In the event a service user, or supported person, displays some form of behavioural distress staff will need to respond positively. They need to make sure they do so in a safe, effective and above all lawful manner. SecuriCare provide a number of care courses aimed at providing the skills and knowledge required, these include ‘Preventing and Managing Challenging Behaviour training, ‘Breakaway Training’ and Physical intervention training. A ‘Physical Intervention’ is quite possibly the most ethically fraught intervention of all. If, as a last resort, it is necessary for staff to resort to such measures they need to make sure they get it right first time. So this begs the question: when is a ‘Physical Intervention’ technique NOT a ‘Physical Intervention’ technique?

Physical intervention trainingA ‘Restrictive Physical Intervention’ is one that involves limiting a person’s freedom of movement and continuing to do so against resistance. (Harris et al, 2008 p20 BILD).  This is generally in response to a piece of behaviour that immediately jeopardises someone’s safety and at the same time all other sub- physical strategies have been exhausted or proved ineffective. The decision to employ the technique is usually taken when, in its absence, harm would reasonably be expected to be caused. A ‘Physical Intervention’ technique then usually refers to a single example of how staff can employ a controlled degree of manual force in a specially configured manner to limit the movement of the person, typically by stabilising one of their limbs, usually an arm.

Risk manager Lee Hollins expands on the subject, “Usually these ‘techniques’ or ‘holds’ are given a proprietary name by the originating training provider for identification purposes. Sometimes alternatives names are bestowed upon them by the organisation employing them to better reflect their values or ethos. You will her terms like a ‘Small Hold’, ‘Gentle Hold’, ‘Firm Hold’, ‘Guide Hold’ or ‘Support Hold’… All of which speak to the techniques intent and hopefully differentiate them from old school techniques that proliferated when systems like C&R prevailed…. ”

“Beneath the descriptive label is a technique involves an initial entry, the arrival at a destination (or stabilising position) and then the final exit or release. The ‘stabilising position’ usually involve getting the limb into a tactically advantageous position and holding it in a way that advantages staff. Ultimately the staff member and service user should be safe from each other, so neither can cause harm to the other and the application thereafter creates an opportunity to hasten de-escalation and therefore the techniques final exit or release..”

“Organisations like SecuriCare are affiliated to accreditation process like those operated by the ICM or BILD, and produce risk assessments to ensure that both the technique is safe, and the individual it is destined to be employed upon is fit and healthy enough to tolerate its use under strictly prescribed conditions… My personal background is in physiotherapy so this knowledge is used to great effect when undertaking risk assessments..”

“The risks that do arise often creep in when staff adapt the technique to make it work better for them. This is referred to in the literature as ‘field modification’ (Paterson, 2007, p31). What happens is staff ‘add’ in something to the technique, or subtract a particular component in order to get a quicker or bigger return on their physical investment. Sometimes this is down to incompetence or incomplete recall of the technique (suggesting perhaps the technique may be too complex), it can also arise out of anger or frustration on the part of staff (indicating that there is work to be done on stress management), and other times it can be because staff have learnt other techniques elsewhere, perhaps on another course or in a martial arts class (this underscores the need to cover accountability during any training session).. Irrespective of the causation it is possible that you end up with a potentially harmful technique being applied…”

“A complete training solution, like the one offered by Securicare cover all the issues previously outlined and also look at dynamic risk assessment as it takes place within any single application and staff are training to look out for three or four key safety indicators that are designed to ensure each application passes off safely, effectively and above all lawfully…”

SecuriCare offer a range of courses designed to ensure that nominated trainers can help staff to respond safely and effectively to any ‘Challenging Behaviour’ that may occur, including the application of ‘Physical Interventions techniques’. 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.

Contact us for more information and to discuss your needs: E: trainers@securicare.com or T: 01904 492442

Harris, J, Cornick, M, Jefferson, A and Mills, R (2008) Physical Interventions: A Policy Framework. Second edition. Kidderminster: BILD.

Paterson, B. (2007). ‘Millfields Charter: drawing the wrong conclusions’. Learning disability practice. 10 (3) 30-33