Channel 4’s Dispatches programme has broadcast an expose revealing serious concerns about the way care is delivered and restraint is being used at St Andrew’s hospital in Northampton. St Andrews is one of the biggest care charities in Britain and the Channel 4 documentary has revealed that within its walls one of the most contentious restraint practices, being held in the prone position (Face down) is all too common an occurrence.
An official report revealed how patients at St Andrews were subject to restraint, seclusion and sedation. The Care Quality Commission inspection report published in September 2016 found that prone restraint was widely used across all wards at St Andrew’s, Northampton. In the six months in 2015/16 there were 600 incidents of prone restraint in their child and adolescent wards alone. It is ironic then that St Andrews has just opened FitzRoy House, Europe’s newest and largest adolescent mental health facility. It provides specialised, personalised care for up to 110 young people with some of the most complex mental health needs in the UK.
SecuriCares Risk Manager Lee Hollins highlights the dangers of prone restraint, “On a psychological an emotional level alone being held face down can be a frightening and demeaning experience. Imagine your son or daughter being held face down during a time of crisis on what is sometimes an unwashed or dirty floor, with every attempt to stand being thwarted by a far more powerful team of staff who are calling the shots… It must be terrifying, and re-traumatising for those who have previously experienced physical abuse..”
“If that wasn’t enough this position is positively correlated with respiratory distress. People find it harder to breathe when they are held in this position forcibly. The compression of the abdomen against the hard unyielding floor has been enough on many many occasions to compromise breathing altogether… Just Google ‘restraint asphyxia deaths UK’ and see what your search returns…”
In the programme the case of 19 year old Fauzia Hussains was examined. Fauzia, who has has Tourette’s and autism, along with complex sensory difficulties, spent almost two years in St Andrew’s Healthcare. She was fifteen when she was sectioned under the Mental Health Act and admitted to St Andrew’s. There she was prescribed high doses of medication, including anti-psychotic drugs and remained, mostly in segregation, for 22 months in a room with very little natural daylight. When her family visited her they witnessed her being dragged by the arms forcefully.
Norman Lamb, the coalition government minister in charge of Learning Disabled Care at the time, said “I had heard very big concerns about the nature of the care in this institution. So I went to St Andrew’s in Northampton, and saw Fauzia in her room, which in effect was a cell, it seemed to be that a 15-year-old girl [Fauzia] was being treated in effect like a prisoner. It was one of the most shocking things that I’ve seen in my time in parliament. Just as a human being I was just horrified…”
With the help of their local authority, Fauzias family found another care provider willing to take her, and after several delays, Fauzia left St Andrew’s in September 2014. Since leaving her quality of life has improved dramatically. She now lives in residential care but comes home to visit her family once a month. Less than a month after arriving at her new care provider, Fauzia was no longer being medicated and has never been restrained since arriving.
Lee Hollins continues, “When you consider Fauzias story, and that of other in the documentary you can’t help but conclude that there seemed to be an absence of person centred care and of basic human empathy. The programme seemed to suggest that restraint was being used as some kind of routine management technique rather an emergency measure used in strictly defined circumstances… I can only hope St Andrews are able to take concrete action to assuage any fears, and manage the inevitable risks that arise when restraint is being used to frequently..”
Jan Tregelles, chief executive at Mencap, and Viv Cooper, chief executive at the Challenging Behaviour Foundation were both very vocal, “Dispatches: Under Lock and Key should shock the nation as to how young people with a learning disability can be subject to a childhood stuck in institutions. 6 years after the Winterbourne View Scandal and countless promises made by Government to families, we still see the concerning overuse of seclusion, physical restraint and over medication suffered by people with a learning disability whilst in inpatient settings across the country. How much longer do families have to wait until the NHS stops sending their loved ones to these out-dated institutions? There needs to be a national spotlight on this issue. We are denying people with a learning disability their basic rights by sending them to places where they remain under lock and key, with no guarantee of when or if they will return home to their communities…”
Training is one part of the solution. SecuriCare offer a range of courses designed to enable support workers, carers and foster families to best respond to any ‘Challenging Behaviour’ that may occur. All programmes are finalised after full training needs analysis and delivered by experienced frontline practitioners. Click to see our ‘Preventing & Managing Challenging Behaviour’ Course which includes ‘Positive Behaviour Management’ techniques designed to minimise the need for any kind of restrictive intervention. You can also take a look at our person centred Behaviour Planning Service.
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