Leading by example to reduce restrictive practice

By Lorna Durrant, Head of Specialist Strategies and Outcomes, Eden Futures

Care England highlighted recently that more than 2,000 adults needing specialist accommodation are having to remain long-term in hospital because of flawed policy and inflexible bureaucracy – something they’re campaigning to change.

As a specialist provider of support and enablement for adults with learning disabilities and mental ill-health and autistic people, this is something we wholeheartedly support. There’s great commitment across the country to get people out of hospital and into their own homes in the community, but there’s always more to do given the numbers of adults needing this kind of care and support.

The transition into supported living is not always plain sailing. It’s important to understand the history of a person as well as who they are today. That’s why it’s essential we work with the person to co-produce support plans that work for them, as well as ensuring the staff team have access to appropriate learning and development. This includes training and coaching in Positive Behaviour Support to ensure that staff are equipped to provide safe and effective support in the least restrictive way.

To help with this, we’ve established an Expert by Experience (EbE) programme across Eden Futures. EbE encourages people who live in our services to work alongside our teams to visit services to speak with staff and service users about how the service meets people’s needs and to deliver L&D sessions to inductees to aid understanding of the impact their own behaviour can have on those they support. Our Experts also sit on interview panels to help us recruit the best talent. These paid positions ensure people have a voice and supports change and improvement.

Eden Futures has pledged support to the Restraint Reduction Network (RRN). We’ll work with other like-minded organisations to reduce reliance on restrictive practices to make a real difference to people’s lives. Whilst its training standards are being developed for use by all NHS commissioned services and the CQC from April, we’ve been working hard to adopt them already to promote best practice. We’re currently working to become an associate trainer to deliver training that meets the standards. They embrace a person-centred, human rights approach to restrictive interventions, which is consistent with our beliefs and training approach.

Whilst the RRN recognises that there’s an increased focus on restraint reduction across the NHS and adult social care in the UK, there is still significant concern surrounding the over-reliance on restrictive practices when supporting distressed, vulnerable people, resulting in a number of scandals.

A report issued last year by the CQC found that many staff “lack the necessary training and skills” to work with autistic people, complex needs and behaviours that challenge others. It is essential that staff understand and apply the ethos of minimising use of force and this new guidance is a positive step.

In support of Eden Futures’ continued commitment to embed the principles of positive behavioural support (PBS) into everyday practice, we worked with MAYBO on the inception of licenced trainers. PBS helps us to understand the function of a person’s behaviour and what maintains it. The primary goal of the support we provide is to increase the person’s quality of life and the secondary goal is to reduce the frequency and severity of the behaviours of concern.

There are occasions when physical interventions are required to ensure everyone stays safe in a crisis. MAYBO’s suite of learning & development programmes ensures the approaches we use reduce risks to everyone involved and focuses on alternatives to force by adopting the least restrictive intervention.

Increasing knowledge and understanding supports confidence and competence in our teams to safely and effectively manage behaviours of concern, improving quality of life to those in our services and minimising risks.