Posted By Bill Elliott Nigel Hi - we are an NHS Trust also supporting people with a learning disability. The definitions we use are as follows: Minor - incidents where - somebody suffers no evident injury or only minor injury which necessitates no or minimal medical treatment or first aid; where some minor, but measurable financial loss is incurred through accidental or deliberate damage; where some risk is discernible through actions or threats. Near miss - incidents that did not - but could have - led to harm, loss or damage. In reporting our report forms have pick lists, one choice covers - violence, abuse or harrassment and the person completing the form is required to indicate a contributory factor. In a number of instances this contributory factor is quoted as "challenging behaviour" or "autism" or "ritualistic" to give you a few examples.

Posted By David Edward Partington Nigel, these days I am BSc MIOSH etc however, I spent 12 years as a resi worker working with this and other client groups. My last HS post was within a Social Services Department, where I also kept a register of incidents. I am fairly clear that this is an assault as defined by RIDDOR "non consensual violence" is reportable if it leads to three days absence. What you need to be clear about is why you are keeping these statistics. What do you hope to achieve? Probably the most important areana is the staff meetings and the case reviews, at this point you can review your RAs and determine wheather you are set up to deal with this level of violence. Clearly you must accept that if you work with people that are likely to be violent then one will get thumped from time to time. You must aim to reduce the consequences of the act via control and restraint training, staff numbers and building design. You must decide what level of risk is acceptable to you and your staff. Until recently I had responsibility for a secure unit for young men. Our acceptable level of risk was that all staff regards of assaults should be able to go home at night. Even if this was via the hospital. In my last year with this organisation we had some 80 assaults. If the violence became more serious then we would hand the offender back to the Home Office and thence the prison system. Therefore on your RAs you must determine what level of risk you are prepaid to accept with your staffing levels. Hope this helps. Regards David.

Posted By David Edward Partington Craig the issue is "Do you provide a service or not". Clearly violence is not acceptable however, if you work with a group that are potentially violent, staff and clients will be asserted. If is a fact of life. Therefore one must ameliorate this as far as it is possible to do so. If you do not accept this level of risk then you should not be providing the service. Regards David.

Posted By Nigel Hammond Hi folks Thanks for your help. One thing is clear - We all seem to use different terms! I like Craig's term for near miss, which is 'No Injury'. The other feedback will also be very useful. I'm not sure where this thread is going now with acceptable levels of risk. Whenever we take on new children and adults with learning disabilities, there is always some settling in - getting used to the new environment and staff getting used to the new person's idiosyncrasies. Even with the best planning, there is often aggressive challenging behaviour at the start. The important thing is that we work towards zero violence - without using extreme and abusive measures. For example, doping people senseless with drugs can eliminate violence but is cruel and is practically murdering their personality. Using excessive control and restraint is abuse. Staff being beaten up or injured is also cruel – so we have to get the balance right. We try to reduce violence with a range of measures such as better communication, staff training, behavioural support plans, adapting premises, right medication, physical intervention etc. The combination of these measures are unique for every client. However, we also need to think corporately. It is important that we know the size and nature of challenging behaviour in our organisation so we can set corporate objectives and direct our resources appropriately. Hence, the importance of getting accurate statistics - coming back to my original question.