Reducing the use of restrictive practices

Around half of all people with learning disabilities and challenging behaviour are subject to physical interventions.

The right policies and practice, and high quality training to increase staff skills and confidence and reduce injuries, is therefore critical.

Much has been achieved by the British Institute of Learning Disabilities (BILD)  work in this area over the last 10 years through the BILD Code of Practice and Policy Framework and our Physical Interventions Accreditation Scheme >

Positive Behaviour Management is at the forefront of strategies to reduce restrictive practices and has been practiced by Elliots Hill for over 10 years.

What is Positive Behaviour Management?

Aggression is one of the most common and certainly one of the most challenging of ‘challenging behaviours’.

Positive Behaviour Management is a reactive strategy of Positive Behaviour Support and aides with the capacity for understanding, preventing and responding to aggressive acts.

The consequences of failing rise to the challenge of aggression are serious indeed. People with learning disabilities who show aggressive behaviours are often excluded, not only from community settings, but also from the very services which are designed to provide support. Aggression can and does result in people being hurt physically and emotionally.

Carers. Staff, other people with learning disabilities and members of the public are at risk of physical injury as a direct result of aggression. The person with a learning disability himself or herself is at risk of injury resulting from unskilled attempts to diffuse or contain aggressive episodes. They are also at longer term risk of ‘injury’ as a direct result of inadequate attempts to ‘treat’ their aggression, for example through the prolonged and unnecessary use of antipsychotic medication.

There are three main things we need to do in order to improve our capacity to understand, prevent and respond to aggressive acts:

  1. First we need to learn from the knowledge which already exists about the meaning and causes of aggression and the nature of effective ways of responding
  2. Secondly we need to take seriously the tasks of prevention and treatment
  3. Thirdly we need to learn the skills involved in the de-escalation and management of aggressive episodes.

Attending to only one of these is insufficient. Complex problems require complex solutions.

Elliots Hill has  a wealth of expertise relevant to all three areas, based on extensive experience and a detailed understanding of what aggression is, what it means and what can be done about it.

Elliots Hill employs extensive training to ensure that care staff are equipped with the values, knowledge and skills necessary to work closely with people with learning disabilities who may become aggressive.

People with learning disabilities and those who care for them  have a right to demand that services avail themselves and their staff to well thought out, tried and tested reactive strategies that are comprehensively integrated with the concepts of positive behavioural support.

PBM is compliant with and supportive of the:

  • All Wales NHS Violence and Aggression Passport and Information Scheme (The Passport)
  • The NHS Counter Fraud and Security Management Service (NHS CFSMS)
  • NICE (Clinical Guideline 25)
  • BILD Code of Practice for  the Use of Physical Interventions
  • LYON et al. Publication, Physical Interventions and the Law
  • DFES/DOH Guidelines on Restrictive Physical Interventions

PBM is:

  • Accredited by BILD, current accreditation valid until June 2015
  • Rolled out as specific BTEC qualifications
  • Mapped out against NVQ Qualifications  Levels 2, 3 & 4 (HSC) and Level 4 (L&D)
  • Mapped out against the QCF Diplomas’ in Health and Social Care for adults with a learning disability at levels 2, 3, & 5
  • Mapped out against the NHS Knowledge and Skills Framework

PBM won:

A National Training Award in 1997 in recognition of its impact on improving services for people with learning disabilities and challenging behaviour

Useful Links

PBS Qualifications -

Positive Response training -

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