Behaviour Management

Behaviour Management Guidance in Foster Homes - May 2012 - reviewed August 2014

Scope of this guidance

This Guidance is applicable to the management of foster children in foster homes approved by Brighton and Hove City Council, including connected persons.

  1. Encouraging and rewarding children
  2. Planning for success
  3. Reminders and reprimands
  4. Sanctions
  5. Managing confrontation/challenging behaviour
  6. Physical interventions (including restraint)
  7. Flowchart: Encouraging and rewarding success
  8. Flowchart: Reminders and reprimands

1. Encouraging and rewarding children

Whilst children bring their own values and behaviours to placements, staff and carers play a key role in influencing children.

The culture of the home, generated by the foster family members living or working there, is crucial.

A restrictive, unsupportive, discouraging and punishing culture will result in instability, hostility and possibly severe disruption.

When children live for any length of time in homes which have clear, fair boundaries, where they feel safe, encouraged and appropriately rewarded, they will thrive and do well. Such homes will also experience less instability and disruption.

It is for each home, primarily the people working or living in them, to create their own culture, but the following may be helpful.

  1. Listen to and empathise with children, respect their thoughts and feelings and take their wishes into consideration.
  2. Look for things that are going well, or any step in the right direction, and appropriately reward it.
  3. Rewards should be used in a creative and diverse way, specific to children’s needs, capabilities and interests.
  4. This may mean that children are rewarded with toys, games, activities or monetary rewards.
  5. All ‘tangible’ rewards should be accompanied by the use of ‘non tangible’ encouragement and support – by staff and carers demonstrating to children that they have done well.
  6. Such ‘non tangible’ rewards include praising, smiling, appropriate touching and hugging children.
  7. Children usually benefit, early on, from rewards which may appear to outweigh that which is expected. This is normal; over time rewards can be more relevant as children’s self esteem and skills improve.
    For example: children who have few social or life skills and whose self esteem and confidence are low may require forms of encouragement and reward which are intensive and frequent in order to help remind them that they are doing well and are appreciated. A child who has previously been unable to get up for school may be offered a more expensive present than usual, or an activity for getting up on time for a few days.
  8. Over time, as children achieve what is expected, such rewards should be reduced or children should be expected to achieve more for the same or a similar reward.

2. Planning for success

Where behaviour is the cause for concern it is critical that plans are established to manage and hopefully change the behaviour.

Consistency is the key, as, when staff/carers manage behaviour inconsistently, little if any progress will be made; it may result in more disruption.

Where staff/carers work together, improvements will be made.

The setting of objectives or expectations must not be ad hoc or unplanned. It should be part of a strategy, based on children’s assessed needs, interests and capabilities.

Planning is critical; particularly where children’s behavioural needs are complex or where behaviours give rise to serious concern, such as violence, drug or substance misuse, self harming, or bullying.

Some children’s behaviour can also put staff and carers at risk and consideration needs to be given how both staff and carers can manage children’s behaviour that does not place them or the children at risk of harm.

In such situations a Behaviour Management Plan must be drawn up and incorporated into children’s Placement Plans If the Behaviour Management Plan cannot be incorporated into the Placement Plans, it can be formulated separately and be an addendum of it.

If a child is being referred to a new service e.g. a family centre, and there are concerns about the child’s behaviour then it may be appropriate to draw up a Behaviour Management Plan prior to attendance. A meeting involving key professionals and where possible the child, should be held so that all are clear about the proposed Behaviour Management Plan.

Behaviour Management Plans should summarise how behaviours should be managed, including the strategies that will be adopted in managing the behaviours; they should also state how acceptable behaviours will be encouraged and promoted.

These strategies can include therapeutic interventions, physical interventions, sanctions and other measures; for example the use of incentive or reward programmes, charts etc.

Children should be involved in drawing up Behaviour Management Plans and should understand the relevance of them; though this may not always be possible, for example, where the child has severe learning disabilities.

Children should also be capable of achieving what is expected; maybe with help or support from an adult or mentor, which may include another child.

Expectations placed upon children should never be beyond their capabilities; start small and encourage steps in the right direction.

Over time, children should be encouraged and supported to acquire the skills and level of responsibility and freedom which is within their capabilities and understanding; in turn, this will improve their self image and confidence.

If children are capable of it, they must be involved in monitoring and reviewing their plans – and in agreeing new objectives and strategies, so far as this is compatible with them also living as normalised a family life as possible..

3. Reminders and reprimands

3.1 Reminders

Whilst it is important to reward acceptable behaviour, it is also critical to manage unacceptable or disruptive behaviour in the same, positive and consistent manner.

Matters of concern must be raised at the time the matter is observed,and discussed with the child, with a view to giving the child a fresh start – with support and encouragement.

If misbehaviour is persistent or serious, other strategies may have to be adopted; but minor or non-persistent behaviours should result in staff/carers reminding or cautioning children.

This is a strategy adopted successfully by the criminal justice system, assuming that children respond positively to cautions accompanied by active encouragement and support to put things right.

Reminders and cautions should be clear and to the point, with clarity about:

  • The behaviours which are unacceptable;
  • The impact or influence that the behaviour is having on the child or others;
  • Clarity about what is acceptable;
  • Help, advice and encouragement to put things right;
  • A fresh start with no recriminations or further reminders.

Staff/carers should employ a range of non-verbal and verbal techniques to show their disapproval; but they must avoid moody looks, innuendo and public scoldings. Staff should use the above techniques face to face, and they must not use e-mail, tweets, facebook or any other similar medium to get the message across.

Any step in the right direction must be approved of and rewarded whilst mistakes or problems should be openly discussed and strategies for change identified and encouraged.

The overall strategy should be to help the child do well.

3.2 Reprimands

Where behaviour is persistently or seriously unacceptable, it may be appropriate to reprimand children.

However reprimands may only be used in the following circumstances:

  • If children are capable of behaving acceptably and, preferably, understand what is expected;
  • Where children have persistently or seriously failed to do as required/expected;
  • Where nothing else can be done to change the behaviour, for example, by encouraging and rewarding acceptable behaviour rather than noticing and reprimanding unacceptable behaviour.

If it appears that a reprimand is justified, it should preferably be delivered in private, on the spot or as soon after the misbehaviour as possible.

Reprimands don’t have to be loud but the person delivering them should appear ‘in charge’ or ‘in control’ and it should be said with feeling, with the adult stating clearly what is wrong, how s/he and others are affected by the misbehaviour and – critically – what should be done to put things right.

The person delivering the reprimand should provide the child with an opportunity to explain but should not necessarily expect an apology. However, there should be clarity for the child that improvement is expected – and as necessary the adult should discuss what support and encouragement will be given to put things right.

An effective reprimand is over and done with in a few minutes – and then the child should be given a fresh start.

4. Sanctions

4.1 Approved and Non Approved Sanctions

Certain sanctions may be imposed on Children

The following sanctions may not be imposed upon children (they are Non Approved):

a) Any form of corporal punishment; i.e. any intentional application of force as punishment, including tapping, slapping, pushing, punching, pulling, grabbing or rough handling and throwing missiles.

This does not prevent a person using necessary physical intervention,.

b) Any sanction relating to the consumption or deprivation of food or drink.

It is well established that the enjoyment of eating and drinking is fundamental to a child’s healthy physical and emotional development. Meal times should be well-managed, orderly, social occasions in the life of a child and it would be quite inappropriate for a child to be refused meals or food, or routinely be excluded from communal meals.

Deprivation of food and drink should be taken to include the denial of access to the amounts and range of foods and drink normally available to children in the home to maintain their health and happiness, but would not include instances where specific food or drinks have to be withheld from a child on medical advice. Equally, it would be inappropriate to force a child to eat foods, which he disliked. It would be right, however, to encourage a child to try a wide range of foods. Medical advice must be sought if children consistently refuse to eat, over eat or appear to have eating disorders such as bulimia or anorexia nervosa. Meals are provided at reasonable set mealtimes and food is available to children when they miss a set meal

c) Any restriction on a child's contact with his or her parents, relatives or friends; visits to the child by his or her parents, relatives or friends; a child's communications with any of the persons listed in Section 4.2 ‘persons with whom the child can have contact’, below; or his or her access to any telephone helpline providing counselling or advice for children;

This does not prevent contact or communication being restricted in exceptional circumstances, where it is necessary to do so to protect the child or others.

The value for most children of maintaining contact with their families and friends cannot be overstated. The restriction or refusal of contact as a punishment is not permitted but it is recognised that in some circumstances as part of the management and planning of his/her care, some restrictions may have to be placed on contact with certain individuals or on the facility to receive, or – especially – make visits. Children sometimes need to be protected from visits. The foster home must be guided in its approach to contact by the planning decisions of the local authority and those with parental responsibility. Where contact is restricted in accordance with these plans it should be recorded on each occasion in the child’s personal records”.

In general, arrangements for making and receiving visits and for other contacts will have to be compatible with the reasonable requirements of the efficient management of the foster home. It will continue to be legitimate to control unplanned visits. Where parents insist on visiting a child, despite this being contrary to the care pan which has been drawn up, it will be necessary for carers to find tactful ways of dealing with this and to counsel the child.

d) Any requirement that a child wear distinctive or inappropriate clothes.

Some children in foster homes will already have a very negative perception of themselves. Requiring them to wear distinctive or inappropriate clothing would serve only to further undermine their self-esteem and to damage their self-confidence. Distinctive or inappropriate clothes should be taken to include clothes which are inappropriate to the time of day and/or the activity being undertaken. This applies also to footwear and hairstyles. The wearing of distinctive clothing for purposes connected with education or any uniformed organisation, i.e. Scouts and Girl Guides, is of course, not excluded.

Children are able to exercise choice in clothes they buy. Younger children are accompanied by carers, and older children are given the choice of shopping alone or with the guidance of their foster carer, subject to a risk assessment where shopping alone involves significant risks.

Choice of clothes are supported and positively promoted with regard for cultural, racial, ethnic and religious expectations.

e) The misuse or withholding of medication or medical, dental or optical treatment.

This would be a dangerous and utterly unacceptable practice and is accordingly totally forbidden in all circumstances, whether as a disciplinary measure or other wise, to control the child. The use of medicines that have been prescribed for another person is prohibited.

f) The intentional deprivation of sleep.

g) The modification of a child’s behaviour through bribery or the use of threats;

h) Any sanction used intentionally or unintentionally which may humiliate a child or could cause them to be ridiculed;

i) The imposition of any fine or financial penalty, other than a requirement for the payment of a reasonable sum by way of reparation.

Fines imposed by courts must, of course, be paid but it is not considered appropriate for foster carers to impose such sanctions. In cases of wilful damage or of misappropriation of monies or goods belonging to others, however, it would be perfectly proper for the perpetrator to be required to pay for or at least to make a contribution towards the costs of repairs or replacement of misappropriated monies or goods.

j) The Court may impose fines upon children which staff should encourage and support them to repay.

k) Any intimate physical examination of a child. In some circumstances it may be appropriate to search a child’s clothing and/or his/her belongingsif it is felt by the carer that not to do so could result in harm to the child or the carer’s family.

l) The withholding of aids/equipment needed by a disabled child;

m) Any measure which involves a child in the imposition of any measure against any other child; or the sanction of a group of children for the behaviour of an individual child;

n) Swearing at or the use of foul, demeaning or humiliating language or measures.

4.2 persons with whom the child may have contact (in relation to Section 4.1 c) above)

a) Any solicitor or other adviser or Advocate acting for the child;

b) Any officer of the Children and Family Court Advisory and Support Service appointed for the child;

c) Any social worker for the time being assigned to the child by his placing authority;

d) Any person appointed as an Independent Person in respect of the Complaints Procedure;

e) Any person appointed as an Independent Visitor;

f) Any person representing the Regulatory Authority

g) Any representative from the local authority in whose area the foster home is situated;

h) Any person with delegated authority from the Secretary of State to conduct an inspection of the foster home and the children there.

i) Any friend or family member whose contact is agreed as desirable in the care plan

4.3 Guidance on use of Sanctions

Sanctions can be very effective but, before imposing them, think about it.

Most looked after children have come to view themselves, and may be viewed, as failures.

They have had their fill of neglect and abuse, and of sanctions, usually imposed inconsistently, unfairly or as acts of revenge.

Before imposing sanctions, adults should do all they can to support and encourage children to do well.

If children do not behave acceptably, strategies should be adopted that are encouraging and rewarding.

Rather than noticing and sanctioning misbehaviour it is always better to notice and reward good behaviour – or any step in the right direction.

For example, it may be more effective to allow a child to have use of a video or TV at bedtime for getting up on time, rather than taking the TV away for getting up late. Same deal, different meaning!

The former is discouraging and causes resentment; the latter is encouraging, can improve self-esteem and relationships between children and staff/carers.

If children continue to behave in unacceptable ways, they should be reminded about what is expected and given further encouragement to get it right.

If misbehaviour persists or is serious, effective use of reprimands can act as a disincentive or firm reminder. If this does not work, or may not, sanctions may be effective.

Where sanctions are used they must be reasonable and the minimum necessary to achieve the objective. Also, there should be a belief that the sanction will have the desired outcome – increasing the possibility that acceptable behaviour will follow.

If sanctions are imposed, adults should apply the following principles:

a) Sanctions must be the exception, not the rule. A last resort.

b) Sanctions must not be imposed as acts of revenge or retaliation.

c) Think before imposing the sanctions; don't apply it in the heat of the moment, and think carefully about the potential impact on the child and the meaning for them of being sanctioned..

d) Sanctions may only be imposed upon children for persistent or serious misbehaviour; where reminders and reprimands have already failed or are likely to fail.

e) Sanctions should only be used if there is a reasonable chance they will have the desired effect of making the point and in reducing or preventing further unacceptable behaviour.

f) Before applying any sanction, make sure the child is aware that his/her behaviour is unacceptable and, if possible, warn him/her that sanctions will be applied if the unacceptable behaviour continues.

g) It is the certainty not the severity of sanctions that is important.

h) Sanctions should only last as long as they need to, allowing the child the opportunity to make a fresh start as quickly as possible. Sanctions should be applied as part of a behaviour management plan.

5. Managing confrontation/challenging behaviour

Children have a right to expect that they will receive the care, encouragement, safety and security that good, reasonable parents provide. They should also expect their carers to respect them as individuals, listen to their views and help build their self esteem and identity.

The principles that should be followed are as follows:

  • Carers should seek to achieve a balance between care and control. The child should be offered a nurturing environment with firm boundaries. This should enable the child to develop a sense of care, security and personal responsibility that will allow them to become mature, sensible adults.
  • Through the use of effective care and control policies children are able to make choices about and take responsibility for their behaviour in the context of a caring and trusting relationship. Methods of care and control are applicable at all times when children are being looked after but there are certain methods that are particularly useful in dealing with challenging behaviour.
  • As every child is unique and has different life experiences, there is a need for foster carers to have maximum flexibility in the care they provide. Many children who are fostered have been victims of various forms of abuse and carers must have regard for these experiences at all times when they are caring for the child or young person and managing their behaviour.
  • Every child who is looked after has a right to have their needs respected in terms of gender, religion, ethnic origin, language, culture, disability and sexuality. This must be taken into account when exercising care and control.
  • For carers looking after disabled children, there are specific issues regarding care and control. Children’s impairments affect behaviour in different ways, for example, the difficulty adults may have in communicating non-verbally can cause frustration – which may lead to conflict and challenging behaviour.
  • All children have rights under the UN Convention on the Rights of the Child, some of which are specific to looked after children, for example Article 20 states:

    (1) A child temporarily or permanently deprived of his or her family environment, or in whose own best interests cannot be allowed to remain in that environment, shall be entitled to special protection and assistance provided by the state.

    (2) When considering solutions, due regard shall be paid to the desirability of continuity in a child’s upbringing and to the child’s ethnic, religious, cultural and linguistic background.

Our policy aims to assist carers to manage difficult and challenging behaviour. An understanding of the term is gained from the following definition:

Challenging behaviour jeopardises the physical, emotional and psychological safety of the young person exhibiting the behaviour, of those who care for or are responsible for her or him, and of others who may be in the vicinity; it is behaviour of such intensity, frequency or duration, that its containment is especially difficult to manage. (Barnardo’s)

The care and control policy

Foster care is a difficult and demanding task and it is also a very isolated one in comparison with other types of placement. This policy aims to ensure that carers are equipped with the skills and techniques they need to manage difficult situations safely in relative isolation and are compatible with good behaviour management as well as with safe caring principles. As a result, carers should adopt a proposed method of care and control that endeavours to avoid the use of physical interventions whenever possible. There maybe some very rare circumstances where physical intervention including restraint could be considered. However they should only do this if they have received specific training.

The proposed model of care and control for foster carers is:

  • The Positive Interventions Model for Family Care Providers.
  • Techniques for the release from grabs, bites, hair pulls etc without harming the child.
  • Exemptions: for some disabled children they may be in a setting where a particular method is already being used, for example, in school. It is not expected that in these instances carers should adopt a different method to the one already in use. In these circumstances exemptions can be sought in consultation with the Head of Service and in the best interests of the child, with details documented in the care plan.
  • Training: all Brighton and Hove City Council carers must be trained in the proposed method of care and control.

Wherever possible, carers should try and manage behaviour by non-physical means before children become violent. For every child or young person whose behaviour is known to present a challenge, there should be an individual strategy (Behaviour Management Plan) for responding to violent behaviour, which will form part of the child’s care plan. Where appropriate, this will include specific directions for using physical interventions. In these circumstances it should be agreed by carers, parents, professionals and the young person (where possible) what the appropriate strategies will be. This will be discussed at the introductory stage of the placement and will be included as a written part of the placement plan. If it is known that the child presents challenging behaviours at the outset of the placement a Behaviour Management Plan can be drawn up and incorporated into the Placement Plan. If the child develops challenging behaviour it may be necessary to draw up a Behaviour Management Plan at a later date in the placement.

In certain circumstances, (where the child’s safety or the safety of another child or person may be in question if the child leaves the room or premises), good practice involves communication to try and persuade the child on a different course of action. However where this is ineffective, the carer should reinforce dialogue with such actions as standing in the way of a child wishing to leave, or may place a hand on the child’s arm, or hold the child if they are highly distressed or in danger, for example if a child is trying to run out of the house onto the road in a distressed state. These methods should only be used for the minimum time needed and with the minimum force necessary to ensure the child’s safety The child should always be told that the Police will be involved if they run away. Any sanctions or interventions used must be recorded straight away in the child’s daily diary.

These approaches are used in the context of engaging the child/young person in discussion about their behaviour, listening to them and showing empathy to their distress.

Holding discourages the child from harming themselves or others, whereas physical restraint uses an element of force which is not appropriate for foster carers working in isolation with the child.

Positive Interventions for foster carers – an outline of training provided to support care and control policy

Brighton & Hove City Council foster carers who are caring for children or young people who display challenging behaviour should receive training in Positive Interventions to support the implementation of the care and control policy. Preferably this training should be provided before carers have to handle challenging behaviour. This training provides a range of non-contact techniques for managing difficult behaviour and to help carers to respond positively to difficult and challenging behaviour.

Positive Interventions emphasises a therapeutic response to challenging behaviour including a range of practical skills such as de-escalation and counselling techniques but does not teach a method of restraint.

However there will be instances, particularly for carers looking after children with specially challenging behaviour, when they need to release themselves from grabs, bites, hair pulls and chokes.

Training for residential staff includes methods of escaping these holds, which do not cause harm to the young person, and these should be included in training for foster carers.

The focus of Positive Interventions for foster carers is on conflict resolution and communication with the child and does not advocate the use of restraint techniques because of the family orientated nature of foster care. These methods should be used in conjunction with general guidance on setting appropriate boundaries and positive control. The ethos behind this method is summed up in the following statement:

Our ability to relate to children and their families in an open, sensitive, consistent and caring way is the single most important contribution. It is our action – and reactions – that so strongly shape and influence the subsequent behaviour and growth of the young people we care for.

The thinking behind the model is to encourage the carer to approach a crisis situation, when challenging behaviour is being demonstrated, as a learning opportunity from which the young person can grow through an understanding of their behaviour and experience, therefore:

Carers’ skills, knowledge and professional judgement are critical in helping children learn constructive and adaptive ways to deal with frustration, failure, anger, rejection, hurt and depression.

6. Physical Interventions

Physical Interventions are interventions that employ a level of physical force to protect a child or others from injury or to protect property from being severely damaged.

6.1 Definition of Physical Intervention

There are four broad categories of Physical Intervention.

  1. Restraint: Defined as the positive application of force with the intention of overpowering a child. Practically, this means any measure or technique designed to completely restrict a child’s mobility or prevent a child from leaving, for example:
    • Any technique involving the child being held by two or more people;
    • Any technique involving a child being held by one person if the balance of power is so great that the child is effectively overpowered; e.g. where a child under the age of ten is held firmly by an adult
    • The locking or bolting a door in order to contain or prevent a child from leaving.

    The significant distinction between the first category, Restraint, and the others (Holding, Touch and Presence), is that Restraint is defined as the positive application of force with the intention of overpowering a child. The intention is to overpower the child, completely restricting the child’s mobility. The other categories of Physical Intervention provide the child with varying degrees of freedom and mobility.

  2. Holding: This includes any measure or technique involving the child being held firmly by one person, so long as the child retains a degree of mobility and can leave if determined enough.
  3. Touching: This includes minimum contact in order to lead, guide, usher or block a child; applied in a manner which permits the child quite a lot of freedom and mobility.
  4. Presence: A form of control using no contact, such as standing in front of a child or obstructing a doorway to negotiate with a child; but allowing the child the freedom to leave if they wish.

6.2 Who may use Physical Intervention

Under normal circumstances, only carers who have been trained to an appropriate level may use physical intervention In these circumstances, the interventions used must be consistent with the procedures outlined in this manual – and the guidance set out in this chapter.

It is worth noting that the use of physical intervention could place children and young people at risk of harm and carers/staff at risk of allegations if not managed correctly. Hence training in the use of physical interventions is essential.

Whenever possible, the techniques used should reflect the person’s previous training in the appropriate use of physical interventions.

In any case, the techniques used must:

a) Not impede the process of breathing

b) Not be used in a way which may be interpreted as sexual

c) Not intentionally inflict pain or injury

d) Avoid vulnerable parts of the body, e.g. the neck, chest and sexual areas

e) Avoid hyperextension, hyper flexion and pressure on or across the joints

f) Not employ potentially dangerous positions

*Restraint should only be practised if the likely injury is significant or the likely damage to property is serious and could result in significant physical injury. Restraint should only be practised by carers who have been specifically trained. Restraint should only ever be practised as a last resort. Some foster carers may legitimately refuse to practise restraint even if trained. Those who do practise it, do so in the knowledge that they may place themselves at risk of personal harm or allegation.

6.3 Planning Ahead – Care and Placement Planning

It is accepted that physical intervention will often be used reactively, by adults faced with situation posing potential risks of injury or damage to property.

However, research evidence shows that injuries to adults and service users are more likely to occur when physical intervention is used to manage events which have not been foreseen, and for this reason great care should be taken to avoid situations where unplanned physical interventions might be needed.

PLAN AHEAD!

As a matter of routine, preferably at the point of referral or placement or as soon as possible thereafter, managers must conduct Risk Assessments to tease out whether the child’s placement poses any risk of injury or damage to property – to the subject child or others living in the home. This must include the risks of physical and sexual assault and arson.

Alternatively, such risk assessment and planning should occur after incidents where physical intervention may have been applied.

If continuing risks exist, managers and supervising social workers must establish a plan outlining the strategies to be adopted to reduce or prevent the behaviour occurring.

As far as possible, as described elsewhere in this guidance, those strategies must avoid the use of physical interventions.

For example, the best way of helping a child to tolerate other children without being violent may be for an adult or mentor (another child, for example) to ‘shadow’ the child to help him/her.

However, such plans should include contingencies outlining whether physical intervention should be used; and advising the adults which techniques may be beneficial.

These plans and strategies, if possible, should be shared with the child concerned and should be reviewed – either routinely or after serious incidents have occurred. (when required, plans also need to be shared and agreed with social worker, family. The plan should be written in the young persons file)

6.4 Justification for using Physical Intervention

There are different justifications for restraint, intended to overpower a child, and other, less intrusive forms of physical intervention.

Restraint is the intentional use of force with a view to overpowering a child, and therefore may only be justified where the likely injury is Significant or the likely damage to property is Serious..

Other forms of physical intervention, which are less intrusive by degrees, such as holding, touching and presence, may be justified to prevent injury or damage to property which is less than significant or serious; which is also defined below.

However, for any form of physical intervention to be justified, the person applying it must be satisfied of the following (more detailed guidance is contained below):

1 That injury or damage to property is likely to happen in the predictable future

2 And that immediate necessary action to reduce or prevent the likelihood of the injury or damage,

3 And that the use of physical intervention is a last resort,

4 And that the amount of force used is the minimum necessary to achieve the objective,

6.5 The meaning of (Significant) Injury and (Serious) Damage to Property

There are differing justifications for the use of restraint and other physical interventions.

Restraint is a form of physical intervention used to overpower a child, and should therefore only be used where the likely injury is SIGNIFICANT or the likely damage to property is SERIOUS.

Other forms of physical intervention, which are less intrusive by degrees, such as presence, touching and holding, may be justified where the likely injury or damage to property is less significant or serious.

It is not possible to provide an exhaustive definition given the variety of situations that adults may face or how they should act. It is for the adult(s) on the spot to decide themselves and act accordingly – in keeping with procedures and guidance set out in this guidance and the training they may have received.

However, injury and damage (which is not significant or serious) may justify less intrusive physical interventions such as presence, touching or holding include the following:

a) Minor injuries caused to the child or others;

b) Wilful or reckless behaviour which may result in the child/others being at risk of harm;

c) The likelihood of criminal offences not involving violence or potential risk of injury;

d) Minor drug or alcohol misuse

e) Minor damage to property belonging to the child, the authority or others

For restraint to be justified (the use of physical intervention with the intention of overpowering the child) the likely injury must be significant and the likely damage must be serious.

Significant injury is broadly defined as actual or grievous bodily harm, physical or sexual abuse, risking lives of or injury to, the self or others by wilful or reckless behaviour and self-poisoning. This may include the following:

a) Abduction

b) Actual and grievous bodily harm or more serious violent offences

c) Attempted suicide or death

d) Contact with known or suspected person who is or may be a ‘risk to children’

e) Poisoning

f) Injury requires medical attention

g) Serious drug or alcohol misuse

h) Sexual exploitation, including sexual abuse, child pornography or prostitution

i) Theft/being carried in a stolen vehicle, or other criminal offences of a serious nature

j) Serious damage to property

For any form of physical intervention to be justified those using it must firstly believe that injury or damage is likely in the predictable future.

6.6 The meaning of ‘Predictable Future’

For any form of physical intervention to be justified, there must be a risk the injury or damage is likely in the predictable future.

The fact that injury or damage has already occurred would not be a justification for physical intervention UNLESS there is a risk that further injury or damage would follow if adults did not act. For example, a child may break a small window, which may be interpreted as a minor misdemeanour and unlikely to be repeated; therefore physical intervention may not be justified.

However, if the child is likely to use fragments of the glass as a weapon to cause significant injury to him/herself or another person, the use of physical intervention, even restraint, may be justified in order to protect the person(s) and confiscate the glass.

Adults must not only believe that the injury or damage is likely in the predictable future but also that action is immediately necessary.

6.7 The meaning of ‘Immediately Necessary’

Immediately necessary means that staff/carers believe it is necessary to act, at the time, to prevent a child or others from being injured or to prevent property from being damaged at some time in the predictable future.

If at all possible, all the adults caring or the child should consult each other before acting; even if there is an agreed plan or strategy in place to manage the behaviour.

However, if this is not possible, the adults must act as they see fit on the spot – as far as possible within the parameters of the child’s Care Plan, Placement Plan or other plan in place.

If no plan/strategy is in place, the adults must act as they see fit within the procedures and guidance in this manual and the training they have received.

Before acting, the adults must satisfy themselves that their actions are necessary as a Last Resort.

6.8 The meaning of ‘last resort’

Last resort means:

  • That all other non-physical methods of persuasion or control failed;

Or

  • That all available non-physical methods would not work in the circumstances.

The other methods, which may work in the circumstances, can include less intrusive physical interventions. However, adults may not use any physical interventions unless they are satisfied that non-physical interventions have failed or would not work in the circumstances.

If possible, adults must adopt verbal and non-verbal skills, engaging children, calming, reaching; using humour, the intervention of colleagues; negotiating, listening, ignoring or leaving the situation if it works.

If these actions are not working (or adults believe they would not work if tried) they may use physical interventions.

However, adults who use physical intervention before trying or considering non physical methods leave themselves open to criticism and could be subject to complaint, disciplinary action, involvement of the Police or Child Protection agencies.

Also, if physical intervention is required, adults may only use the minimum force necessary to achieve the objective

6.9 The meaning of Minimum Force

If physical intervention is immediately necessary, as a last resort, the force used must be the minimum necessary to achieve the objective.

The minimum necessary means exactly that:

The amount of force used must be commensurate with the desired outcome and the specific circumstances in terms of intensity and duration.

For example, it may be necessary to hold or restrain a child for a short period whilst s/he calms down sufficiently to re-join an activity; or to temporarily block or prevent a child from leaving the foster home to give carers time to divert the child’s attention from absconding.

It may also be appropriate for a person to block or prevent a child’s mobility or movement using restraint whilst help is summoned, then giving the opportunity for the intervention to be reduced when they arrive.

In all cases, the measures must be used for the minimum or shortest time necessary; and the amount of force used must be the minimum that is necessary. The possible adverse affects associated with the measures used must be less severe that the adverse consequences which may have occurred without it.

The minimum necessary may mean that proximity or use of physical presence will work in the circumstances; and that it will not be necessary to use more intrusive forms of physical intervention.

However, where the risks are greater, and other less intrusive interventions have failed or would not work, holding or restraint may be the minimum that is necessary to achieve the objective.

In any case, caution should be exercised in releasing or reducing interventions too early; to do so may escalate rather than calm the situation. Disengagement should normally be undertaken in a planned and controlled manner.

If it is not possible to consult others before acting, the onus is on adults, on the spot, to decide what level of intervention is

appropriate in the circumstances; considering, for example:

a) Any agreed strategy or plan that may exist for managing a given situation;

b) The age, size and ability of the child and person managing the behaviour;

c) The understanding of the child and ability to make informed decisions;

d) Any disabilities or medical conditions that the child may have.

e) The abilities, skills of the person(s) managing the incident, and the training they have undertaken;

f) The emotional and mental state of the child; and whether the child is under the influence of alcohol, drugs or other substances;

g) The child’s background, history of using violence etc

Whatever interventions or measures are taken, the adults must not place themselves in a position where anyone’s safety is seriously compromised. In such circumstances they should call for help, maybe from the Police, or retreat if that is the only safe option open to them.

6.10 Use of physical intervention as a sanction

Physical intervention may not be used as a sanction.

6.11 Using physical interventions to prevent children being absent

Using restraint to prevent a child from leaving

Restraint may be used to prevent a child from absenting him/herself in the following circumstances:

  • To prevent any child from leaving where there is a likelihood of significant injury or serious damage to property at some time in the predictable future.
  • To prevent a child who is remanded or otherwise lawfully detained in local authority accommodation from leaving, if the offences for the remand/detention are serious, for example, of a violent nature.

Restraint may include the locking of a door, but only very temporarily to prevent a child from leaving.

Using other, less restrictive forms of physical intervention to prevent a child from leaving

Physical interventions which fall short of restraint, such as holding, touch or presence, may be used to prevent a child from leaving where the risk of injury is not significant or the risk of damage is not serious.

These measures can include the bolting of a door temporarily to restrict a child’s mobility or win time to call for help from others.

Such measures may be appropriate in the following circumstances:

  • Where a child or young person persistently attempts to leave the home in the evening against the instructions of the adults, where these instructions are based on a considered and reasoned view that the child’s welfare is likely to be prejudiced or s/he is likely to come to harm.
  • Where a teenager is known to be engaged in vice or criminal activity or otherwise known to be under negative influence or be at risk of harming him/herself or others.

In these and other similar circumstances which do not necessarily constitute significant injury or serious damage to property, adults must first try persuasion and patient engagement in trying to prevent children from leaving; but if these actions fail or it is believed they would fail adults can use their presence, touch or holding to prevent children in these circumstances from leaving.

It may also be reasonable for adults to bolt a door temporarily to restrict a child’s mobility, or in order to win time, slow a child’s progress or call for help from others.

However, the physical intervention used must be used as a last resort, and must be proportional to the risks.

If the child persisted in the circumstances and there was no risk of significant injury or serious damage to property the adult may have to allow the child to leave.

6.12 Forcing compliance

Physical intervention may not be used simply to enforce compliance or in response to challenging behaviour unless the behaviour gives rise to the expectation of injury or damage to property.

For example, if a child was arguing or being offensive toward another child or others including the adults looking after them, it may be appropriate to remonstrate, caution or reprimand the child; it may be appropriate to impose a sanction.

It may also be appropriate to use such measures if a child was refusing to comply with a reasonable instruction, such as a request to leave the room, get up in the morning or retire at night.

Such measures as reprimands and sanctions may be appropriate if other, more encouraging measures are unlikely to work in the circumstances.

However, it would not be appropriate to use physical intervention unless injury or damage was also likely.

Therefore, if a child was refusing to leave a room, and the adults suspected that if the child did not leave, injury or damage to property would follow in the predictable future, they may be justified in using their presence or other less intrusive forms of physical intervention to guide the child into doing as required.

An alternative would be to ask colleagues to remove or withdraw the other children present.

The same principles may apply in getting a child up in the morning. Physical intervention would not be justified simply to get a child out of bed if there were no likelihood of injury or damage to property in the predictable future. However, it may be reasonable to take such action if doing so prevented disruption leading to injury or damage to property within a predictable timescale.

In all these and other similar circumstances adults should discuss such issue and plan ahead; preferably setting out the strategies to be used in the child’s Placement Plan.

It must be remembered that if there is a persistent need for control measures, the placement may not be the right one and the supervising social worker will need to discuss with the carer, the children’s social worker and the Practice Managers the possible need for a change of placement.

Flowchart: Encouraging and Rewarding Success

FLOWCHART-Encouraging-and-Rewarding-Success

 

Flowchart: Reminders and Reprimands

FLOWCHART-Reminders-and-Reprimands