Morning, all.

Interested in the real basics on this, particularly whether an untrained person should take part in these things.

There can always be a spontaneous element to these situations (violence & aggression in healthcare setting - not mental health btw) but would your policy ever treat it as a resource to assist your trained pesonnel? 

And, in the absence of any recognised standard for this activity, and good substitutes out there? 

Hi safetyamateur,

There are numerous organisations offering training in this. If there's a risk you shouldn't have untrained personnel; in such cases everyone should be trained in dealing with potentially violent situations. You do need to be very careful that your ras and documents etc are very clear, and that staff are instructed to avoid restraint unless it is absolutely necessary. They are dealing with people, and you don't want to encourage another Winterbourne View. Good training should include all that, but you do need to get your policies and procedures sorted as well,

John

Edited by user 24 July 2017 10:16:31(UTC)  | Reason: Typo

I guess it must be difficult starting from scratch

We had a combination of job roles requiring CALM training, as mandatory, then we had some service users whose support staff needed to be CALM trained to deal with possible physical restraints, or small holds

Your compamy has to buy in to the ethos though.  We had trained CALM trainers, who ran the courses internally, but they needed to be assessed and registered (I think).  Plus all staff had to do refresher and then reaccreditation every three years.  So it is an investment, but it was for the service users sake, as well as the health and safety of the staff

Google CALM for more up to date info

Hi,

I used to work with young people who had challenging behaviour and have some experience within this field.

In the ideal world all your staff should be restraint trained as it is a foreseeable that physically restraining a person may be required as a control measure if all else fails (de-escalation techniques etc.) However we live in the real world and it’s not always going to be the case that all staff on shift will be trained (they may be a new member of staff who have not yet received training etc.).

As you have already mentioned there may be a spontaneous element to a situation. Firstly during your hand over I would reinforce any standard operational procedure you already have to deal with these situations and make staff aware of what these are.

For example if you have 4 staff on shift and only 2 are restraint trained then if a situation was to arise the staff members who are not trained should only have minimal involvement in the situation and should call on the trained staff to deal with any restraints. Of course any untrained staff should be trained at the nearest opportunity.

On the flip side of the coin if you only have 1 staff member on shift who is trained then they may need assistance. So long as an untrained person involvement can be justified then I shouldn’t think there should be a problem so long as they take instruction from the trained person and only use necessary force.

This however is a reactive control measure and brings me back to my first point, all in all there is a balance to be struck. Do you not let untrained staff get involved and increase the risk of physical injury to staff or do you let untrained staff get involved and increase the risk to a vulnerable person?

I stand by my decision that so long as an untrained person’s involvement can be justified then they will have a strong defence, but the organisation should have taken proactive control measure to minimise this kind of involvement in the first place.

I work in a different sector to hospitals but one where control and restraint techniques are used on a very regular basis and all staff have to attend yearly refresher training on restraint techniques.  if for somereason they fall out of ticket then they can be placed on restricted duties until they attend a course.

Admin staff are also required to attend personal safety or 'break away' training each year to learn basic defense techniques in case they become involved in an incident.

I think if it is a forseeable risk then you need to train your staff in resraint techniques in order for them to learn how to do things as safetly as possible.  Our staff are also required to complete detailed paperwork after each incident and have to indicate when their last refresher training was done.

My first post :-)

Firstly are you talking about restraint in regards to service users/patients or general public ? 

My background is forensic mental health and I was one of the first "restraint instructors in the country" gave it up a while ago as getting to old and fat now :-) but have trained staff in restrictive techniques forover 20 years in settings from High Secure Psychitric Hospitals to small community based LD services.

There is actually no regulation or universal standards or approved restraint techniques for restraint, there is some accredited cours providers by the likes of BILD and some universitys but this is being looked into.

There is litlerly 100s of training providers with fancy acronames and impressive looking credidntials  - some good, some bad and its hard to tell.

Going back to your question though - any member of staff expected to be involved in a restraint situation should be trained to a level thats indicated by your risk assessment 

you alos need clear organisational policies which reflect professional or clinical guidance, current legislation, case law and evidence of best practice.

I see CALM have been mentioned they have good reputaion, been around for years and have sound techniques the founders are very very experienced in health and social care practise and theory.

I would also recommend the GSA as a training provider 

Dont hesitate to give me a shout if you need any further info