Use of force

Do I have a choice?

We encourage all our patients, their families, supporters and advocates to be involved in care planning with staff to help us avoid the use of force. This may involve conversations about what is helpful when someone is becoming distressed and what to do or avoid as far as possible.

Some people might prefer for a certain type of medication or restraint to be used or avoided. This may be recorded in your care planning as a preference, or more formally known as an advanced decision. It may be that in some situations a person’s wishes are overridden to keep themself or others safe.
Patients may be in hospital on a voluntary basis or detained under the Mental Health Act (MHA) which may influence some of the care provided.

In both cases, staff will always explain a person’s rights to them, work collaboratively and only use restrictive interventions as a last resort.

Examples of restrictive interventions

Staff are trained to always use the least restrictive interventions that are a proportionate response to the risk and for no longer than necessary. Staff will always minimise any harm and treat people with respect and dignity.

This training is certified to meet the Restraint Reduction Network (RRN) Training Standards.

• Standing: Staff members may take hold of a person’s arms and may guide them to another area.
• Seated: Staff members may sit either side of a person in a safe area, and support their arms.
• Beanbag: Staff members may support a person lying on their back, on a beanbag.
• Supine: Staff members may support a person lying on their back on the floor.
• Prone: Staff members may support a person lying on their front on the floor.
• Seclusion: Staff members may guide a person to a designated isolation area, away from others. Staff will remain with the person but will be outside of the room. The person will need to remain in this room until it is safe for them to leave.
• Rapid tranquillisation: Sometimes staff may offer medication to help reduce distress. In cases of extreme distress or agitation and where a person is unable to take medication orally, it may be given as an injection while the person is in restraint.

What happens afterwards?

After any use of force, staff will offer those involved a debrief, this may also include families, carers and advocates. The debrief is a conversation about what has happened and how we can avoid the same situation happening again. Staff will also have their own debrief.

Staff will frequently check physical observations such as blood pressure and pulse. These steps are important because it allows staff the opportunity to check on someone’s physical and mental wellbeing after any use of force.