Restrictive Practices Policy - Southern Health NHS ... Restrictive Practices Policy Version: 2 March...

1 Restrictive Practices Policy Version: 2 March 2018

SH NCP 83

Restrictive Practices Policy

Version: 2

Summary: This overarching policy states the position of Southern Health Foundation

Trust in relation to the use of restrictive practices. It should be read in conjunction with the policies and protocols that deal with specific restrictive interventions.

The aims of the policy are:

1. To ensure that the human rights of all adults, children and young people who use our services, as well as the staff who work within them, are respected and protected.

2. To minimise the use of restrictive practices of all forms and to prevent the inappropriate use of such practices.

3. To ensure that where, in order to achieve a legitimate aim, some rights may have to be restricted, it is done in a transparent and lawful manner with every effort (both systemic and operational) being made to ensure that it is a proportionate, demonstrable and necessary last resort.

4. To ensure proper monitoring of restrictive practices and to provide a complete record to monitor compliance and audit.

Keywords: Restrictive Practice, Restraint, Observation, Seclusion, Control

Target Audience: All staff, volunteers and students of Southern Health NHS Trust

NB: A plain English and ‘Easier to Read’ version will be available

Next Review Date: March 2019

Approved &

Ratified by:

SAFER Forum Date of meeting: 13 March 2018

Date issued: March 2018

Author: Dr Mayura Deshpande, Associate Medical Director/ Nicola Bennett, Associate Director of Nursing, Adult Mental Health

Director: Dr Sarah Constantine, Medical Director


Version Control Change Record

Date Author Version Page Reason for Change

27Oct 2017

Nicola Bennett 1 Review of policy 4,3 page 6 - update 5.9 page 7 – update 10.page 11 – update and policy addition

27Nov 2017

Nicola Bennett 1 All pages

Change PRISS to sSs

March 2018

Nicola Bennett 2 Policy Review

24.3.18 Louise Hartland 2 12 Updated TNA

Reviewers/contributors

Name Position Version Reviewed & Date

SHFT CQC Assurance Group via JD Chief Nurse V1. 8/8/2016 (presentation)

10/8/2016 to group

Dr Jennifer Dolman Clinical Director – Learning Disabilities V1 24/9/2016

Dr Mary Kloer Clinical Director - AMH V1 11/8/2016

Dr M Deshpande Associate Medical Director V1 2/8/2016

Dr Sarah Constantine Associate Medical Director V1 23/9/2016

Dave Atkinson External Expert V1 1/8/2016

Nicola Bennett ADON/Service Manager –Specialised Services V1 2/8/2016

John Stagg ADON LD V1 8/8/2016

Carol Adcock ADON AMH V1 16/1/2016

Paul Munday CSM - LD V1 12/8/2016

Simon Tarrant Service Manager for Forensic LD V1 12/8/2016

Jayne Jazz Patient Experience Lead - LD V1 8/1/2016

Simon Beaumont Head of Information V1 31/1/2016

SAFER Forum V1 4/1/2016




Quick Reference Guide For quick reference, this page summarises the actions required by this policy. This does not negate the need to be aware of and to follow the further detail provided in this policy. This is a new overarching policy that sets out the position of Southern Health NHS Foundation Trust in respect of the use of restrictive practices. The policy defines what can be constituted as a restrictive practice, including examples of interventions that are categorised as restrictive. Duties of the organisation, managers and individuals are clarified. Restrictive practice must be legally and ethically justified. Applying restrictive practices without consent or lawful authority could make individuals and their employees liable for civil or criminal actions.


Contents

Section Title Page

1. Introduction

5

2. Who Does This Policy Apply To?

5

3. Definitions

5

4. The Trust’s Strategic Objectives

6

5. Context and Legal Framework

6

6. Duties and Responsibilities

9

7.

Training Requirements 10

8. Monitoring Compliance

11

9.

Policy Review 11

10.

Associated Trust Documents 11

11.

Supporting References 11

Appendix 1

Training Needs Analysis 12

Appendix 2 Equality Impact Assessment

14


Restrictive Practices 1. Introduction

1.1 This overarching policy describes the approach of Southern Health NHS Foundation

Trust (the Trust) to the use of restrictive practices and interventions.

1.2 This document includes definitions, the Trust's strategic objectives and duties/responsibilities of key staff.

1.3 This policy sets out the overarching framework for the use of restrictive practices within

the Trust’s services; it includes details of the legislative framework and guiding principles within which all staff should work. The policy is supported by a ‘suite’ of subordinate policies and protocols that provides further detail and guidance on the safe, lawful and legitimate use of specific forms of restrictive interventions.

2. Who does this policy apply to?

2.1 All employees, including agency and contracted staff, students and volunteers working in Southern Health Foundation NHS Trust.

3. Definitions 3.1 Restrictive practices comprise a wide range of activities that either individually or in

combination involve ‘making someone do something they don’t want to do or stopping someone doing something they do want to do’. Such acts risk engaging or possibly breaching a person’s human rights1.

3.2 In particular, the following rights are at risk of being breached where restrictive practices

(of any form) are implemented outside of a robust policy framework:

The right to freedom from torture, inhuman and degrading treatment (Article 3)

The right to liberty and security (Article 5)

The right to respect for private and family life, home and correspondence (Article 8) 3.3 Restrictive practices can be very obvious and easily recognized, or sometimes may be

more subtle; they may be planned in advance, or used as a response to an unforeseen emergency. Examples of restrictive practices include the use of ‘blanket rules’ such as the routine locking of doors; observation levels, use of seclusion; restraining an aggressive patient; locking toxic cleaning chemicals out of harm’s way; delivering planned or unplanned care and treatments such as the medication whereby sedation occurs either as a therapeutic, or an adverse effect. They also cover measures that meet the definition of “supervision and control” as identified in the Cheshire West Case2.

3.4 Restrictive interventions are a specific subset of restrictive practices. They are deliberate

acts on the part of other person(s) that restrict a patient’s movement, liberty and/or freedom to act independently in order to:

1 Council of Europe (1950) The European Convention of Human Rights

2 Cheshire West and Chester Council v P (2011) EWCA Civ 1257

http://www.mentalhealthlaw.co.uk/Cheshire_West_and_Chester_Council_v_P_(2011)_EWCA_Civ_1257

http://www.mentalhealthlaw.co.uk/Cheshire_West_and_Chester_Council_v_P_(2011)_EWCA_Civ_1257


Take immediate control of a dangerous situation where there is a real possibility of harm to the person or others if no action is undertaken, and

End or reduce significantly the danger to the patient or others.

3.5 Examples of restrictive interventions that may be used are:

Physical interventions and restraint (including mechanical restraint)

Rapid tranquilisation

Seclusion

Long term segregation

Personal and other searches

Enhanced observation

Withholding of information or equipment

Blanket restrictions

4. The Trust’s Strategic Objectives 4.1 The Trust aims to reduce the use of restrictive practices in all its services. Therefore,

every inpatient mental health and learning disability service in the Trust will have a least restrictive practices action plan.

4.2 The Trust will ensure that any use of restrictive practices is carried out within a clearly

defined legal framework, is proportionate to the risks of the situation, is the least restrictive intervention possible, and is for the minimum duration required. Therefore, a suite of policies and procedures dealing with a range of restrictive practices has been developed and forms part of this suite of policies. The trust will ensure that any restrictive practices used, including restraint, will be based on best available evidence and best practice, with appropriate training for staff.

4.3 The Trust will put in place systems to monitor the use of restrictive practices and provide

a complete record of compliance and audit. This is achieved via the use of Ulysses. 5. Context and Legal Framework 5.1. In 2014 the Department of Health launched the guidance Positive and Proactive Care:

Reducing the Need for Restrictive Interventions. This document aimed to provide a framework to support the development of service cultures and ways of delivering care and support that better met people’s needs and which enhanced their quality of life. It provided guidance on the delivery of services together with key actions which aimed to reduce the need for restrictive interventions and promote recovery.

5.2. The guidance was informed by, and responded to, a number of key investigations

including:

Transforming Care: A National Response to Winterbourne View

MIND report: Mental Health Crisis In Care: Physical Restraint In Crisis

The Francis Inquiry and Report

CQC Inspections of 150 learning disability in patient services that found an over reliance on the use of restraint

5.3. Positive and Proactive Care was launched alongside A Positive and Proactive

Workforce. The guide aimed to help commissioners and employers to develop a workforce that is skilled, knowledgeable, competent and well supported to work in


positive and proactive ways. In addition it outlined key points for organisations, to ensure that any restrictive practices or interventions are legally and ethically justifiable and underpinned by the key principles of Positive and Proactive Care.

5.4 Whilst Positive and Proactive Care amounted to non-statutory guidance, it informs the

Care Quality Commission when assessing whether a provider is delivering safe and effective care. In 2015 the revised Mental Health Act Code of Practice was brought into alignment with Positive and Proactive Care, thus elevating many of its recommendations to the status of statutory guidance.

5.5. Also in 2015, NICE guidelines on the short term management of violence and

aggression were updated, once again emphasising the recommendations of the earlier policy initiatives.

5.6 Any restrictive practice must be legally and ethically justified. Applying restrictive

practices without consent or lawful authority could make individuals and their employers liable for civil or criminal actions for assault, battery, negligence, false imprisonment, ill treatment or neglect. It is therefore vital that when we impose restrictions that we have, and remain within, a correct and relevant legal basis for doing so.

5.7 The Mental Health Act (1983) makes clear that any restrictive practice undertaken must

be necessary to protect the person or others. It provides authority to detain, assess and treat individuals for mental disorder whether they have capacity to consent to admission and treatment or not.

5.8 The Mental Health Act Revised Code of Practice (2015) specifically notes that

restrictive interventions should not be used to punish or for the sole intention of inflicting pain, suffering or humiliation; and when a person restricts a patient’s movement, or uses (or threatens to use) force then that should:

Be used for no longer than necessary to prevent harm to the person or to others

Be a proportionate response to that harm, and

Be the least restrictive option 5.9 The Act sets out five guiding principles that should be considered when making all

decisions in relation to care, support or treatment provided under the Act. These are set out below with consideration to their application of restrictive practice:

Least restrictive option and maximising independence: this means only using the powers of the Act to compulsorily treat people when absolutely essential and then for the shortest possible time. It also means that services must avoid blanket or ‘de-facto’ restrictions on patients and must have effective pathways by which to encourage independence and promote recovery. Ref Blanket Restrictions Policy (SH NCP 88)

Empowerment and Involvement: this means ensuring that we involve patients as fully as possible in planning their own care and treatment, including any use of interventions that might be considered restrictive. This includes providing information and supported decision making, recording patient views and involving families and advocates should the patient wish this.

Respect and Dignity: this means ensuring that we deliver person-centred care, tailored to individual needs. It also requires us to work respectfully and ensure that the patients, their families, carers and friends are listened to, and that their views are understood, including in regard to any restrictions placed on them.


Purpose and Effectiveness: this means that decisions about care and treatment (including any restrictions placed on the person) must have clear therapeutic aims, promote recovery, satisfy current national policy and be in accordance with evidence and best practice guidelines.

Efficiency and Equity: Providers, commissioners and other relevant organisations should work together to ensure services are of high quality, that physical and mental health have parity of esteem and that any discharge from detention is timely, safe and supportive. There has been a legal requirement for many decades that people with mental health needs, learning disabilities and autistic spectrum conditions are cared for in the least restrictive setting possible. The human rights principle of ‘progressive realisation’ of rights means however that we must constantly improve the efficacy of our services and demonstrate an ever increasing equity of outcome amongst otherwise marginalised populations. This means that what was previously innovative should now be everyday practice and that what used to be everyday practice may no longer be good enough.

5.10 It is essential that managers and practitioners ensure they are working in accordance

with the requirements of Mental Health Act 1983 and its Code of Practice including guidance which addresses the particular needs of children and young people; people with learning disabilities or autistic spectrum conditions; and the provision of gender and culturally sensitive services.

5.11 Mental Capacity Act (MCA) 2005 including the Deprivation of Liberty Safeguards

(DoLS) adopts a broad definition of ‘restraint’ and offers legal justification for its use, in the case of people who cannot agree to it, to protect them from a risk of serious harm. It also prescribes a lawful mechanism, under extreme circumstances whereby a person can, with safeguards (DoLS), be deprived of their liberty. In basic terms people are deemed to be deprived of their liberty if they:

Are under continuous supervision and control

Are not free to leave, and

Lack capacity to consent to these arrangements 5.12 It is clear in the Act that any action or practice that we may undertake to meet a need

which may restrict a person’s freedom must be the least restrictive option by which to meet that need. The MCA states that we must assume a person over the age of 16 years has capacity to make a decision unless there is evidence to the contrary and in this case we must assess capacity and remember that it is both decision and time specific. Staff must therefore ensure that where the MCA applies, they are working within its parameters and importantly, ensuring they are doing all they can to enhance an individual’s ability to make their own decisions, for example, by providing easier to read information.

5.13 Where the restriction amounts to a deprivation, it must always be undertaken in

accordance with a lawfully prescribed mechanism. When making an application for DoLS, best practice indicates that practitioners must detail all elements of any restrictions. This might include limited access to areas of a ward, eating in a separate environment, therapeutic holding or physical prompting to engage or support a patient to move into a different area.

5.14 The Children’s Act 2004 deals specifically with the care and welfare of children and

young people up to the age of 18 years old. Staff working with children should be aware of the United Convention on the Rights of the Child and remember that all persons


under‐18 are classified as children and that the Local Safeguarding Children Board procedures apply.

5.15 Safety at Work Act (1974) establishes that employers have a duty to ensure so far as is

reasonably practicable, the health, safety and welfare at work of their employees and the health and safety of others that maybe affected by the employers undertaking. This includes assessing risks to employees (including reasonably foreseeable violence and any risks associated with inappropriate environments); providing adequate information, instruction, training and supervision in relation to risks arising from violence and aggression, and associated with the use of restrictive interventions; and monitoring and reviewing the efficacy of arrangements on an ongoing basis.

6 Duties and Responsibilities 6.1 Trust Board Responsibilities

a. Executive Board Members who authorise the use of restrictive practice must fully understand the context in which these take place and ensure there are effective governance systems to monitor the use of restrictive interventions. This includes regular and detailed quantitative and qualitative reporting at Trust Board level (and every level below) on the scope and frequency of such practice.

b. There will be a named Executive with explicit responsibility for the oversight and

governance of the use of restrictive interventions within the Trust. This executive will also ensure that relevant policies, procedures and protocols within the Trust from a cohesive framework to enable staff to practice.

c. The responsible executive director will ensure that a specific and detailed action

plan sets out the actions intended to bring about a long term reduction in the use of restrictive interventions and in particular the use of physical interventions including the use of prone restraint only for medical reasons. This plan will be evaluated and revised on the basis of empirical data regarding the use of restrictive interventions, the testimony of those subjected to them and lessons learned from post-incident analyses. This will include data from all service user groups across all divisions within the organisation, enhancing participation and maximising feedback by paying attention to accessibility and making reasonable adjustments.

d. The responsible executive director will also hold lead responsibility for increasing

the use of recovery-based approaches including, where appropriate, positive behavioural support planning.

e. The Trust will ensure that accurate, service specific, internal data is gathered,

aggregated and published (including progress against restrictive intervention reduction programmes) along with details of training and development in annual quality accounts.

f. The Trust will ensure that patients, their relatives and advocates are treated as

equal partners in their care and treatment and have access to appropriate information and guidance. There will be provision in the quality assurance process to specifically monitor and report on this requirement.

g. The Trust will promote a culture of learning from practice and ensure that there is a

structure in place that enables the sharing of information and good practice across the organisation and with other agencies as appropriate.


6.2 Managers’ Responsibilities

a. Managers of services (at all levels) will ensure that services are resourced appropriately and that their staff teams able to access training, supervision and support to enable them to practice in a manner that complies with the relevant legislation and guidance.

b. Managers will design staff structures to minimise restrictive practice by maintaining

a consistent workforce with the right values, attitudes and skills and in the right numbers.

c. Managers will ensure that all areas have regular forums and opportunities for

patients, their families and advocates to contribute to the design, delivery and evaluation of services with specific reference to reducing the need for restrictive practices.

d. Managers will ensure that post-incident reviews and debriefs take place so that

lessons are learned from incidents occur wherein restrictive interventions have had to be used. This includes garnering the views of the patient and the experience of restraint or restriction placed on them, why this occurred and their understanding of the situation.

6.3 Individual Responsibilities

a. All staff members have an individual responsibility to ensure they work within the legal and ethical framework that pertains to practice and interventions that would be defined as restrictive with a pro-active response to poor practice.

b. All staff must ensure they comply with Trust policies relating to restrictive practice

and contribute to activities designed to support a reduction or elimination of restrictive practices.

c. All staff must ensure they are competent within their role and within the setting in

which they are employed in order to meet the needs of the patients being cared for. Any gaps in knowledge, skills or practice in the area of restrictive practice and/or restrictive interventions must be raised swiftly by the individual to their supervising manager.

6.4 Safeguarding Lead responsibility

a. Safeguarding leads will ensure that there are systems in place for appropriate reporting, recording and monitoring of safeguarding incidents involving adults, children or young people and assist/support staff in considering the legal and ethical dilemmas that may arise.

7 Training Requirements 7.1 Southern Health NHS Foundation Trust will provide appropriate training and education

to support staff who may be required to instigate restrictive interventions. 7.2 Any training or education relating to restrictive interventions will include learning about

human rights and other relevant legislation including (but not confined to) the Mental Health Act (1983), the Revised MHA Code of Practice (2015), the Mental Capacity Act (2005) and the Children Act (2004).


7.3 Training should be adjusted/ augmented where required to meet the needs of specific service user groups.

7.4 All education and training should be co-produced with people who use services and their

families. 7.5 All bank and agency staff must receive the same training as all staff in equal,

substantive roles. 7.6 Staff will receive training commensurate to their role to ensure they practice within a

legal and ethical framework when undertaking restrictive interventions. 8. Monitoring Compliance 8.1 The effectiveness of this policy will be reviewed on an annual basis and assessed by

reviewing its implementation and application across the organisation in line with the requirements of the Trust Reducing Restrictive Practice Strategy and the Trust’s SAFER Forum leading on the reduction of restrictive practice agenda.

9. Policy Review 9.1 This policy will be reviewed annually as a minimum, and more frequently as required by

the Safer Forum. 10. Associated Trust Documents SH NCP 23 Restrictive Interventions Policy SH CP 107 Seclusion and long term segregation policy SH CP 15.2 Safeguarding Adults Policy SH CP 56 Safeguarding Children Policy SH CP 48 Rapid Tranquilisation Policy and Practice SH NCP 21, 22, 23 Management of Violence and Aggression Policies and Procedures SH CP 37 Observation and Engagement Policy SH HS 07 Search Policy SH NCP 88 Blanket Restrictions Policy 11. SUPPORTING REFERENCES (within text)

Element to be monitored Lead Tool Frequency Reporting arrangements

Frequency, types and trends of Restrictive practices

Matron/Senior Nurse/Clinical Directors

Tableau & Ulysses data sets

Monthly

Monthly Q&S

Safeguarding Incidents relating to restrictive practices



Monthly Monthly Q&S

Complaints by patients and families relating to restrictive practices



Monthly Monthly Q&S


Appendix 1 – Training Needs Analysis If there are any training implications in your policy, please complete the form below and make an appointment with the LEaD department (Louise Hartland, Quality, Governance and Compliance on 02380 874091) before the policy goes through the Trust policy approval process.

Topic/Subject Frequency Course Length Delivery Method Facilitators Recording

Attendance Strategic & Operational

Responsibility

Conflict Resolution Training

Once followed by refresher every 3 years

Initial and Refresher – 3.5 hours

Face to face LEaD LEaD Strategic - Medical Director Operational - Head of Nursing, AHP and Quality for MH.

Service Target Audience

MH/LD

Adult Mental Health

All staff who are not required to complete Supporting Safer Services (sSs) training Specialised Services

Learning Disability Services

Older Persons Mental Health

ISD Adults

All Staff

Childrens Services & Quit for Life

Corporate

Director of Nursing

Medical Director

Chief Executive

Chief Financial Officer

Development Director

People of Communications

Property and Estates


Topic/Subject Frequency Course Length Delivery Method Facilitators Recording

Attendance Strategic & Operational

Responsibility

Supporting Safer Services (sSs) Full programme once only followed by annual Refresher

Full programme – 30 hours Refresher – 15 hours

Face to face LEaD LEaD Strategic - Medical Director Operational - Head of Nursing, AHP and Quality for MH.

Service Target Audience

MH/LD

Adult Mental Health

All registered nurses, mental health practitioners, trainee practitioners and health care support workers who work in the following services; Elmleigh (Elmleigh Inpatients, Elmleigh FM); Antelope House (Hamtun, Trinity & Saxon wards); Parklands Hospital (Hawthorns Inpatients, Hawthorns MOD & Hawthorns PICU); Melbury Lodge (Kingsley Ward & Mother & Baby Unit).

Specialised Services

All registered nurses, mental health practitioners, trainee practitioners and health care support workers who work in the following services; Leigh House All registered nurses, mental health practitioners, occupational therapists, OT technicians, trainee practitioners and health care support workers who work in the following services; Ashford Unit, Ravenswood House (RSU Clinical Management, RSU Ashurst, RSU Lyndhurst, RSU Malcolm Faulk Ward, RSU Mary Graham Ward, Meon Valley Ward, RSU Therapies, RSU Clinical Risk & Security Liaison, RSU Support Services); Southfield (Cedar, Oak and Beech wards, Southfield OT & Southfield Reception and Security); Bluebird House (Bluebird Nursing & Security, Hill Ward, Moss Ward & Stewart wards, Bluebird House Site Services, Bluebird House OT, Bluebird Staff Dummy) and Specialised Services Management.

Learning Disability Services All registered nurses, assistant/associate practitioners, and health care support workers who work in the following services; Willow Assessment & Treatment Unit;

Older Persons Mental Health

All registered nurses, mental health practitioners, trainee practitioners and health care support workers who work in the following services; Gosport War Memorial Hospital (Dryad & Daedalus wards); Melbury Lodge (Stefano Oliveri ward); Parklands Hospital (Beechwood & Elmwood wards) and Western Community Hospital (Beaulieu & Berrywood). All inpatient modern matrons (OPMH Western Management).

ISD Adults

Not Applicable

Childrens Services & Quit for Life

Corporate

Director of Nursing

Medical Director

Chief Executive

Chief Financial Officer

Development Director

People and Communications

Property and Estates

Strategy Director


Appendix 2: Equality Impact Assessment The Equality Analysis is a written record that demonstrates that you have shown due regard to the need to eliminate unlawful discrimination, advance equality of opportunity and foster good relations with respect to the characteristics protected by the Equality Act 2010. Stage 1: Screening

Date of assessment: 01/08/2017

Name of person completing the assessment: Nicola Bennett

Job title: ADON and AHP

Responsible department:

Intended equality outcomes: Eliminate unlawful discrimination

Who was involved in the consultation of this document?

Safer Forum , Trust staff

Please describe the positive and any potential negative impact of the policy on service users or staff. In the case of negative impact, please indicate any measures planned to mitigate against this by completing stage 2. Supporting Information can be found be following the link: www.legislation.gov.uk/ukpga/2010/15/contents

Protected Characteristic Positive impact Negative impact

Age

Disability

Gender reassignment

Marriage & civil partnership

Pregnancy & maternity

Race

Religion

Sex

Sexual orientation

Stage 2: Full impact assessment

What is the impact? Mitigating actions Monitoring of actions

Blanket restrictions may be in use and therefore may impinge human rights

Review of restrictions at team level and governance process

Via Safer forum

http://www.legislation.gov.uk/ukpga/2010/15/contents


Equality Impact Assessment – Screening Tool

Positive impact

(including examples of

what the policy/service

has done to promote

equality)

Negative Impact Action Plan to address negative impact

Actions to overcome problem/ barrier

Resources required

Responsibility Target date

Age

Applied to all Protected Characteristics: Everyone has a duty to be cared for in the least restrictive requirement.

Compromising Human rights as per Article 8 of the EHCR

Applied to all Protected Characteristics: Monitoring

Number of incidents being reported;

Number of incidents passed onward to the SAFER forum

The uptake of training programmes;

Employees can expect that the Trust will: Uphold the principles of the

Included in existing training

Local Services

On-going: will be reviewed at Policy Review stage and monitoring data will be used to inform any changes


Human Rights Act that all individuals should be treated with fairness, respect, equality, dignity and autonomy

Undertake continual monitoring and evaluation of such incidents

Disability

The Trust will ensure that all its facilities and estates are accessible and safe through: Disability Access Audits and the design of service areas and personal alarms

Patients with a dual diagnosis (co-existing mental illness and substance misuse) are much more likely to be subject to care within identified environments.

Estates and Facilities Management

Local Security Management Specialist

On-going: EqIA will be reviewed at Policy Review stage and monitoring data will be used to inform any changes

Gender Reassignment

Transgender people may experience infringement of their rights in relation to inpatient accommodation

Appropriate management of single sex accommodation




Marriage and Civil Partnership


Pregnancy and Maternity

Some community staff workplace may be patient’s home

Policy and procedure will support staff



Race

The David Bennett Inquiry (2004) highlighted the importance of considering the needs of black and minority ethnic groups when managing disturbed/violent behaviour in the short- term.

Discrimination based upon race affecting staff and service users

Policy and procedure will support staff in dealing with incidents




Religion or Belief

The Trust needs to be aware that often people have specific requirements relating to an individual’s religion, belief or non-belief and these requirements should be accommodated wherever possible i.e. Multi-faith concerns: Possession of Kirpan.



Sex

In terms of managing violent/aggressive behaviour in psychiatric in-patient settings, the main concern raised in The women and mental health strategy has been to identify gender specific needs, such as single-sex facilities, and to ensure that both male and female service users feel safe, listened to and involved in identifying and meeting gender related needs



(Mainstreaming gender and women’s mental health implementation guide 2003).

Sexual Orientation

Gay, lesbian and bisexual individuals are likely to face additional concerns around homophobia and gender discrimination.

It is important that staff are trained to be aware of the specific requirements of the Equality Act 2010 and Human Rights Act. Human rights will therefore be reflected where it is appropriate to do so in general training within SHFT. This includes Corporate Induction Training, Respect and Values and E- Learning.

Equality and Diversity Lead


Restrictive Practices Policy - Southern Health NHS ... Restrictive Practices Policy Version: 2 March...

Documents

Transcript of Restrictive Practices Policy - Southern Health NHS ... Restrictive Practices Policy Version: 2 March...