Over the half term break I completed the second Expert Witness case within recent months where a person has been restrained by staff for approximately one hour in duration. One case was in a school on a child, and the other was in a clinical hospital setting. The child survived but the adult died.
Both cases raise the issue that professional staff failed to recognise that restraining someone for around an hour was disproportionate and excessive in time. The longer someone is restrained for, the more the risk of harm increases for both staff and the service users.
As far back as 1995 a man died in a hospital setting where he was restrained by medical staff for approximately 25 minutes. The Coroner’s Court found that 25 minutes was far too long to restrain a person and they recommended at that time that restraint in any prone position (ie where the body is face down or flat against a surface area) should never exceed three minutes.
Ultimately people die, or receive life-changing disabilities, as a result of restraints going badly wrong in care settings such as schools, hospitals, care and custody.
Staff may receive basic training, but this does not make restraining staff 'experts' on this subject. A false sense of security often sets in and restraints increase in volume and longevity.
If your care setting is involved in restraints which last anywhere near 25 minutes we suggest you have an impartial review to look at the necessity, proportionality and reasonableness of this work-related activity.
A physical intervention is a work-related activity covered by the Health & Safety at Work Act. It is an activity which should have all risks to staff, service-users and others suitably assessed for risk, and that risk be eliminated or managed down to its lowest level
Never forget that when a person is restrained several things happen to their anatomy which include:
- their blood pressure greatly changes
- their oxygen levels change
- their chest walls may be restricted
- their diaphragm may be restricted
- any underlying medical condition may be triggered or aggravated
Total Train can provide a range of training and consultancy for managing down challenging behaviour, in addition to safer restraint and physical intervention techniques. An overview of the Total Train training can be viewed on this short video by following this link Duration of Physical Restraints.
Please remember that for every moment a restraint is applied to a person it must be proved to be lawful - necessary, reasonable and proportionate in the circumstances and complying with the principles of safe restraints. Failure to show lawfulness could bring investigations under criminal or civil legislation.