Positive Behaviour Support, Contact and Restraint

Supported Accommodation provide bespoke accommodation to young people living on their own or in a group living settings. Each Care Plan and package of care/support should meet the needs of the individuals placed.

The Service fully recognises the contribution it makes to safeguarding and promoting the welfare of its young people that it supports.  We recognise that all staff have a full and active part to play in protecting our young people from harm and this includes supporting young people with relationships and helping them to maintain their placements with the Service including supporting them with positive behaviours and making suitable relationships.

Appropriate plans/agreements should be drawn up with the professionals working with the young person if there are issues and clear messages around behaviour, and resolutions should be addressed in the plan on how this is achieved.

The aim is always for young people to maintain their tenancies and/or placements. Good matching is essential to make sure a supported accommodation placement is the right option for the young person.  If there are issues around relationships and behaviour, then the Service will talk to the young person about their placement and try and make changes within their placement or group setting, to iron out any difficulties or issues. However there may be situations where the placement is not right for the young person and notice may need to be given.

However this would only be if:

• All solutions had been exhausted by staff;
• Other key professionals have been involved;
• Specialist support has been offered if appropriate such as counselling, medication;
• The reassessment of the young person’s needs indicate a different service is needed;
• The young person wants to look at other options as they do not feel the placement is meeting their needs.

The Service will promote the development of positive and respectful relationships between staff and young people.

Young people are helped to develop, and to benefit from relationships based on:

• Mutual respect and trust;
• An understanding about acceptable behaviour; and
• Positive responses to other young people and adults.

In particular, the registered person will ensure that staff:

• Meet each young person's behavioural and emotional needs, as set out in the young person's relevant plans;
• Help each young person to develop socially aware behaviour;
• Encourage each young person to take responsibility for their behaviour, in accordance with their age and understanding;
• Help each young person to develop and practise skills to resolve conflicts positively and without harm to anyone;
• Communicate to each young person expectations about their behaviour and ensure that the young person understands those expectations in accordance with their age and understanding;
• Help each young person to understand, in a way that is appropriate according to their age and understanding, personal, sexual and social relationships, and how those relationships can be supportive or harmful;
• Help each young person to develop the understanding and skills to recognise or withdraw from a damaging, exploitative or harmful relationship;
• Strive to gain each young person's respect and trust;
• Understand how young people's previous experiences and present emotions can be communicated through behaviour and have the competence and skills to interpret these and develop positive relationships with young people;
• Are provided with supervision and support to enable them to understand and manage their own feelings and responses to the behaviour and emotions of young people, and to help young people to do the same;
• De-escalate confrontations with or between young people, or potentially violent behaviour by young people;
• Understand and communicate to young people that bullying is unacceptable; and
• Have the skills to recognise incidents or indications of bullying and how to deal with them; and
• That each young person is encouraged to build and maintain positive relationships with others.

The Service will support young people to maintain a reasonable standard of behaviour that reduces the risk of harm to, and supports the welfare and protection of themselves and others.

The Service will make clear to young people, the expectations in relation to their behaviour, what will happen if those expectations are not met, and how the registered person will ensure that children know what those behaviour expectations are.

The Service’s approach to positive behaviour support:

• Aims to create a safe, caring environment where young people are supported to develop understanding and empathy towards others;
• Ensures that all young people have opportunities to become confident and achieve their full potential;
• Encourages the young person's consultation and participation in setting rules and consequences;
• Ensures that all young people have clear expectations in relation to their behaviour, are supported to understand and to develop alternative positive approaches to challenges within their lives;
• Ensures that all young people understand how positive behaviour is recognised;
• Ensures that all young people are supported to understand the consequences of negative behaviour;
• Ensures that all staff understand and share the principles of positive approaches to behaviour;
• Accepts the individuality of young people and celebrates the diversity of their backgrounds.

Staff training on behaviour management techniques and strategies will enable them to achieve and develop a more positive relationship with the young person and support them to develop a more harmonious life which enables the young person to feel good about themselves. The development of safe, stable and secure relationships with staff is central to the ethos of the Service and supports the development of secure attachments that, where appropriate, persist over time.

The capacity and competence of staff to build constructive, warm relationships with young people that actively promote positive behaviour, provides the foundations for managing any negative behaviour. Where positive relationships exist between young people and staff this should be respected and maintained as far as possible when making any decisions to alter staffing arrangements.

Positive behaviour and relationships should be reinforced, praised and encouraged; poor behaviour should be challenged and discussed.

Staff should at all times endeavour to:

• Understand factors that affect young people's motivation to behave in a socially acceptable way to enable them to respond to each young person’s individual behaviour;
• Encourage an enthusiasm for positive behaviour through the use of positive behaviour strategies in line with the young person's relevant plans;
• Listen to and empathise with young people, respect their thoughts and feelings and take their wishes into consideration;
• Look for things that are going well, or any step in the right direction, and appropriately praise it. Make sure that young people are aware of the things that they have done well. This should involve prompt verbal feedback, along with clear recording in the young person’s file;
• Where necessary, manage conflict, maintain constructive dialogues and react appropriately if challenged by a young person.

Staff should, where possible be trained in preventative and de-escalation techniques, safe practices around managing difficult behaviour and effective conflict management and conflict resolution. Staff should be expected to use these measures when dealing with challenging behaviour.

In managing difficult situations and violent behaviour, it is important that any action taken by staff is measured and proportionate and does not cause unnecessary criminalisation of young people. More information can be found in the National Protocol on Reducing Unnecessary Criminalisation of Looked-after Children and Care Leavers.  

It is expected that given the assessed needs and level of independence, autonomy, and responsibility of young people in supported accommodation - restraint would not be necessary in this provision. Restraint includes physical restraint techniques that involve using force or restricting liberty of movement.  Even though the use of restraint in supported accommodation is expected to be extremely rare and exceptional in nature, training may, in some cases, also extend to the use of safe restraint practices. 

Restraint may only be used in relation to young people in the Service in exceptional circumstances where it is deemed an appropriate and proportionate response to preventing injury on the very rare and unforeseen occasions where the young person presents an immediate danger to themselves or those around them, or to prevent serious damage to property. In the rare event of an extreme emergency where preventative and/or de-escalation methods are not effective in managing the situation and staff are concerned for the safety of any person including themselves, staff should follow the Service’s emergency protocols. If the urgency of a situation results in a member of staff restraining a young person for the purposes of preventing harm or injury to any person (including the young person who is being restrained), or to prevent serious damage to property, this should be the minimum restraint for as short a period as necessary to prevent the harm, injury or damage. If restraint is used on a young person, staff must ensure the young person obtains medical assistance if they have been hurt.

Staff should not restrict the movement of a young person to keep them inside the setting, even if they have safeguarding concerns. As part of developing and maintaining good and trusting relationships with young people, staff should encourage open dialogue so they can discuss risks and concerns with the young people to support them to keep themselves safe. If staff have concerns around a young person’s safety and/or risk of harm or exploitation, they should follow the Service’s safeguarding procedures. See Safeguarding Young People and Referring Safeguarding Concerns. 

Any restraint of a young person must be necessary and proportionate.

In the unlikely event of a staff member needing to use restrictive physical intervention, the following points should be noted:

• Staff members must only use the approved restraint methods that they have been trained to use;
• Restrictive physical intervention must be consistent with the concept of proportionality and reasonable force;
• The circumstances must warrant the use of force;
• The degree of force employed must be in proportion to the circumstances of the incident and the minimum to achieve the desired result;
• Avoid causing pain or injury;
• Do not hold a young person face down on the ground or in any position that might increase the risk of suffocation.

Before intervening physically, staff should wherever practicable, tell or ask the young person to stop, and what will happen if they do not.

The staff member should continue to attempt to communicate with the young person throughout the incident and should make it clear that physical contact or restraint will stop as soon as it ceases to be necessary.

In such cases only the minimum force necessary will be used whilst maintaining a calm and measured approach.

Staff should not put themselves at risk of injury. In these circumstances, the staff member should remove the young people who may be at risk and seek assistance from a colleague/s and if necessary telephone the police.

Staff should inform the young person that they have sent for help. Until assistance arrives, staff should continue to attempt to defuse the situation orally and try to prevent the situation from escalating or leave until help has arrived.

If you are aware that a young person is likely to behave in a way that may require physical control or restraint, there should be a clear plan in place on how to manage this situation.  

• Manage the situation by defusing the situation;
• Involve the social worker/parents so everyone is aware of the plan;
• Brief staff to ensure that they know exactly what action should be taken and where appropriate provide training or guidance;
• Ensure that additional support can be summoned if appropriate.

Where there is use of a measure of restraint of a young person, the registered person must ensure that:

1. Within 24 hours of the use of the measure, a record is made which includes:
   1. The name of the young person;
   2. Details of the young person’s behaviour leading to the use of the measure;
   3. The date, time and location of the use of the measure;
   4. A description of the measure and its duration;
   5. Details of any methods used or steps taken to avoid the need to use the measure;
   6. The name of the person who used the measure, and of any other individual present when the measure was used;
   7. The effectiveness and any consequences of the use of the measure;
   8. A description of any injury to the young person or any other person, and any medical treatment administered, as a result of the measure;
2. Within 48 hours of the use of the measure, the registered service manager, or a person who is authorised by the registered service manager to do so has:
   1. Spoken to the young person about the measure;
   2. Signed the record to confirm that it is accurate;
3. Within five days of the use of the measure, the registered service manager or the authorised person adds to the record confirmation that they have spoken to the young person about the measure to agree the accuracy of the report.

If a restraint incident does occur, incident reports must be produced by staff and the registered person to learn from the incident and consider the impact on the young person. If restraint occurs, the registered person must follow requirements in the Regulations regarding notification of a serious event to Ofsted and each other relevant person without delay. See Notification of Serious Events.

The impact of a restraint incident on the relationships between the young person and staff or other young people who witness the restraint should be assessed and appropriate action should be taken to manage any consequences. Any young person who has been restrained should be offered emotional support with an appropriately trained staff member as soon as is practicable, ideally within 24 hours of the restraint incident.

A robust review of the incident, including producing relevant records must take place with the young person and relevant key workers such as a social worker, personal advisor or advocate, where possible within 24 hours of the incident. Records should set out the name of the young person, the details of the behaviour that led to the restraint, the time, date and location of the use of restraint, the reason why the restraint took place, what steps were taken to prevent the use of restraint and how the restraint was carried out, who carried out the restraint and a description of any injury to anyone as a result of the incident. The review should provide the opportunity for amending practice and policies to ensure they are lawful and meet the needs of young people.

As part of the review process, young people should be given the opportunity to feedback on how the situation was handled. Within five days of the incident the registered person should have spoken to the young person about the incident, to agree the accuracy of the report and identify any support needs and any steps the registered person has taken to reduce the likelihood of restraint ever needing to be used in future.

Physical contact may be misconstrued by the young person, others or an observer. Touching young people including well-intentioned gestures, can if repeated regularly lead to serious questions being raised.

There are occasions when physical contact with a young people may be necessary, for example when providing first aid. Young people may need prompts or to be shown how to do something.

There may be occasions where a distressed young person needs comfort and reassurance, which may include physical comforting such as a caring parent would give. Staff should use their discretion in such cases to ensure that what is normal and natural does not become unnecessary and unjustified contact, particularly with the same young person over a period of time.

Staff should use their own professional judgement when they feel a young person needs this kind of emotional support. Where a member of staff has a particular concern about the need to provide this type of support and reassurance they should seek the advice and guidance of their line manager.