Andrew%20Masterman

1
Andrew Masterman Policy Lead Violence Strategy
Date 26 06 14
2
Collaborative approach
3
Timeline
4
National picture
Minimising the use of physical restraint
DH Positive Safe Programme
MH Crisis Care Concordat
MoJ - Death in Custody principles / NHS Care in
Custody
RCN - Positive and Proactive Care
SfHealth/Care - Positive and Proactive Workforce
NHS Protect - Meeting Needs and Reducing Distress

• NICE - Guidelines
• Violence Aggression
• LD Challenging
• Behaviour

RCN Forum
NHS England -NRLS and Patient Safety Incidents
RCPsych
Research
Health Education England
CQC
5
Why is this guidance important?

• Vulnerable patients
• Other patients
• Staff
• Relatives and carers
• Organisational reputation

6
Our approach
Preventing challenging behaviour and minimising
restrictive practices
7
Understand

• What is meant by clinically related
  challenging behaviour
• Clinical condition or other factors
• How it presents and early signs
• Antecedents and triggers
• Common reasons - physical, cognitive,
  psychological/emotional, environmental/social
• Translate unmet needs into delivery of care

8
Manage risk

• Recognise a persons vulnerability
• Implement strategies to stay safe
• Manage escalating situations
• Deal with immediate, obvious causes
• Consider other strategies, e.g. assistance,
  observations
• Know when to use physical interventions in
  emergency situations
• Review incident

9
Prevent

• Recognise individual's rights and dignity
• Positive engagement, attitudes, communication
  critical to prevent challenging behaviour
• Information gathering, observation and
  assessing behaviours when planning care
• Plan individualised care understand what causes
  behaviour, what alleviates it, what can we do
  differently document and share with colleagues
• Factors communication, environment, activities,
  independence, mobility, sleep, rest and nutrition
• Review care plan

10
Training
Level Core Core Role specific Targeted (risk based) Targeted (risk based)
Module Challenging behaviour awareness CRT Assessment and planning Assault reduction Physical intervention
Content Awareness Recognise Prevent Manage risks Responsibilities Support Risk awareness Dynamic risk assessment Communication Calming Responsibilities Reporting Support Assess diagnose Care planning Individualised care Prevention Special observation Behaviour management Problem solving Recording Support Risk awareness Positioning Safer practices Avoiding blows Releases Guiding redirecting Policy, law, ethics Appropriate restrictive skills Medical risks Duty of care Teamwork Leadership Emergency response
Audience All staff with direct patient contact All staff with direct patient contact Nurses, doctors, AHP Nurses, doctors, AHP in high risk areas Response teams, security function
11
Resources

• Versatile video resource
• Supports guidance
• Learning outcomes
• Relevant to clinical and
• non-clinical staff
• Scenarios to understand,prevent, manage
  behaviour
• Shared expertise and practical advice

12
www.nhsprotect.nhs.uk/reducingdistress
13
The future?

• Guidance, website and video resources
• Project implementation and evaluation
• Future engagement participate in work streams to
  minimise restrictive interventions
• Identify opportunities for further work
• Training

14

• CONTACT DETAILS
• andrew.masterman_at_nhsprotect.gsi.gov.uk