Autumn Newsletter - Page 5



The CQC have expressed ongoing concerns about the
quality of care that is being provided across the country
and ratings for NHS inpatient services for people with
learning disabilities or autism reveal that only 17 out of 32
(53%) providers are rated as ‘good’ and only two care
providers (6%) are rated as ‘outstanding’.
We often find that although there is support for the
principle, there is no published organisational strategy and
action plan to reduce restrictive practice. We look out for
evidence of Board oversight but also that all staff are
informed, educated, supported and committed.
Families frequently tell us that they have not been involved
One of the major challenges within organisations is how to in care planning or treatment reviews, and they then have
evidence that the highest possible standards are being
to resort to making a formal complaint. This often becomes
achieved, maintained and measured.
a lengthy, bureaucratic and ultimately, costly process which
is better avoided.
The Six Core Strategies for reducing seclusion and
restraint indicates that commitment and leadership at
senior level is necessary to ensure a positive and safe
Remember… ‘Positive and Proactive Care’ has
culture where use of restrictive practice is limited.
6 guiding principles:
Begin with the end in mind
Other necessary components include working in
partnership with the people using services, developing the
workforce, using restraint prevention tools and providing
robust data to inform practice.
Initiatives such as SafeWards have offered a model of care
aimed at avoiding conflict and containment and improving
the safety of patients and staff. Positive Behavioural
Support (PBS) is also increasingly used to promote a more
ethical approach to behaviour that challenges others which
is “based on an assessment of the social and physical
environment in which the behaviour happens, includes the
views of the individual and everyone involved, and uses
this understanding to develop support that improves the
quality of life for the person and others who are involved
with them”.
NHS England’s new policy for people with learning
disabilities and autism; and the new ‘Service Model’, refer
to ‘golden threads’ in supporting people with a learning
disability and/or autism who may have a mental health
condition. Components which should be reflected in local
commissioning strategies include:
safety
choice + control
Quality of life
minimal intervention
equitable outcomes
Children, young people and adults with a learning
disability and/or autism who display behaviour that
challenges, including those with a mental health condition
have the right to the same opportunities as anyone else to
live satisfying and valued lives and, to be treated with the
same dignity and respect. They should have a home
within their community, be able to develop and maintain
relationships and get the support they need to live a
healthy, safe and fulfilling life.
1. compliance with the relevant rights in the
European Convention on Human Rights at all
times;
2. understanding people’s behaviour allows their
unique needs, aspirations, experiences and
strengths to be recognised and their quality of
life to be enhanced;
3. involvement and participation of people with
care and support needs, their families, carers
and advocates is essential, wherever
practicable and subject to the person’s wishes
and confidentiality obligations;
4. people must be treated with compassion,
dignity and kindness;
5. health and social care services must support
people to balance safety from harm and
freedom of choice; and
6. positive relationships between the people who
deliver services and the people they support
must be protected and preserved.
Debra Moore leads DMA, which is a
team of people committed to
supporting better health and social
care for people who are most at risk of
experiencing inequality or exclusion.
Carol Rooney is the Head of
Investigations at Niche and has led on
many high-profiled homicide reviews,
investigations and serious case
reviews.
Carol.Rooney@nicheconsult.co.uk
5





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