1. Reducing Risk and Restraint
Nick Burnett

2. To physically intervene or not?

3. Background
• Values
• Current Position
– Asia Pacific
– UK

4. Values
• Relationships and Communication
– Redirect v Reject
– Teach a better way v Control
• Risk Reduction
– Foreseeable Risk
• Safety is Paramount
– Safety of the child
– Safety of the staff

5. Values
• “I care enough about you not to let you be out
of control.”
• Seeking help – a professional expectation and
strength
• It is about how staff show restraint,
rather than apply it!

6. Physical Interventions
• Minimum force, time and last resort
• Maximum amount of care, control and
support
• Allow for verbal communication and do not
rely on pain or “locks” for control
• Gradual and graded
• For safety and to de-escalate a situation

7. Physical Interventions
• Responses should be jointly planned, written,
agreed and included in Positive Handling Plans
• There should be a supportive and reflective
structure in place for children and staff
• All incidents should be reported, recorded,
monitored and evaluated

8. Current Position
– Asia Pacific
• Australia
• New Zealand
• Hong Kong
– UK
• BILD Code of Practice

9. Asia-Pacific
• Australia
– Common Law
– Varies from State to State
– Western Australia – best developed
• New Zealand
– Common Law
– Education – nothing in place
– Health and Disability Services (Restraint Minimisation
and Safe Practice) Standards
• Hong Kong
– Education – nothing in place

11. UK
 BILD Code of Practice
 Best interests of the student
 Minimum force for the shortest time
 Prevent injury, pain and distress
 Maintain dignity
 Reasonable and Proportionate
 Action should be necessary

12. Collecting Data
• Hard
• Soft
• Audit tool

13. Reducing Risk and Restraint Audit Tool
• Background
– Development
– Use
• Case Studies

14. Development
• NFER review on how 10/98 On” The Use of Force to Control or
Restrain Pupils.” had impacted on services.
• In addition, target objectives have been shaped by the guidance
produced by the DfES IRS Co-ordinators.
• George Matthews providing expert witness reports related to
investigations into staff practice have helped determine the key
areas that managers should be aware of related to risk and
restraint.
• Thanks and Acknowledgements are due to:
– the UK Team-Teach Steering Group
– the Team-Teach Principal, Senior and Employers tutors
– JBE training and Development
– David CoultonPh.D for producing a “Checklist for assessing Your
Orgainisation’s Readiness for Reducing Seclusion and Restraint”
– Nick Burnett for changes for Team-Teach Asia Pacific.

15. How safe is your service/setting?
• Employer Strategy
• Critical Friends
• Risk Assessment
• Incident reports
• Positive Handling Plans
• Complaint and Concern Procedures
• Listening and Learning
• Staff Training
• Training Provider

16. Employer Strategy
• Is there a named person responsible for co-
ordination, monitoring and evaluation of Positive
Handling?
• Is this recognised in their job description and are
they given time to achieve this?
• Is there a designated Manager to oversee this
area?
• Are Positive Handling issues on management and
staff meeting agendas?
• Have Managers/Principals attended training?

17. Policy
• Is there evidence available to demonstrate that staff
have read and understood their service setting Positive
Handling policy?
• Does the policy define the relevant terms?
• Are primary & secondary prevention strategies stated
in the Local Policy?
• Is risk in relation to techniques mentioned?
• Is staff entitlement to training which includes Positive
Handling mentioned?
• Does the policy mention the entitlement of staff and
service users to a repair and reflection process?
• Are Positive Handling Policies reviewed every 12
months?

18. Critical Friends
• Have relevant placing authorities received a
copy of the service setting Positive Handling
Policy?
• Have parents, children and young people been
informed of the Positive Handling policy?
• Are the local police aware of the Positive
Handling Policy & Practice?

19. Risk Assessment
• Is there a Risk Assessment Form that measures
the risks presented by the students behaviours
and as a result a planned risk reduction strategy
is documented and developed?
• Has the training provider satisfied the employer
& local manager that the standards achieved and
the techniques taught are relevant to the risks
presented by their service users and managed by
their staff.

20. Incident Reports
• Does the incident report cover the key areas as stated
in Federal/State Guidance?
• Are incidents recorded within 24 hours?
• Does the incident form include the use of de-escalation
strategies prior to the physical intervention?
• Does the incident form include information on the
effectiveness (safety and calming) of techniques?
• Does the incident form include a data field regarding
injuries to students and staff arising from the use of
particular techniques?
• Is this information conveyed back to the
District/Region/Placing Authority?

21. Positive Handling Plans
• Is there a Positive Handling Plan in place for students
who require this level of support?
• Has the student been informed and involved in the
positive handling plan?
• Have the parents been informed and involved in the
positive handling plan?
• When appropriate, does the Positive Handling plan
state which techniques and strategies should not be
used?
• Are environmental changes or primary strategies in
place to reduce the likelihood / impact of dangerous
behaviours?

22. Positive Handling Plans
• Are staff aware of the key de-escalation strategies
and praise points of those students who require
the highest level of Positive Handling support?
• Are strategies indicated in the plan to help the
student learn alternative behaviours?
• Is their proposed plan documented and
reviewed?
• When required has medical advice been sought
regarding the proposed strategies?

23. Complaint & Concern, Listening and
Learning Procedures
• Are students aware of the process by which
they can raise their concern with regard to the
operational use of Positive Handling
strategies?
• Are staff aware of the process by which they
can raise their concerns or complaints
regarding application of Positive Handling?
• Is there a documented process of listening and
learning for students and staff following a
critical Positive Handling Incident?

24. Listening and Learning
• Life Space Interview
• Restorative Justice
• Views of Children

25. Is there a better way to hold?

26. Squeezing too tight

27. Staff Training
• At interview, are prospective staff informed of the
policy, practice and expectation of staff in the
application of Positive Handling?
• Are steps taken to consider the placement of staff in
relation to the risks they face and the knowledge,
skill and understanding they possess.
• Are new staff trained and authorised before being
placed in foreseeable risk situations and
circumstances?
• Is there a list available of staff who have been
authorised and trained to use Positive Handling
strategies?

28. Preferred Training Provider
• Has your preferred training provider achieved
independent accreditation in relation to the training it
provides?
• Does your training provider embed the physical
Interventions within a framework of behaviour
supports and interventions that are relevant and
appropriate to your settings?
• Does the training provider understand the setting
context into which the training is being delivered?
• Is the training delivered by tutors who have recent
background and experience of working in that
particular service setting?

29. Preferred Training Provider
• Does your preferred training provider subject the
physical techniques to on-going review and a risk
assessment process?
• Does the training provider insist on an initial
visit/discussion to identify the training needs
before delivering the programme?
• Does the training provider insist on quality
control and assurance procedures with regard to
reporting of injuries, operationally and in
training?

30. Preferred Training Provider
• Does the training provider insist on feedback
concerning the quality and outcomes of staff
training?
• Does the training provider promote an “In
House” trainer system for staff training and
refreshers?
• Does the training provider issue a Code of
Practice and Protocols indicating the respective
responsibilities of “In House” trainers and
employers?

31. Case Studies
• Broad Elms SEBD School
• Kingstanding
• Warrington PRU

33. Broad Elms SEBD School
• After implementing a whole school approach
and using the audit tool to guide
developments:
– Designated a national centre of excellence for the
management of challenging behaviours.
– resulted in serious incidents at the school being
reduced by over 90%
– no fixed term exclusions for over a year.

34. Kingstanding
• “In September 2004 there had been 259
recorded incidents of challenging behaviour at
Kingstanding Special School...one year later
there were 48 recorded incidents...and by the
beginning of this school year incidents were
being recorded at less than 10 a year” 2009
• Offers outreach support to other settings

35. Warrington PRU
• Warrington Horizons is a Pupil Referral Unit and therefore caters for
vulnerable and challenging young people. In September 2008,
Ofsted reported that :
• “Students’ enjoyment of their education is outstanding as a result of
the great gains in motivation and the very positive attitudes to
learning which are established as soon as they join the unit”.
• “The pastoral care of students is very good. The strong commitment
of all staff secures their enjoyment and promotes health and safety
effectively. This supportive environment helps students to grow in
confidence and motivation”
• In the 2 year gap between visits the need for handling reduced to 1
case only !

36. Characteristics of effective services for
reducing risk
 A leadership and management team
actively owning, committed and being
accountable for the training.
 Documentation that underpins
practice:
 Local setting and organisational policies.
 Plans and risk assessments in place.
 Supportive and reflective structure in place for
students and staff
36

37. Where to from here?
• Increasing the shift from:
– Not talking about restraint
– How to restrain ‘better’
– How to restrain ‘less’
• Increasing:
– Accountability
– Openness
– Honesty
• Sharing effective good practice

38. The Focus on Rights
Staff Children’s
Rights Rights
The Optimum

39. Holding does not always = wrong!

40. Keeping in touch!
• For a copy of the PowerPoint and/or Reducing
Risk and Restraint Audit Tool, put your name
on the sheet at the front or back of the room
• ‘Like’ me on Facebook – just search for Nick
Burnett CCP
• ‘Follow Me’ on Twitter – nick_burnett
• Buy my e-book! – www.myebook.com - search
for ‘Reducing Risk and Restraint’
• Email me: nickburnett@me.com