1 Positive and Safe: reducing the need for restrictive interventions Guy Cross – Policy Lead, Positive and Safe, Department of Health NAPICU 11 TH SEPTEMBER 2015

2 Overview Recap on the policy Challenges and Implementation What does good look like? Where next? Reducing the need for restrictive interventions

3 Why Positive and Proactive Care? Abuse at Winterbourne View Subsequent investigations show that these findings are widespread Transforming Care Programme Mind Freedom of Information request shows wide variation in the use of restraint Reducing the need for restrictive interventions

4 Why focus on reducing restrictive interventions? Human rights Injuries to staff ‘It’s what people do when the don’t understand me’ NSUN service user No one likes restraining service users Money

5 Positive and Proactive Care Aims Cultural change Therapeutic environments Focus on quality of life Governance models Reducing reliance on restrictive interventions Learning, sharing and promoting practice innovation To ensure that restrictive interventions are used in a transparent, legal and ethical manner

6 Challenges Positive Behaviour Support Staff safety College of policing Expert opinion Safe staffing

7 Implementation - data Use of Restraint per 10 beds

8 Implementation – data Use of prone restraint per 10 beds

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10 Implementation - data

11 Implementation - Building a Network of Champions Moving towards 300 champions 2 national and 2 regional champions’ events 4 regional culture change workshops with FoNS over 300 staff attended Monthly newsletters Positive and Safe ups/positive-safe- champions/resources/

12 What does good look like? Service users are involved in developing policy Training includes legal context, de-escalation and a proportionate approach to restrictive interventions Carers are supported An active protocol with the police Transparency Focus on quality Reducing the need for restrictive interventions

13 Aims of NAPICU to improve patient experience and outcomes to promote staff support and development to improve the delivery of care to audit the effectiveness of care to promote research, education and practice development to provide best practice guidance in association with national bodies Enter the presentation's title using the menu option View > Header and Footer

14 Where next? Clarification Training Restrictive Intervention Reduction Plans Focus on quality When do restrictive interventions happen? What can be learnt from each incident? Guidance for children and young peoples services Enter the presentation's title using the menu option View > Header and Footer

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16 Guy Cross Contact Details