Towards Safer Services

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Andy Johnston is co-author of Towards Safer Services the Minimum Standards for Organisational Restraint Reduction Plans.

The authors and publishers are reviewing the publication for the second edition. You can read the Executive Summary and access the pdf below.

Executive summary

This document outlines minimum standards for restraint reduction plans* in mental health and learning disability services and is designed to advise care and education settings that may implement restraint. It offers a framework to support providers to reduce their use of restrictive practices. In restraint reduction, the general principles are well established, but it is implementation that is the challenge. Restrictive practices are often a response to behaviours described variously as ‘behaviours of concern’, ‘challenging behaviour’, or ‘behaviours which challenge’. Such behaviour occasionally includes willful acts that cause or have the potential to cause harm. However, the behaviour is often a symptom of distress or frustration and a response to the environment or situation that the person finds themselves in. If the legal framework is observed, these minimum standards acknowledge that, in accordance with the Mental Health Act Code of Practice, interventions to prevent a greater harm, such as a breach of human rights, are sometimes necessary. The content is in line with the legislative requirements outlined for mental health services in the Mental Health Act Code of Practice (Department of Health, 2015) and other relevant legislation, such as the Human Rights Act 1998 (HRA). It is informed by evidence-based best practice where possible. These minimum standards were developed in consultation with expert practitioners and experts by experience. They bring together recommendations from the publications listed in the selected bibliography. They aim to protect human rights and maximise the safety and welfare of the people who receive services and the staff who work in them. The compliance statements contained in this document provide a structure that may inform both internal quality assurance and external regulation. Due to their systematic nature, the statements vary in their scope and so we have given a thematic summary at the start of some sections, similar to the style of the foundational 2004 NIMHE document. The standards are applicable to all providers of mental health and learning disability services including independent health and social care providers. They will, by extension, be of interest to any health, care or education service or sector where there are risks associated with behaviour and restriction.