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10th April 2014

Restrictive Intervention – Reducing its Use

restrictive interventionWe were all appalled and shocked by the revelations of abuse by staff at Winterbourne View, which prompted a national overhaul of the way we manage and support people with behaviour that challenges in care settings.

New guidance on use and reduction

This month, the Department of Health has launched guidance for health and social care services on how to reduce the use of so-called ‘restrictive interventions’ to safeguard the people in our care. The guidance aims to support a culture where restrictive interventions are only ever used as a last resort and only then for the shortest possible time.

It defines the type of restraint that should be prohibited, such as holding people face down and restricting their airway or circulation. It states that if a restrictive intervention is used, it should be the minimum and for the shortest amount of time. Interventions should be enshrined in agreed care plans and not include seclusion.

Governance and monitoring

The guidance also sets out mechanisms to ensure accountability for making improvements, including effective governance, transparency and monitoring by providers. The audience for this paper is not only providers of health and social care, but also the police and the prison service. It requires board-level governance of restrictive interventions in services, through policies which are available to Service Users and their families. Boards and providers will also be required to report to commissioners on the use of restrictive practices in their organisations.

In addition to reporting to commissioners, organisations monitored by CQC will be subject to scrutiny through the inspection process. The guidance will inform the way CQC monitors and reports on this area of practice and providers will be expected to show progress in the reduction or removal of restrictive intervention through their inspections.

Who is the intended audience?

It is essential that those managing and working in services caring for people who are exposed to restrictive interventions, should review this guidance and integrate it into their services. These includes services for people with autistic spectrum conditions and learning disabilities, but it also applies across any adult health and social care settings where people using services may, on occasion, present with behaviour that challenges but which cannot reasonably be individually predicted and planned for.

The full guidance document can be found at:

Ginny Tyler – QCS Learning Disability " href="" target="_new" data-tooltip="Learning disabilities have an impact on a service user’s everyday life, which in turns places specific demands on providers of care who specialise in services that offer support to those with learning disabilities.  Everything from arranging a visit to a shop, to going on a bus, to meeting someone new, can for some be a profoundly difficult undertaking, so appropriately qualified care providers are on hand to offer their expertise and guidance to make the lives of their service users that much more simpler and enjoyable.<br /><br />Learning disabilities are a broad spectrum and include Down’s Syndrome, Autism, Aspergers Syndrome, Fragile X Syndrome and many more.  It is distinct from learning difficulties, such as dyslexia, which do not impact upon intellect.  With the right care and management people with learning disabilities can still lead normal lives. Profound and Multiple Learning Disabilities (PMLD) present even greater challenges to the care service, but there are many services throughout the UK equipped to deal with even the most significant of learning disabilities.">Learning Disability Expert Contributor


Sarah Riley

Senior Customer Care Executive

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