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Like-minded organisations in pursuit of restraint-free services

Restraint Reduction Network Leadership Awards 2018

Caption: From top left, Jeff Kirkham and Professor Joy Duxbury, Richard Chapman and Gemma Nicholls from Calthorpe Academy with Beth Morrison, the MacIntyre and Redstone PBS team, the No Force First Team

These awards recognise good practice and contributions to the development of minimising the use of restraint. They aim to recognise and celebrate the best in reducing restrictive practices.

There were two categories, Innovative Practice and Inclusive Practice, and the quality of submissions was high. We have been given some amazing examples of how people are going above and beyond to change the culture of organisations and dramatically improve quality of life for the people they support.

Innovative practice

Our first category is Innovative Practice. Nominees in this category have used innovative and creative methods to reduce restraint or other restrictive practices. Their work could have resulted in a significant reduction for an individual or reduction at a service or organisational level.

Winners – No Force First Team, Mersey Care NHS Foundation – Dr Jennifer Kilcoyne, Iris Benson, Danny Angus, Scott Parker, Dr Lianne Franks and Dave Riley

This team has worked incredibly hard to spread their reducing restrictive intervention programme from four in-patient units to almost 60 areas. They have developed a comprehensive guide to implementing the process and ensured all areas received sessions in which people who use services gave accounts of traumatic physical interventions.

They wanted to make sure a critical emotional connection was made with the workforce around the need for change. Their work achieved a 37% reduction in the use of physical intervention across inpatient areas in their trust.

At a personal level, all of the team members are incredibly committed advocates for the people that use services. They are prepared to constructively challenge restrictive practices at all levels of the organisation while operating with an acute understanding that the transition towards new ways of working can often be a difficult process. They understand that staff have to be gently supported through and encouraged to achieve.

Runner up – Jeff Kirkham, Behaviour and Attendance Manager, Lever Park Academy

Jeff Kirkham joined a school in crisis and reduced an average of 150 physical interventions per week down to just one or two.

Lever Park Academy in Bolton was in special measures. It was a violent and unwelcoming place where attacks on staff and pupils were commonplace. Drug dealing was a massive problem and pupils absconded on a daily basis.

Jeff was brought in to tackle behaviour and attendance and he brought an approach built around warmth, affection, care and unconditional positive regard. He has implemented new systems which have proved to be highly successful. The list includes:

  • A new waves of intervention model which relies on high quality teaching, intimate pastoral care, ‘walk and talk’ methodology, reflection opportunities for pupils and support from the leadership team if required.
  • A new system of co-production where the adults work closely with the pupils to find out why the children may be upset, what triggers their mood changes and how can staff best staff support them when they are feeling agitated or upset. As a result of this, all staff now understand how to individually treat each pupil should they be unhappy
  • The introduction of ipsative behaviour and attendance targets for pupils. This means that pupils now have individual targets rather than general ones. This allows staff and pupils to focus together on what they need to do to achieve their targets and aim for higher targets as the year progresses.

Inclusive practice

Our second category is for people who have found a particularly inclusive way of reducing the use of restraints. The nominee may have worked closely alongside the person themselves and their family to reduce restraint use or developed person centred and inclusive systems and strategies that really support consumer involvement.

Winner – MacIntyre, Redstone Positive Behaviour Support

The winners of this award is a whole team of people who have dramatically improved the quality of life for one of the people they support.

An individual known as CM was repeatedly kept in a padded room at his residential school. He showed behaviours that were called “some of the worst that had ever been seen”. He had been diagnosed with autism and long-standing, complex behaviours resulting in self-injury and injury to those around him.

This individual moved into his own house in February 2016 after spending 10 years in various residential schools, in-patient services and Assessment Treatment Units.

Before being supported by our winners, this individual showed up to 100 incidents of physical aggression per day, with self-injurious behaviour occurring up to 200 times per day at the highest frequency. Now physical aggression is shown less than once per day and self-injurious behaviour has reduced to a highest frequency of 18 incidents per day.

Together with Redstone Positive Behaviour Support, our award winners worked closely with this individual’s family to reduce the use of restraints and self-injurious behaviour. They took the time to get to know this individual by shadowing his support at the ATU and learning more about his behaviours. Initially, he would communicate that he didn’t like a situation by self-injuring or showing physical behaviour towards staff. Now he trusts the staff team and they are able to enjoy activities such as swimming and eating meals together.

Schools award

This final award is to recognise a person or organisation that has reduced reliance on restrictive practice in schools. There is a great deal of concern around child services and schools can be a particularly difficult area to influence change at the right level. We were looking for a school who has been on a journey of cultural change, guided by strong and effective leadership.

Winner – Calthorpe Academy, Principal Richard Chapman and Assistant Headteacher Gemma Nicholls

The winners of this award have taken a school that was placed in Special Measures with high levels of physical intervention, and created a positive environment that has allowed pupils to thrive.

In November 2017 , Calthorpe Academy was graded ‘good’ by Ofsted and the Leadership and Management was graded as ‘outstanding’. In its report, Ofsted commented:

“The use of physical interventions has reduced enormously over the last year and is now infrequent. Other incidents of concerning behaviour have also become far less frequent. Staff use their skills and knowledge of communications and behaviour to support pupils in a quick and thoughtful way, helping pupils to express their needs and feelings in a more acceptable way.”