speak to another professional, their supervising social worker, a fostering manager or duty worker or a member of the Emergency Duty Team. The aim should be to recover and to learn from the experience in order to avoid its repetition as far as possible.

The social workers and parents of the children involved should be informed and the Restraint should be recorded in a separate Restraints Book. A copy of the entry must be placed on the child’s file and a copy sent to the social worker.

An incident record should also be completed by staff/carers - see Section 11 below.

The incident should be followed up within 48 hours by the residential manager/supervising social worker undertaking an investigation/review. The report should then be sent to the Team Manager for the residential or fostering service within 5 working days to ensure that all necessary follow up action has been taken. A copy should also be sent to the Service Manager.

For further guidance on management reviews, see Incident Guidance.


11. Recording of Incidents

A full incident report should be prepared by all the staff and carers involved. This report should include the time and place of the incident, the child/children involved, the staff/carers involved, the facts as to what happened, whether Restraint was used, whether the Police were called, any follow up action taken, including the views of those involved and/or present. It is important that the report is written up as soon as possible after the event when memories are fresh. The time of writing the report should also be recorded. 

For further guidance on the making of an incident report, see Incident Guidance.


12. Training and Staff Development

It is important to acknowledge the importance of the development and training of staff and foster carers in helping them provide good quality care.

This is especially relevant in the case of Restraint as lack of clarity of “approved” methods leaves staff and carers in an invidious position. No technique will cover every eventuality and there will always be some situations that are unmanageable.

Also, any Restraint procedures will not be right first time and will need on going monitoring and review.

It is, therefore important that this policy is underpinned by the comprehensive training strategy that will include a rolling programme of follow up training in all areas.

A training strategy for residential staff and foster carers has been produced in conjunction with this document.

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