Restraint and force

What is the use of force?

When someone is unwell they may become frustrated, frightened and extremely distressed. No matter what happens they need to be treated with care and compassion, and we would like to keep them safe.

The Trust is committed to ensuring it always provides the least restrictive care possible for all patients. Our staff will try to avoid the use of force through providing therapeutic ward environments and using techniques to gently calm people down if they become agitated, upset or distressed. You can tell us any activities, techniques or environments that you find helpful to reduce your distress or anger.

Sometimes these may not be enough to calm people down and staff will need to use force (restraint and restrictive practices) to keep you and others safe and ensure that you do not come to harm. Rapid tranquilisation is the use of medication, usually given as an injection, to quickly calm someone who is distressed and at risk of harm to themselves, or possibly those around them.

At times these are necessary, but as a Trust we would like to work with you to try and prevent these situations occurring and will always use these as a last resort.
You can discuss restraint and the use of force with your named nurse.
All of our staff who may need to use force are specially trained to do so, and have learnt techniques that do not inflict pain and help reduce distress.

The use of force is monitored and reviewed by the Trust and also the Department of Health.

Examples of different types of restrictive practice

  • Sometimes staff will sit side by side with a person on chairs or a sofa to help them calm down.
  • A member of staff may put their hands on a persons, arm, elbow or shoulder to guide them away from the door or an incident.
  • Staff may use prone restraint, where a person is held by staff lying face down, or supine restraint where you may be held by staff lying on your back, either on the floor or a bean bag. These will always be used as a last resort and for the shortest amount of time possible.
  • Sometimes a person may be moved to a specific area, away from others, and prevented from leaving because the risks towards others is so great. This is called seclusion.
  • Sometimes medication may be use as an injection whilst a person is in restraint to help someone quickly calm down and reduce their distress - this is called rapid tranquilisation.

Force and restraint.JPGDo I have a choice?

Sometimes you may recognise you are becoming distressed, upset, frustrated or angry and it can be useful to seek out staff or ask for oral medication.

Staff will use restraint or rapid tranquilisation as the last possible option to keep you safe.
You can make an advanced plan about how you would prefer to be treated should a situation arise where you may require restraint or rapid tranquilisation - for example you can request face up restraint only or not to be given a certain type of medication.

It may be that in certain circumstances though that your wishes are overridden in order to keep you and others safe.

What happens after restraint?

When the situation has calmed down and you are able, you will be offered an opportunity to meet with a staff member to talk about your feelings and experience. This can help provide feedback to staff and an opportunity to inform your care plan so that together we can try and reduce the likelihood of this happening again and inform staff of any wishes you may want considered if you have to be restrained in future.

The staff will request to take physical observations like blood pressure and pulse. This will happen every 15 minutes for the 1st hour and then hourly for two hours, and then reducing over the 24 hour period.

This is to help keep you safe and ensures that your physical health and wellbeing are being monitored. The staff will inform your medical team about the incident.

If you have nominated someone to be notified about the use of force in your care plan, staff will notify them.

What happens if I am unhappy that force has been used?

In the first instance we would suggest speaking to a professional on the ward. If, you do not feel that your concerns have been fully addressed you may wish to consider mak-ing a complaint about any issues relating to the use of force, you can do this in the following ways:

Email

dhc.pals@nhs.net

Telephone

PALS freephone 0800 587 4997
Complaints Team 01202 277024/277025

Post

Dorset Health Care
Complaints Team
Sentinel House
4-6 Nuffield Road
Poole BH17 0RB

Online

PALS team page

Your stay or appointment