“…We feel our son may not have died in vain. If we can make sure this never happens to anyone else, that would be an amazing legacy for Seni.”
Aji and Conrad Lewis, parents of Seni Lewis, who died as a result of prone restraint
The Restraint Reduction Network has worked with Health Education England to produce a set of ethical training standards that protect human rights and support the minimisation of restrictive practices.
The Restraint Reduction Network Training Standards apply to all training that has a restrictive intervention component and will provide a national and international benchmark for training in supporting people who are distressed in education, health and social care settings.
These Standards will ensure that training is directly related and proportional to the needs of populations and individual people and that training is delivered by competent and experienced training professionals who can evidence knowledge and skills that go far beyond the application of physical restraint or other restrictive interventions.
In addition to improving training and practice, the Standards will:
- protect people’s fundamental human rights and promote person centred, best interest and therapeutic approaches to supporting people when they are distressed
- improve the quality of life of those being restrained and those supporting them
- reduce reliance on restrictive practices by promoting positive culture and practice that focuses on prevention de-escalation and reflective practice
- increase understanding of the root causes of behaviour and recognition that many behaviours are the result of distress due to unmet needs
- where required, focus on the safest and most dignified use of restrictive interventions including physical restraint.
It is important they are applied consistently to services:
- across education, health and social care
- across children and adult services
- across the UK and internationally
- for all populations, including people with mental health conditions, dementia, learning disabilities and autistic people in order to consistently minimise the risk of physical and psychological harm to all people in all settings in all nations in the British Isles
These Standards support the human rights of all populations and may be useful to the private security industry, but are not specifically designed for
training providers outside of education, health and social care sectors.
Staff must have face to face training in preventative/primary strategies and secondary strategies before they are taught to use restrictive interventions
These Standards will be mandatory for all training with a restrictive intervention component that is delivered to NHS commissioned services for people with mental health conditions, learning disabilities, autistic people and people living with dementia in England.
Implementation will be via commissioning requirements and inspection frameworks. Any training with a restrictive intervention component will need be certificated against the standards by a UKAS (United Kingdom Accreditation Service) accredited organisation, www.ukas.com .
This includes services in the independent, private and voluntary sectors. Other UK countries may benefit from following the principles and standards, albeit within a devolved legislative context, where country specific legislation applies.
Requirements for certified training (during Covid-19 pandemic in 2020)
The Restraint Reduction Network Training Standards focus on preventing the need for restraint wherever possible. Therefore the standards require two days (12 hours) face to face training in preventative approaches as specified in standards 2.1-2.15 prior to being taught physical skills techniques. The majority of these two days must be face to face. (Standard 1.2.1)
Due to social distancing it is more challenging to deliver face to face training safely. Therefore the Restraint Reduction Network are changing the requirements for face to face training during the Covid-19 pandemic in 2020.
These will be reviewed in early 2021 and a review of the effectiveness of blended learning approaches to support restraint reduction will take place in 2021.
The requirement for training providers to evidence that the training methods they choose are effective in supporting learning and cultural change remain .
We all have a role to play in reducing restrictive practices
Professor Tim Kendall, National Clinical Director for Mental Health, NHS England, said: “The NHS welcomes the publication of the Restraint Reduction Network Training Standards. These standards have been written to focus on ensuring training promotes human rights and supports cultural change necessary to reduce reliance on restrictive practices (rather than purely focus on technical skills). Certification of compliance with these standards will be a requirement in NHS commissioned and CQC regulated services from April 2020’
Chair of the Restraint Reduction Network, Professor Joy Duxbury, said: “These Standards are a really exciting development. They are vital in our work to reduce the use of restrictive practices and, on those occasions when restraint is unavoidable, to make sure it is safer and dignified.”
Joy Duxbury, Chair of the Restraint Reduction Network, tells us what the Standards are all about
Iris Benson MBE, Beth Morrison and James Dickinson speak about their experiences of restrictive practices.
Whilst focusing very much on the restraint reduction message this video does include discussion and disclosure of traumatising restraint experiences. Viewer discretion is advised.
Become a certificated training service
Certification against the Standards will be mandatory for all training providers (commercial and in-house) working with the NHS from April 2020.
Bild Association of Certified Training is currently the only organisation that certifies training services against the Restraint Reduction Network Training Standards. Find out more
Implement the Training Standards with this new tool
Implement the Training Standards with this assessment tool
Patients were restrained 22,000 times in NHS mental health hospitals alone in 2018.
The majority of such restraints are preventable.