Physical or Restrictive Intervention Policy

Branksome Heath Middle School

PHYSICAL OR RESTRICTIVE INTERVENTION
POLICY

Revised October 2009

Aims

Branksome Heath Middle School aims to promote the use of effective non-aversive intervention strategies. However, it is recognised that there are a very small number of children and young people for whom physical and restrictive intervention is likely to form part of the range of strategies necessary to meet their needs and to ensure the safety of others.

It is important to ensure that all adults working with children in the school are clear about their role, in order that their own rights, and those of the children in their care, are protected. Those staff who are likely to face situations in which physical or restrictive intervention may be necessary must understand the procedures to be followed in planning, applying and reviewing the use of physical or restrictive intervention.

Objectives

To provide guidance to staff on the circumstances in which physical and restrictive intervention may be used.

To clarify the procedures that are in place to ensure that where physical or restrictive intervention is used, the techniques used are safe and appropriate to the situation.

The use of force will always act as a last resort and will only be seen as appropriate when a raft of alternative strategies have been explored.

This Policy is designed to maintain the safety of the staff and pupils in the school.

The Policy will allow staff to use force that is "reasonable and proportionate" in situations where there has been a serious breach of school discipline and will include serious damage to property.

This Policy will follow Government guidance and support and encourage best practice.

Staff Authorised To Use Force

All teachers and staff who have been authorised by the headteacher (or head of setting) to have control or charge of pupils automatically have the statutory power to use force. Staff whose jobs do not normally involve supervising pupils will have temporary authorisation if they are called upon to do so. (The Use Of Force To Control Or Restrain Pupils DCFS 2007).

The school will follow the Borough of Poole recommendation that before any level of physical intervention can be considered; those staff who will be involved in interventions will need training on safe methods of positive handling. This training will normally be delivered by Team Teach and for key members of staff will be regularly updated.
Any physical intervention recommended needs to be justified through evidence of:

A. An evaluation of previous approaches and the success of those approaches
B. Consideration of whether to implement strategies already used in other settings
C. An evaluation of the potential risks involved
D. Consideration of the least invasive interventions necessary to address any particular behaviour
E. Reference to established good practice and guidance in the field of physical intervention
F. Full consultation with those who have parental responsibility

Responses to challenging behaviour should take into account the individuality of the child or young person. In identifying appropriate physical interventions for an individual pupil, a comprehensive assessment of that individual's needs should be carried out, using a multi-agency approach. When planning the use of physical intervention, it is important to ensure that the particular intervention is not contraindicated because of personal characteristics or health/medical factors.

All decisions regarding the use of specific physical and restrictive interventions should be made on the premise of minimum reasonable force. In each case the safety of the individual and others should be paramount.

For each individual, physical interventions should be sanctioned for the shortest period of time consistent with his or her best interests. At all times the aim should be to seek to reduce the necessity for physical intervention, and to seek on an ongoing basis to reduce the frequency of use, or intensity of that intervention.

As soon as it becomes clear that some form of intervention is necessary, a judgement should be made on the least restrictive intervention necessary to bring about a prompt resolution. Staff are not expected to work their way through a hierarchy of increasingly restrictive interventions.

Where physical intervention is used, it should be applied for the minimum duration of time necessary to reduce any immediate risk and bring the situation under control. The length of time that any intervention is used must be recorded.

No physical interventions should be intended to cause pain or harm and the risk of causing inadvertent harm should always be minimised.

As soon as a situation is brought under control, steps should be taken to decrease the intensity of any restrictive intervention as the individual calms and is able to take more control of their own behaviour.

Staff should not intervene in situations of risk without the presence of another adult, except in exceptional circumstances.

Any individual member of staff using a specified physical intervention must have been trained in the use of that intervention. The only exception will be where the actions of staff can be justified because of the level of risk posed to themselves or others.

There may be occasions where the situation presents such a high level of risk that no direct intervention is considered safe or appropriate. In such circumstances it will be necessary to call in outside agencies such as the Police. This is particularly important in situations where an individual has some form of weapon that increases the risk of harm being inflicted.

Deciding Whether To Use Force

The Local Authority (LA) and the school are committed to promoting a framework of managing challenging behaviour through a variety of approaches. This framework emphasises the importance of adults having the skills and confidence to maintain control of any situation through calm, positive actions, maintaining communication at all times and offering clear options.

The LA Behaviour and Attendance Plan provides detailed advice on the support that schools and other services should provide for pupils with behavioural difficulties. The pyramid below represents the staged process of intervention for behavioural difficulties. The majority of pupils in our school will have their needs catered for at the lower end of the pyramid.

POSITIVE HANDLING PLANS

INDIVIDUAL BEHAVIOUR PLANS AND RISK ASSESSMENT PASTORAL SUPPORT PLANS

SCHOOL BEHAVIOUR POLICY CLASS RULES, BOUNDARIES AND EXPECTATIONS REWARD SYSTEMS MODELLIN, DEFLECTION, DIVERSION

SCHOOL ETHOS, LANGUAGE, GENERAL EXPECTATIONS, ADULT BEHAVIOUR

The Team Teach approach adopted by the borough and the school focuses on de-escalation and prevention. All teachers need to be able to develop basic skills in dealing with difficult pupils and situations, and to have an understanding of which actions are likely to defuse a situation rather than exacerbate any difficulties.

The school's behaviour policy sets out the agreed responses to specific behaviours. All staff and adults need to be aware of and understand their role in applying the behaviour policy for that setting. Pupils also need to be familiar with the rules and expectations, and should be confident that the responses of staff to difficult behaviour will be consistent and fair.

Where a pupil's behaviour does not respond to the normal range of strategies used to manage problem behaviour, a more in depth assessment of their behaviour will be undertaken. This will include gathering information on how individual needs (linked, for example to learning difficulties, ability to communicate, physical and perceptual impairments, medical factors, emotional needs, skill levels, emotional maturity) affect behaviour.

It is important to recognise that challenging behaviour serves a function for the individual engaged in that behaviour. The behaviour may signify that they do not know how to get their needs met in a more appropriate way. Inappropriate or challenging behaviour can often signal that the environment and/or provision are not meeting a key need for the individual concerned.

WHEN TO INTERVENE - TYPES OF INCIDENTS

The following categories would be considered legitimate situations in which to consider physical intervention as a response:

 committing a criminal offence (or would be an offence if pupil not under age of criminal responsibility - 10 years).
 where there is risk of injury to self and/or others.
 where there is risk of significant damage to property.
 Where a pupil is behaving in a way that is compromising good order and discipline.

However, physical intervention should only be chosen as an option
when the following judgements have been made:

 Alternative calming and defusing strategies have failed to de-escalate this situation.

 This response is in the paramount interest of the pupil.

 Not intervening is likely to result in more dangerous consequences than intervening.

HEALTH AND SAFETY

When using physical intervention, the pupil's health and safety must always be considered and monitored. The following physical functions should be monitored:

 respiration
 circulation
 state of consciousness

The hold should be stopped immediately if significant signs of physical distress are seen ie:

 sudden change in colour
 difficulties in breathing
 vomiting

Some pupils may have medical conditions which make them vulnerable to injury, eg where they have a specific medical condition or a history of aggressive or self-harming behaviour. Some known conditions which may give rise to particular difficulties are:

 Down's syndrome - respiratory difficulties
- increased potential for cervical vertebrae dislocation
 Brittle bone syndrome
 Asthma
 Epilepsy
 Congenital Heart Disease

This should not be considered as a definitive list and advice from the medical profession should be sought if there are ANY concerns eg the designated medical officer for special educational needs. The pupil's behaviour management plan should reflect the advice given.

Parents/Carers should be involved in the process and be advised to alert the school of any new developments which might make it necessary to seek updated medical advice.

All holds should be devised to minimise the risk of injury. Physical holds should not cause pain. The following guidelines should be followed:

 Airway - ensure a free passage of air through airways
 Breathing - avoid pressure on the chest area
 Circulation - avoid pressure on arterial pressure points (inside of upper arm)
 Avoid pressure on joints
 Keep the body in good alignment
 No face down holds are permitted

Physical interventions should use the minimum amount of force necessary to resolve the problem and calm the pupil.

Risk Assessment

In the context of managing challenging behaviour, a risk assessment can be used to identify what level and type of intervention (including physical or restrictive intervention) or support will be needed in different situations in order to ensure that an individual's behaviour will not threaten safety.

Risk assessment can also be used as a process to identify what actions will need to be taken to allow an individual access to activities. In some circumstances it may be necessary to avoid a particular activity because of the level of risk posed to the pupil or others. However, staff will need to be mindful of the potential for discrimination against an individual if their access to an activity is being restricted unnecessarily.

The LA has a duty to inform schools when a pupil who has been identified as being at risk of displaying extreme behaviour is due or is likely to be placed there. It is anticipated that risk assessments will be incorporated into a general system for identifying and clarifying very individual complex needs at the point when placement decisions are made for specialist provision. The aim is to allow any necessary planning and training to take place before the child starts at a new school.

In circumstances where a pupil whose behaviour is identified as challenging is joining a mainstream school or specialist provision, it is important to recognise that behaviour is context dependent. The impact of the particular environment will have an effect on the level of risk. It will therefore not be possible to cover every eventuality until the pupil is at school, and so an additional risk assessment will need to be carried out after placement and when the child has had a chance to settle in.

Positive Handling Plans

It is crucial that any potential need to employ physical or restrictive intervention is acknowledged, so that an appropriate intervention can be properly planned. If a pupil's behaviour indicates that there is a strong likelihood that it will become necessary to use some form of physical or restrictive intervention, a Positive Handling Plan will be drawn up. This will be preceded by an in depth risk assessment.

In drawing up plans for the use of physical or restrictive intervention, close liaison will be maintained between the school and other services involved with the pupil.

Those with parental responsibility, and as far as possible, the child or young person themselves, will be involved in the planning, monitoring and review of the strategies identified to address challenging behaviour, including the use of physical intervention.

Physical interventions should only be used in conjunction with other strategies designed to help the individual learn alternative non-challenging behaviours. As well as identifying responses to challenging behaviour, any individual plans should include details of environmental changes, teaching opportunities and the provision of particular resources or activities that will enable the individual to learn to meet their own needs through more appropriate behaviour

The Legal Position

"Section 93 of the Education and Inspections Act 2006 enables school staff to use such force as is reasonable in the circumstances to prevent a pupil from doing or continuing to do any of the following.
A. committing any offence (or, for a pupil under the age of criminal responsibility, what would be an offence for an older pupil);
B. causing personal injury to, or damage to the property of, any person (including the pupil himself); or
C. prejudicing the maintenance of good order and discipline at the school or among any pupils receiving education at the school, whether during a teaching session or otherwise" (from THE USE OF FORCE TO CONTROL OR RESTRAIN PUPILS, DCFS).

There is no legal definition of when it is reasonable to use force. That will always depend on the precise circumstances of individual cases. However to be judged lawful the degree of force must be the minimum to achieve the desired result and proportionate to the consequences that it is intended to prevent.

Use of force cannot be justified to prevent trivial misbehaviour but how trivial the behaviour is depends on circumstances, for example a child breaking a pencil may not be regarded as trivial if the pencil is used as a weapon to poke another child in the eye. (The positive handling plan is a useful tool in clarifying these difficult legal situations).

Recording

All staff have a legal duty to report any matter in which safety is compromised. Any physical violence directed towards staff or others needs to be reported and recorded even if individuals feel able to tolerate different levels of aggression. Reporting of incidents enables incidents to be reviewed so that in the future preventative measures can be put into place to avoid the continuation or escalation of aggression. It also addresses the need of pupils to develop more appropriate behaviours in response to difficulty.

The use of physical or restrictive intervention needs to be recorded as soon as possible after the event. There may be a need at a later stage to demonstrate that decisions about the intervention used were appropriate, given the circumstances.

Schools and educational establishments are required to keep contemporaneous written records of all incidents where physical or restrictive intervention has been used.

The following key details should be recorded before the relevant staff leave the premises:

A. An overview of the circumstances leading to the use of physical intervention.
B. The intervention(s) used.
C. The length of time that each intervention was used before calming/release.
D. The staff members involved.
E. Any injury caused to any individual.
F. Any need for follow up action.

Pupils who receive a restrictive or physical intervention will be routinely assessed for signs of injury or physical or emotional distress by another member of staff. Such assessments need to take into account their ability to recognise and communicate their response to harm. Any necessary medical examination must be carried out by appropriately trained staff.

Records will be made of any bruising or marking caused as a result of physical intervention, including the context in which the bruising occurred. Any injuries reported by the child must also be recorded, whether or not there are visible marks. The extent of any marking or reported injuries must be recorded by 2 members of staff, not just one. If a child in care is injured during a restraint the Social Worker will need to be informed immediately.

Parents/carers should be informed promptly of the use of physical interventions unless it has been specifically recorded in the child's behaviour plan that parents have requested to be informed on a regular but not necessarily immediate basis.

Reviews

The use of any form of intervention, including primary and secondary measures, and positive handling, should be the subject of ongoing review. Evaluation of the effectiveness of the approaches used will help to clarify a pupil's needs. Specific strategies will need to be varied according to individual circumstances and the context in which they are being used.

In the majority of cases, the use of physical or restrictive intervention will be rare. In such cases, a review should be carried out once everyone involved has had a chance to calm, but close enough to the incident to ensure an accurate recall of events. Those involved in the intervention should be given separate opportunities to talk about what happened in a non-judgemental way. The aim of a review is to discover what happened and why in order to assist in planning for the future, not to apportion blame or punishment.

Reviews should consider:

A. The effectiveness of primary measures in reducing the likelihood of challenging behaviour.
B. The effectiveness of secondary measures in de-escalating a developing situation.
C. The effectiveness of positive handling strategies, including physical intervention, in bringing a situation to a safe conclusion.
D. The longer term impact on the individual and others of the use of physical or restrictive intervention.
E. Consideration of the contexts in which challenging behaviour is less likely to occur - what is different?
F. The potential consequences of not using a restrictive intervention.
G. Any changes to the individual's circumstances or to the environment that may require the individual's plan to be modified.

When a physical intervention has been sanctioned for a child or young person and is likely to be used on a regular basis, the use of that intervention should be reviewed not less than every half-term. Reviews should be carried out more frequently if the behaviour is especially challenging or if the intervention appears to exacerbate the behaviour.

For some children the complexity of their needs means that the fact that the level of intervention has stayed constant and not increased, itself represents success. Nevertheless, it is important to ensure that the use of physical or restrictive intervention never becomes routine.

Complaints

Parents and pupils have a right to complain about the actions taken by school staff. If an allegation of abuse is made against a member of staff the school needs to follow guidance set out in "Safeguarding Children and Safer Recruitment in Education" (www.everychildmatters.gov.uk/resources-and-practice/IG00176). (then click on Safeguarding Recruiters on the left hand side)

Initially it will be up to the headteacher to respond to the complaint, if parents appeal against this response a panel of governors may be convened.

Further information about handling allegations against staff can be found in "Safeguarding Children and Safer Recruitment in Education"
www.schoolsrecruitment.dcsf.gov.uk (then click on Safeguarding Recruiters on the left hand side).

Should concerns be expressed in regard to a Team-Teach hold an advanced trainer will be available for advice and if required reference will be made to an advanced trainer from outside of the Borough.

Staff Training

All staff who will be required to employ restrictive physical interventions will have specialist training, and should only, except in emergencies, employ those physical interventions for which they have had training. Refresher courses will be taken at a local level to ensure that staff retain their skills and remain confident in their ability to use positive handling techniques, including physical intervention.

Through the Borough of Poole the school has selected Team Teach as their preferred training provider for training on physical intervention. Team Teach offers a number of packages focussing on positive handling techniques and de-escalation of risk. The training follows a core curriculum, but takes into account the specific needs of the setting concerned. A 1 day course is available for mainstream schools. The training that Team Teach provides is consistent with the guidance in this policy and meets the requirements for accreditation through BILD. Team Teach can be contacted at www.team-teach.co.uk.

"Team-Teach techniques seek to avoid injury to the service user, but it is possible that bruising or scratching may occur accidentally, and these are not to be seen necessarily as a failure of professional technique, but a regrettable and infrequent side effect of ensuring that the service user remains safe". (George Matthews - Director)

 Provided staff have followed the recommendations in these guidelines, acted in a professional, considered and informed manner with the pupils' best interests as paramount, the Borough and its legal department will support their actions.

 Teachers and support staff in schools are not under a duty to run the risk of personal injury, by intervening where it is not safe to do so.

 Injuries to staff should be reported to the Occupational Health Service in order to seek advice on appropriate medical support, e.g. bites.

 If there are concerns about Health and Safety regulations in relation to violent incidents, reference should be made to:
"Prevention of Violence and Intimidation at Work"
Safe Working Procedure No. 28.

A Framework for Intervention for Challenging Behaviour

Functional Assessment

When the normal range of strategies for intervention in response to difficult behaviour do not work, it is necessary to look more closely at the behaviour that is causing concern. The aim should be to identify what positive outcome the behaviour is leading to. This may not always be obvious, and the pupil themselves may not be consciously aware of what they are gaining through their difficult behaviour.

The first step is to carry out a functional assessment. This is done through carrying out an in depth analysis of the behaviour, and what goes before and after it. The aim is to identify factors in the environment and in other people's responses to the behaviour that make the behaviour more or less likely to be repeated. In this way it can be possible to identify what function the behaviour serves.

Intervention planning

Once the positive outcome of the behaviour is identified, support arrangements need to be put in place that recognise that the behaviour is rooted in a key learning, emotional or physical need.

Any school based intervention needs to combine four elements:

Proactive Intervention - moving things forward

o Changing systems and expectations and reorganising the classroom to remove or reduce the impact of difficulties in the learning/social environment.
o Improving the pupil's capacity to change by teaching them the skills they lack. Providing support to enable them to cope better with difficulty.
o Providing motivation to increase the likelihood that the child will apply the new skills they have learned.

Reactive Intervention - stopping things getting worse

o Identifying reactive strategies - actions to take to respond to the behaviour in the short term, giving time for long term measures to take effect.

It is important to recognise that intervention will not be effective in the long term if the strategies are used in isolation:

o Changing systems and expectations may protect the pupil, but not prepare them for times outside of any protected environment.
o Teaching new skills will be effective only if the pupil has the confidence and motivation to apply them, and they are effective for the pupil's individual needs.
o Reward systems alone will not work unless the pupil knows what to do differently.
o Reactive strategies will solve a problem in the short term, but do not address the root cause of a difficulty and rarely result in long term change. They can also end up reinforcing problem behaviour.
Plans for intervention need to include provision for:

1. Changing the environment and the behaviour of others

Making changes in the class or school and other people's behaviour that take into account the impact on the child of:

o The effect of the physical environment, school organisation and routines
o The impact of medical problems, learning, social and emotional or communication difficulties on expectations and how tasks should be presented and demands set
o The interpersonal relationships between the child and others
o Gaps in experience or reduced opportunities to develop skills

2. Teaching new skills

Recognising that the pupil does not have the necessary skills to cope with the demands being placed upon them and so needs additional teaching or access to experiences that will help them to develop their skills. Teaching may be needed to develop:

o Academic Skills
o Communication skills
o Coping Skills
o More appropriate skills to reduce problem behaviour

3. Providing motivation

Identifying systems of rewards, and manipulating outcomes for the pupil in order to:

o Increase the likelihood of appropriate patterns behaviour being adopted
o Eliminate or reduce the frequency of problem behaviour
o Allow time for new skills to be consolidated

4. Reactive strategies

Identifying short term responses to problem behaviour that will

o Ensure safety
o Address immediately presenting problems
o Allow time for longer-term strategies to take effect.

Borough of Poole
Positive Handling Plan (PHP)

Name.............................................. Dob........................
In Poole every pupil who has been physically restrained on more than one occasion has an individual management programme in place. This programme is prepared by the classroom teacher in consultation with the class team, senior teachers and wider agencies if appropriate. The plan is reviewed and updated as the need for physical restraint changes and when we review the IEP.

Date PBMP was started...................... Date of this update.................

1. Summary of range of challenging behaviours exhibited to date:

2. The purpose of the challenging behaviour:

3. Triggers leading to / causing the challenging behaviour:

4. Teaching targets for more effective behaviours:
o
o
o
o
o o
5. Environmental changes to support effective behaviour:

6. The programme of positive reinforcement and appropriate sanctions:

7. Early warning signs of challenging behaviours:

8. Range of personal intervention techniques that have been needed to date:

9. Further personal intervention techniques that we may need to use in the future:

10. Defusing and calming strategies to employ when the early warning signs are exhibited:

Borough of Poole Intervention Record Sheet

Student Name: Physical Intervention Book Entry No:
Year Group:
Day: Date: Time: Place:
Setting:

Trigger (Cause of upset):

Behaviour:

Staff Action:

Outcome/Consequence:

Tick to indicate New Behaviour:  □
Has the incident been resolved  □ yes
      □ no - if no what are the plans to resolve this?

Next time try:_______________________________________________________________
What do you think would have happened if you had not intervened?

Do any amendments need to be made to the pupil's Positive Handling Plan as a result of this incident?
Yes/No (if yes, write comments below)

Were any other forms completed? if so what were they and what are their numbers?

Staff member completing form
Name________________________________ training (adv, foundation)

Other staff involved
Name________________________________      training (adv, foundation)
Name________________________________      training (adv, foundation)
Name________________________________      training (adv, foundation)

Non/Accidental Injury to Student: Non/Accidental Injury to Staff:
(delete as appropriate) (delete as appropriate)

Indicate location of injury to pupil                                   Indicate location of injury to staff
Physical Intervention used:     Pupil Name:
If any of the following interventions are used, tick box/boxes to indicate. Physical Intervention and Outcome Note: PI (Physical Intervention)/RPI (Restrictive Physical Intervention) - see Physical Intervention Policy
Type of Physical Intervention or support strategy Specific Technique used Duration mins: secs Type of Physical Intervention or support strategy Specific Technique used Duration
mins: secs
Friendly hold   Breakaway Technique Clothing hold response
    Hug response
Restrictive Physical Intervention Single Elbow walking   Bite response
Figure 4 (1 person)   Hair grab response
Double Elbow walking    Neck grab response
T Wrap  Calming down time/time to refocus
Front Ground Recovery
Other
Note: All must be recorded in the Physical Intervention Book (kept in staff room)
Additional action/comments by Principal/Head of School:
What behaviour was the child/young person presenting that warranted restraint? (Please tick appropriate boxes)
At risk of injury to self or others   At risk of significant damage to property
Compromising good order and discipline  At risk of committing a criminal offence