Use Of Restraints ? On The Rise ... And Not Just the Police

For issues specific to caring for someone with learning disabilities
An emotive issue ... not new by any stretch of the imagination ... and NOT just confined to the less abled with learning problems ... care homes ... nor restricted to hospital /institutional settings ... even within the patient's home ... but needs airing on this forum :

" Shameful " use of restraints on disabled patients.

The use of restraints on adults with learning disabilities in hospital units in England rose by 50% between 2016 and 2017, figures show.

In 2017, restraints were used more than 22,000 times - once every half an hour. This was up from 15,000 times in 2016.

Former Social Care Minister Norman Lamb said the use of restraint was "shameful".

The Department of Health said it was committed to reducing the use of restrictive force in hospitals.

" Absolutely shocking "

The data, which covers both adults and children, obtained from NHS digital by BBC Radio 4's File on 4 programme also found:

Patient on patient assaults rose from 3,600 to more than 9,000 over the same period and figures for January to May this year suggest they are continuing to rise

Instances of face-down or prone restraint - which should no longer be used according to government guidelines - also increased from more than 2,200 to 3,100

Authorities in Wales, Scotland and Northern Ireland said it was not possible for them to provide fully comparative data.

Liberal Democrat MP Norman Lamb, who introduced guidelines to reduce the use of force in hospitals in 2014, said the use of face-down restraint was "absolutely shocking" and "extraordinarily demeaning".

"The bottom line is that I had wanted to see and expected to see a substantial decline in the use of restraint and that hasn't happened.

"I think that's really shameful when we know that it's possible in very many cases to avoid the use of restraint at all through a more sophisticated approach to people in inpatient settings."

" Entirely unacceptable "

Viv Cooper, of the Challenging Behaviour Foundation, a charity which supports people with severe learning disabilities, said: "We're putting people in situations that are causing them distress and that are damaging them - and that's entirely unacceptable."

The increases happened over a period when the government said the overall number of people with learning disabilities in inpatient beds was falling.

But the BBC investigation also found the government's pledge to move between 35% and 50% of people with learning disabilities and autism out of hospitals and into the community by March 2019 was unlikely to be met.

Latest figures show the number of adults in inpatient units has reduced from about 2,600 to about 2,400 but the number of children in such units has almost doubled.

Rob Greig, former national director for Learning Disabilities, said of the government's Transforming Care programme: "All that happened was that one person moved out and somebody else was ready to move in, because someone else had been let down by the community services not supporting them properly."

But a Department of Health and Social Care official said since 2015 there had been about 5,500 discharges into the community and more than 410 inpatient beds decommissioned.

The official added: "People with learning disabilities and autism deserve the best support and care.

"We are clear that any kind of restraint should only be used as a last resort and we are working to reduce restrictive interventions and improve patient safety through improved monitoring and training."

The Local Government Association, which represents councils, said it was working towards getting people the services they needed in the community but adult social care services faced a £3.5bn funding gap by 2025.

A representative said: "For people to receive effective and safe support, social care needs to be financially sustainable."

Let the above article speak for itself.
Same story but different language ... today's Guardian : ... sabilities

Physical restraint used on 50% more NHS patients with learning disabilities.

Health charities criticise increase, which comes despite ministers telling mental health units to reduce use.
Growing numbers of patients with learning disabilities are being physically restrained in mental health units, despite ministers telling NHS trusts to use such techniques less often.

Staff in NHS mental health hospitals deployed restraint on such patients 22,000 times last year, almost 50% more than the 15,000 occasions in 2016, BBC research has found.

That included a rise in face-down or “prone” restraint, which is particularly controversial and has been widely criticised as dangerous. Used 2,200 times in 2016, the figure rose to 3,100 in 2017.

The disclosures, made by Radio 4 programme File on 4, prompted criticism from health charities and the minister who, in 2014, ordered trusts to reduce their use of restraint.

“The treatment of people with learning disabilities within these inpatient units is one of the biggest domestic human rights issues of our time,” said Dan Scorer, the head of policy and public affairs at Mencap.

“These horrific revelations reinforce the fact that the government and NHS England must urgently do a detailed analysis about where this is happening, and why the use of restraints has increased so dramatically in recent years.”

Norman Lamb, the Liberal Democrat MP and ex-mental health minister who introduced guidelines to reduce the use of restraint in mental health settings, said the rise in face-down restraint was absolutely shocking. The practice is “extraordinarily demeaning” for patients, he added.

“I had wanted and expected to see a substantial decline in the use of restraint and that hasn’t happened. That’s really shameful when we know it’s possible in very many cases to avoid the use of restraint at all through a more sophisticated approach to people in inpatient settings,” he said.

Viv Cooper, the chief executive of the Challenging Behaviour Foundation, said: “Restrictive interventions, such as physical and chemical restraint, can have a significant and lifelong traumatic impact.”

File on 4 has also found that another key government pledge on mental health is unlikely to be met.

Ministers promised to move 35-50% of people with learning disabilities and autism out of hospitals – where many stay for a long time – into community-based settings, such as supported housing, by March 2019.

But the number of such patients living in inpatient units in England has only fallen from 2,600 to 2,400, while the number of under-18s being care for there has almost doubled.

The Department of Health and Social Care said more than 410 beds have been decommissioned since 2015 and that the process of gradually reducing their numbers would continue beyond next year’s hoped-for deadline.
All vey well ,but perhaps those that throw up their hands in horror should spend a month working with such patients.

How DO you stop someone doing something that is dangerous, antisocial etc etc.

The whole issue extends way beyond this particular remit. How do you get a disruptive child out of a schoolroom who refuses to go?
Trouble is .... many still restrained are neither violent nor dangerous ... some in their 80s / 90s inside care homes ... others through bad judgement made by their " Handlers. "

The line ?

That's where the fun begins.

Our Joe / Jo Public would agree with the police's policy at times ... " Nick 'em , cuff 'em , let the courts sort 'em out ! " but ... with those suffering from mental illnesses , senior citizens in some care homes ?

Restraint ... chemical as well as physical ?

Slightly different in law but ... the end product is the same ... a deprivation of liberty ?

Could be " Very interesting " if ever extended into a bog standard carer / caree relationship ... with the caree totally dependent on the carer.

Throw in paid care workers coming into our caree's home and this thread would take on a different dimension ?
I certainly don't deny it is a huge issue for all 'civilised societies'.

But it's also easy to criticise from the comfort of our armchairs as well! And to focus on the 'few mistakes' and not the 'many successes' so to speak. That said, would I want to be one of the 'mistakes'?????

Big sociological issues here!!!!!
Hospital with 20 staff suspensions used " Shocking " restraint.

Kelly Wilthew says daughter Faith was lifted from Middlesbrough hospital bed by wrists and ankles.

The mother of a teenage girl with mental health needs has complained about the “shocking” use of restraint at a hospital where 20 members of staff were suspended this month.

Kelly Wilthew says her daughter was lifted from her bed by her wrists and ankles and slammed on the floor while at West Lane hospital in Middlesbrough, leaving her in agonising pain.

“She was screaming saying she was hurt and she was bleeding … I knew it was wrong but we were completely helpless,” she said.

Wilthew says her then 17-year-old daughter, Faith, should not have been restrained on her front due to a hole in her stomach caused by a stoma, the result of an operation to deal with a tumour. Restraining individuals with a stoma can lead to significant and even life-threatening complications.

After a review of restraint techniques, staff were given a beanbag to reduce the impact of restraint on Wilthew’s spine and stomach. This advice was only temporarily followed, say Wilthew and her daughter.

Faith Wilthew, now 18, said the experience left her feeling like she was nothing.

“They kind of treated me like an animal. They would just lift and move me whatever way they wanted to. They definitely did not listen to me,” she said.

Her mother claims inexperienced agency staff were brought in to plug gaps at the Middlesbrough hospital, who were ill-equipped to deal with her daughter’s needs.

On one occasion, Wilthew says an agency staff worker ran out screaming when her daughter was found with a ligature around her neck, despite being in a unit for young people with mental health needs.

On another occasion in December 2017, a letter seen by the Guardian shows that Wilthew complained to managers that staff had left her daughter with a broken arm overnight.

She describes the experience as having been a “living nightmare”.

“I won’t sugarcoat it, it was horrendous. It destroyed the whole family and we’re only starting to pick up the pieces now,” said Wilthew.

Responding to the claims, Elizabeth Moody, the director of nursing and governance at Tees, Esk and Wear Valleys NHS foundation trust, said: “We are aware that Faith’s family were unhappy with the care and treatment she received while she was an inpatient at West Lane hospital.

“At the time we worked with them to try and resolve the issues … We are sorry that they still feel unhappy about her experience on the ward.”

The family were unsurprised by reports that 20 staff have been suspended. Concerns date back as far as 2013, when an investigation took place in response to concerns around safety. No significant issues were raised in the report.

A subsequent inspection in June 2018 raised concerns over increasing use of restraint on Newberry ward, where Wilthew was a patient, and on the Westwood ward. The report raised concerns over low staffing levels and inadequate safety at the hospital.

The Tees, Esk and Wear Valleys Trust has published a statement confirming that concerns over non-approved techniques were being used to move patients had led to the suspensions, adding: “Concerns were raised that some procedures and guidelines were not being followed correctly. Our patients are our priority and we responded quickly to these concerns. We are currently carrying out a full and thorough investigation.”

Additional staff have been temporarily assigned to the ward while the investigation takes place, a measure the trust said aimed to “ensure a safe level of staffing across all wards at West Lane hospital”.

Wilthew did not find the statement reassuring: “That’s what they said [when I raised complaints about Faith] two years ago. Clearly nothing has changed.”

The family are hopeful that increased scrutiny will lead to change for other young people in the hospital: “I feel relieved to think that if there’s so much emphasis on the wards and the stories then maybe it will make them clean up their act.”