The use of restraint in children’s homes has long been a contentious issue. Whilst most people concede that restraint is necessary to some degree in homes caring for children with challenging behaviour, children’s homes must ensure they use restraint correctly and within the bounds of the law. We outline and explore the most recent updates to the law in relation to the use of restraint in children’s homes.
In April 2011, The Children’s Home (Amendment) Regulations 2011 (the “Regulations”) were introduced to strengthen the regulatory regime which protects the rights of children in children’s homes. The Regulations specify that restraint should only be used in children’s homes for the purposes of:
- preventing injury to any person (including the child who is being restrained);
- preventing serious damage to the property of any person (including the child who is being restrained); and
- to prevent the child from absconding from the home (in the case of a child accommodated in a secure children’s home).
Where restraint is used, the Regulations state that the restraint must be proportionate and that staff use only as much force as is necessary. This requires the minimum amount of force necessary to avert injury or serious damage to property, applied for the shortest amount of time. Any technique for restraining a child should never be intended to inflict pain.
The guidance produced by the Department for Education in March 2011 entitled ‘Children Act 1989 Guidance and Regulation Volume 5, Children’s Homes’, (“the Guidance”) stipulates that physical interventions to restrain or protect children and young people can only be justified within a context in which children are offered positive care that meets their individual needs and respects their personal integrity.
In no circumstances will it be acceptable for a staff member to restrain a child in their care as a disciplinary measure in order to enforce compliance with a sanction or instructions.
Policies
Any attempt to restrain a child or young person inevitably carries the risk of causing serious physical injury, psychological trauma or emotional disturbance. It is therefore important for children’s home staff to operate with clear, unambiguous rules regarding the use of restraint and which fit within the home’s behaviour management policy. This requirement is stipulated by Regulation 17B of the 2011 Regulations, which necessitates that the registered person must prepare and implement a written policy which sets out the measures of control, discipline and restraint which may be used in the children’s home and the means whereby appropriate behaviour is to be promoted in the home.
Training
Staff must be trained to apply the restraint policy and know exactly when to follow that policy. Such training will include learning restraint techniques which have been approved to be used in the home.
The Guidance states that before using specific method of restraint, staff will need to demonstrate that they fully understand the risks associated with the technique concerned. For example any techniques that may interfere with breathing should never be used. On no account should neck holds be used as a way of restraining children or young people as holding a child by the neck carries a risk of suffocation or restricting blood flow to the brain, as well as a risk of spinal injury.
The Guidance also sets out how the risks to children when using restraints can be minimised, and provides that children’s home staff take the following into account:
- the age and understanding of the child;
- the size of the child;
- the relevance of any disability, health problem or medication to the behaviour in question and the action which might be taken as a result;
- the relative risks of not intervening;
- the child’s views on strategies that they consider might de-escalate or calm a situation (discussed with the child before the need for the restraint arises);
- the method of restraint which would be appropriate in the specific circumstances; and
- the impact of the restraint on the carer’s future relationship with the child.
Debrief Following Restraint
The Guidance provides that the registered person must ensure that within 24 hours of the use of any restraint, a written record is made in a record book kept for the purpose. The written record must include:
- the name of the child concerned;
- details of the child’s behaviour leading to the use of the measure;
- a description of the measure used;
- the date, time and location of the use of the measure;
- the name of the person using the measure, and of any other person present;
- the effectiveness and any consequences of the use of the measure;
- a description of any injury to the child concerned or any other person and any medical treatment administered;
- confirmation that the person authorised by the registered provider to make the record has spoken to the child concerned and the person who issued the restraint about the use of the restraint; and
- the signature of the person authorised by the registered provider to make the record.
Children’s home staff are furthermore responsible for ensuring that any child who has been restrained should be debriefed within 24 hours by a responsible adult who was not involved in the restraint. The child should be encouraged to record their comments and must be offered the opportunity to have access to an advocate to help them with this process.
Conclusion
The use of restraint by children’s homes is usually considered to be a last resort to control a difficult situation. However, as long as it is used within the bounds of the legal framework and when other options have been exhausted, it can be effective to protect young people in children’s homes from others and themselves.
