Managing risk, minimising restraint: Challenges, dilemmas and positive approaches for working with older people in care homes

This resource explores the ideas that: •Restraint can be a difficult issue in care homes, and the word means different things to different people. •There are many different types of restraint, ranging from active physical interventions to failing to assist a person. •Minimising the use of restraint is important, but sometimes it will be the right thing to do. •Knowing the individual, valuing the views of relatives and working as a team will help reduce the need for restraint.

This resource explores: •How staff, residents and relatives view of risk and risk-taking will influence decisions about restraint. •How making good decisions about restraint is more likely if care staff are positive, show teamwork, keep good records, are aware of the alternatives to restraint and have some basic knowledge of the law on restraint. •How a careful five-step process can help when making difficult decisions about restraint: observe, do some detective work, come to a collective decision, implement and review the plan

This resource explores: •Creating a positive culture of care to lessen the likelihood of care staff needing to use restraint. •Using good communication to help negotiate the many different and often emotive views of everyone involved in a decision to use restraint. •Providing learning and development opportunities that help promote a learning culture and support better decision-making about restraint. •Developing a positive physical care environment to help reduce the need for restraint