1. A positive and proactive workforce - workshop Jim Thomas Marie Lovell The experiences of people who use services and carers; how to work together

2. A positive and proactive workforce  Who is ‘the workforce?  What do they do? where? When?  What skills knowledge, attitudes do they need? And what do they already have?  When and how can we develop the skills that are needed? Developing workers to minimise all restrictive practices.

3. More than just ‘restraint’ Page 12

4. POP quiz hotshot!

9. In fairness, I can see why Dad got mixed up!

13. “Language matters” (if you want something that is saying what helps) “Shattered into a thousand pieces” (if you want something that describes how I felt) Sam O'Brien

14. Table discussions – as a group 1.Choose one of the very brief examples of a restrictive practice (page 14 of the guide) – or a real life example that you are currently dealing with. 2.Consider the key questions in the flowchart (page 15&16 of the guide) in relation to that situation. 3.In what ways can you and other professionals involved work with the person concerned or their family or friends or advocate so that they can help to answer those questions? 4.What barriers might you encounter and how might you overcome them? 5.What skills, knowledge and confidence would people need to fully work together? How can these be built up or shared? 6.How might the guide help you to do this in your work?

15. Is this a planned restriction as part of a care plan? Are you considering restricting someone? Is there a real risk of serious harm to the individual or someone else? Does the person have the mental capacity to make this decision themselves? has every effort been make to help them decide ? Is a restriction in their best interests? does the restriction need to be carried out now? Is the person detained under the mental health act? Is the restriction necessary for their treatment? have you tried all reasonable non- restrictive alternatives? Is this the least restrictive option? Key Questions Pages 15 and 16

16. Restrictions

18. “I don’t want to be too safe, If I can’t go out I might as well be dead.” Ernie

20. “I felt sick at the thought of sedating him. The staff made it clear that giving him ‘something to help with the behaviour’ would speed up the condition and he would deteriorate quickly. They said that if I didn’t agree, he would have to be moved to another home, if I did agree he would die sooner! Even now, I still feel I killed him. As the eldest it was my responsibility to make the decision. I know we discussed it as a family, I know we all agreed it was for the best for him and those around him………but I still feel I killed him.” Sister of a man with dementia

21. “When you all pinned me face down - I thought you were going to kill me - I couldn’t breathe - I don’t trust anyone now.” Man with sensory issues.

22. “When he said all this, his head was in his hands and the look of grief and terror in his eyes, the physical ramifications were awful too. Nightmares and panic attacks to name but a few…” Man’s mother

23. “We have only seen Rhys calm since he moved into his own home.” Jackie and Rhys

24. “Even now Mark will take himself to ground when he feels threatened… He felt out of control when he was held by 4 people at school as part of their approach to challenging behaviour.” Kadie

25. “Language matters” (if you want something that is saying what helps) “Shattered into a thousand pieces” (if you want something that describes how I felt) Sam O'Brien

26. “I was in hospital to get better. Instead I was abused and traumatised.” Rosemary Wilson

28. “At the time it feels like you’re in hell. You’re locked in and can’t get out of it.” “You’re fighting for your life but you can’t do anything against six burly nurses.” Gary

30. Table feedback

31. www.skillsforcare.org.uk www.skillsforhealth.org.uk Jim.Thomas@skillsforcare.org.uk Marie.Lovell@skillsforcare.org.uk