Recording Physical Interventions in Hertfordshire Special Schools & Primary Support Bases

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1 Recording Physical Interventions in Hertfordshire Special Schools & Primary Support Bases

2 note This book is for recording the use of Physical Interventions which fall within the definition of physical restraint on the following pages. Once printed this book MUST be bound. Pages should not be removed from this book, nor should extra pages be pasted, clipped or stapled in. This book and the use of physical intervention in schools should be monitored by the headteacher, the chair of governors and an independent person. In case of a Child Protection Investigation, Police or Social Care staff may also have access to it. Schools should ensure a book is always available.

3 INTRODUCTION Children's Services recognises and affirms the right of all children and young people to live and learn in a safe and secure environment and is committed to the development of policies and strategies which support this vision. The use of force should be avoided wherever possible. It is acknowledged, however that there may be rare occasions when the use of force to control or restrain children and young people is appropriate. When force is necessary, it should always be used in ways that maintain the safety and dignity of all concerned. This document should be read by schools in conjunction with the following documents:- Link to Use of Reasonable Force advice for head teachers, staff and governing bodies use-of-reasonable-force-advice-for-school-leaders-staff-and-governing-bodies Link to Screening, Searching and Confiscation advice for head teachers, staff and governing bodies screening-searching-and-confiscation Link to Safeguarding Legislative links Education and Inspections Act School Standards and Framework Act Education Act DEFINITION Physical Intervention is the positive application of force with the intention of overpowering the young person when verbal commands are no longer sufficient to control behaviour. That is in order to protect a child from harming her/himself or others or to prevent serious damage to property. Section 93 of the Education and Inspections Act 2006 also allows the use of physical intervention to prevent a child or young person committing a criminal offence or engaging in any behaviour which compromises the good order of the school. However, schools should be wary of using physical intervention unless a member of staff or a young person is at serious risk of harm or there is a danger of serious damage to property.

4 RECORDING Any incident of physical intervention should be reported to the headteacher or deputy in the first instance. The use of restrictive physical interventions, whether planned or unplanned (emergency), should always be recorded as soon as practicable (and in any event within 24 hours of the incident) by the person(s) involved. If after the initial reporting of the incident the headteacher considers that the Guidelines have not been followed, the incident itself should not be pursued further but referred for action in accordance with child protection procedures. In these circumstances investigations must cease and no further statements should be taken either from those involved or from witnesses. This does not preclude schools from taking action to ensure the day to day safety of children and young people. POST INCIDENT MANAGEMENT Following an incident in which restrictive physical interventions have been employed, both staff and young people should be given separate opportunities to talk about what happened in a calm and safe environment. Interviews should only take place when those involved have recovered their composure. Post incident interviews should be designed to discover exactly what happened and the effects on the participants. They should not be used to apportion blame or to punish those involved. If there is any reason to suspect that a young person or member of staff has experienced injury or severe distress following the use of a physical intervention, they should receive prompt medical attention. In the event of a violent incident where there is an impact on a member of staff (be that physical or emotional) it must be reported either on an idor form or a VIR form. Where HCC is the employer then these need to be reported to the LA and schools should do this via Solero. For more guidance please see:

5 RISK ASSESSMENT Any physical intervention involves a degree of risk. The purpose of risk assessment is to determine how risk may arise and the action needed to minimise it. The principle of risk assessment is that risks should first be avoided or reduced at source, rather than relying on training to deal with dangers after they have occurred. Risk assessment, then, should endeavour to predict situations where the use of physical interventions is likely, and seek to find solutions so that an intervention can be minimised. This may be, for example, through understanding young people's behaviours within context and thereby avoiding triggers for individual young people; with reference to environmental issues; or by looking at staffing levels. This guidance recognises that in practice it is not possible completely to design out all need for physical intervention; risk assessment, therefore, needs to ensure that staff have the necessary training and skills to minimise risks when physical intervention is required. Individual risk assessment must identify strategies for reducing the likelihood of the use of physical intervention (positive behaviour management) and to minimise the risk of injury to staff or young people when intervention is used. This should inform the young person's care plan, Individual Behaviour Management Plan or Individual Crisis Management Plan and include reference to training and supervision levels. The assessment should seek to determine the reasons for the young person's behaviours and identify triggers and early warning signs to minimise the need for physical intervention. The Care Plan, IBMP or ICMP should indicate appropriate restraints for that young person as well as any restraints that are inappropriate - for example where a child is obese, pregnant or has been sexually abused. Following an incident where physical intervention has been used it is likely that the young person's Behaviour Management Plan will need to be reviewed. A risk assessment pro forma which may be used for this purpose follows.

6 PROFORMA FOR ASSESSING AND MANAGING FORESEEABLE RISKS FOR CHILDREN WHO PRESENT CHALLENGING BEHAVIOURS Name of child... Class group... Name of teacher... School... IDENTIFICATION OF RISK Describe the foreseeable risk Is the risk potential or actual? List who is affected by the risk. ASSESSMENT OF RISK In which situations does the risk usually occur? How likely it is that the risk will arise? If the risk arises, who is likely to be injured or hurt? How serious are the adverse outcomes? Assessment completed by:... Signature... date... RISK REDUCTION OPTIONS Measures Possible options Benefits Drawbacks Proactive interventions to prevent risk Early interventions to manage risk Reactive interventions to respond to adverse outcomes

7 AGREED BEHAVIOUR MANAGEMENT PLAN & SCHOOL RISK MANAGEMENT STRATEGY Focus of measures Measures to be employed Level of risk Proactive interventions to prevent risks Early interventions to manage risks Reactive interventions to respond to adverse outcomes Agreed by: Relationship Date: COMMUNICATION OF BEHAVIOUR MANAGEMENT PLAN & SCHOOL RISK MANAGEMENT STRATEGY Plans and strategies shared with: Communication method Date actioned STAFF TRAINING ISSUES Identified training needs Training provided to meet needs Date training completed

8 EVALUATION OF BEHAVIOUR MANAGEMENT PLAN & SCHOOL RISK MANAGEMENT STRATEGY Measures set out Effectiveness in supporting the child Impact on risk Proactive interventions to prevent risks Early interventions to manage risks Reactive interventions to respond to adverse outcomes ACTION FOR THE FUTURE Plans and strategies evaluated by: Relationship to Child Date...

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10 PROFORMA FOR ASSESSING AND MANAGING FORESEEABLE RISKS FOR CHILDREN WHO PRESENT CHALLENGING BEHAVIOURS Name of child... Class group... Name of teacher... School... IDENTIFICATION OF RISK Describe the foreseeable risk Is the risk potential or actual? List who is affected by the risk. ASSESSMENT OF RISK In which situations does the risk usually occur? How likely it is that the risk will arise? If the risk arises, who is likely to be injured or hurt? How serious are the adverse outcomes? Assessment completed by:... Signature... date... RISK REDUCTION OPTIONS Measures Possible options Benefits Drawbacks Proactive interventions to prevent risk Early interventions to manage risk Reactive interventions to respond to adverse outcomes

11 AGREED BEHAVIOUR MANAGEMENT PLAN & SCHOOL RISK MANAGEMENT STRATEGY Focus of measures Measures to be employed Level of risk Proactive interventions to prevent risks Early interventions to manage risks Reactive interventions to respond to adverse outcomes Agreed by: Relationship Date: COMMUNICATION OF BEHAVIOUR MANAGEMENT PLAN & SCHOOL RISK MANAGEMENT STRATEGY Plans and strategies shared with: Communication method Date actioned STAFF TRAINING ISSUES Identified training needs Training provided to meet needs Date training completed

12 EVALUATION OF BEHAVIOUR MANAGEMENT PLAN & SCHOOL RISK MANAGEMENT STRATEGY Measures set out Effectiveness in supporting the child Impact on risk Proactive interventions to prevent risks Early interventions to manage risks Reactive interventions to respond to adverse outcomes ACTION FOR THE FUTURE Plans and strategies evaluated by: Relationship to Child Date...

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14 School: Hertfordshire Physical Intervention Record Form School Number LOG NUMBER Name of Young Person M/F Looked After Child Y/N If LAC send copy to attached social worker Name of Adult reporting When did the incident occur? Date Time Please describe the incident. Be brief. E.g. where, what was happening at the time. Who else was in the vicinity? 1 What other strategies were used before physical intervention? Why was physical intervention deemed necessary? Staff involved Name Designation TCI/ Approach /NAPPI Date of last training or update Involvement Physical (P) Observer (O) Signed What holds were used? Tick as appropriate. Tick only holds you are trained to use. If you have used a hold for which you have not received training make a note under Other Approach 2 person *tuck / bar over / seated / standing / kneeing / seated/ lying on floor *delete as appropriate 2 person escort TCI Team Restraint Small child restraint NAPPI Capture wrap Other Please give details Duration of restraint If young person was held on the ground did they go independently?

15 BEHAVIOUR MANAGEMENT / HANDLING PLAN / ICMP ETC Has the young person been held before Is a Behaviour Management / Handling Plan / ICMP etc in place? Were the pre crisis strategies outlined in the plan followed? If not indicate why? (e.g., there was not time etc.) NB Good practice indicates that schools should review what happened and consider what lessons can be learned, which may have implications for the future management of the young person. These need not be added to this form but should be incorporated in the individual plans for the young person following review. INDIVIDUAL PLAN A young person should have an individual plan clearly detailing proactive and reactive strategies and physical intervention approaches if they have been involved in physical interventions on more than one occasion Does the plan need to be reviewed as a result of this incident If Yes, estimate the period (less than 4 weeks) within which the review will take place..weeks INTERNAL REPORTING To whom was the incident reported? When was it reported? Date/time Date / /. Time INJURIES Name Injury Treatment Please specify any related record forms completed (please tick) Incident Form Accident Book Racist Incident Form ICMP/BMP Body Map (for injuries marks to the young person) Violent Incident Record Other.

16 REPORTING TO PARENTS/CARERS/SOCIAL WORKER IN THE CASE OF LAC Parents / Carers/ social worker were informed YES / NO Date Time By Whom What form of contact Signature of person reporting the incident. Job title.. Headteacher s signature Date Time. NB Heads must sign each entry off as soon as possible after an incident. YOUNG PERSON S VIEW ( Where practical) Signature Date Time (a) White British Irish Traveller from Irish heritage Gypsy Any other White background Italian Turkish (d) Black or Black British Caribbean African Any other Black background (b) Mixed (c) Asian or Asian British White and Black Caribbean Indian White and Black African White and Asian Pakistani Any other mixed background Bangladeshi Any other Asian background (e) Chinese (f) Any other ethnic group

17 Notes: Front Completed by: Sign: Date: Reviewed by: Sign: Date: Notes: Back

18 School: Hertfordshire Physical Intervention Record Form School Number LOG NUMBER Name of Young Person M/F Looked After Child Y/N If LAC send copy to attached social worker Name of Adult reporting When did the incident occur? Date Time Please describe the incident. Be brief. E.g. where, what was happening at the time. Who else was in the vicinity? 2 What other strategies were used before physical intervention? Why was physical intervention deemed necessary? Staff involved Name Designation TCI/ Approach /NAPPI Date of last training or update Involvement Physical (P) Observer (O) Signed What holds were used? Tick as appropriate. Tick only holds you are trained to use. If you have used a hold for which you have not received training make a note under Other Approach 2 person *tuck / bar over / seated / standing / kneeing / seated/ lying on floor *delete as appropriate 2 person escort TCI Team Restraint Small child restraint NAPPI Capture wrap Other Please give details Duration of restraint If young person was held on the ground did they go independently?

19 BEHAVIOUR MANAGEMENT / HANDLING PLAN / ICMP ETC Has the young person been held before Is a Behaviour Management / Handling Plan / ICMP etc in place? Were the pre crisis strategies outlined in the plan followed? If not indicate why? (e.g., there was not time etc.) NB Good practice indicates that schools should review what happened and consider what lessons can be learned, which may have implications for the future management of the young person. These need not be added to this form but should be incorporated in the individual plans for the young person following review. INDIVIDUAL PLAN A young person should have an individual plan clearly detailing proactive and reactive strategies and physical intervention approaches if they have been involved in physical interventions on more than one occasion Does the plan need to be reviewed as a result of this incident If Yes, estimate the period (less than 4 weeks) within which the review will take place..weeks INTERNAL REPORTING To whom was the incident reported? When was it reported? Date/time Date / /. Time INJURIES Name Injury Treatment Please specify any related record forms completed (please tick) Incident Form Accident Book Racist Incident Form ICMP/BMP Body Map (for injuries marks to the young person) Violent Incident Record Other.

20 REPORTING TO PARENTS/CARERS/SOCIAL WORKER IN THE CASE OF LAC Parents / Carers/ social worker were informed YES / NO Date Time By Whom What form of contact Signature of person reporting the incident. Job title.. Headteacher s signature Date Time. NB Heads must sign each entry off as soon as possible after an incident. YOUNG PERSON S VIEW ( Where practical) Signature Date Time (a) White British Irish Traveller from Irish heritage Gypsy Any other White background Italian Turkish (d) Black or Black British Caribbean African Any other Black background (b) Mixed (c) Asian or Asian British White and Black Caribbean Indian White and Black African White and Asian Pakistani Any other mixed background Bangladeshi Any other Asian background (e) Chinese (f) Any other ethnic group

21 Notes: Front Completed by: Sign: Date: Reviewed by: Sign: Date: Notes: Back

22 School: Hertfordshire Physical Intervention Record Form School Number LOG NUMBER Name of Young Person M/F Looked After Child Y/N If LAC send copy to attached social worker Name of Adult reporting When did the incident occur? Date Time Please describe the incident. Be brief. E.g. where, what was happening at the time. Who else was in the vicinity? 3 What other strategies were used before physical intervention? Why was physical intervention deemed necessary? Staff involved Name Designation TCI/ Approach /NAPPI Date of last training or update Involvement Physical (P) Observer (O) Signed What holds were used? Tick as appropriate. Tick only holds you are trained to use. If you have used a hold for which you have not received training make a note under Other Approach 2 person *tuck / bar over / seated / standing / kneeing / seated/ lying on floor *delete as appropriate 2 person escort TCI Team Restraint Small child restraint NAPPI Capture wrap Other Please give details Duration of restraint If young person was held on the ground did they go independently?

23 BEHAVIOUR MANAGEMENT / HANDLING PLAN / ICMP ETC Has the young person been held before Is a Behaviour Management / Handling Plan / ICMP etc in place? Were the pre crisis strategies outlined in the plan followed? If not indicate why? (e.g., there was not time etc.) NB Good practice indicates that schools should review what happened and consider what lessons can be learned, which may have implications for the future management of the young person. These need not be added to this form but should be incorporated in the individual plans for the young person following review. INDIVIDUAL PLAN A young person should have an individual plan clearly detailing proactive and reactive strategies and physical intervention approaches if they have been involved in physical interventions on more than one occasion Does the plan need to be reviewed as a result of this incident If Yes, estimate the period (less than 4 weeks) within which the review will take place..weeks INTERNAL REPORTING To whom was the incident reported? When was it reported? Date/time Date / /. Time INJURIES Name Injury Treatment Please specify any related record forms completed (please tick) Incident Form Accident Book Racist Incident Form ICMP/BMP Body Map (for injuries marks to the young person) Violent Incident Record Other.

24 REPORTING TO PARENTS/CARERS/SOCIAL WORKER IN THE CASE OF LAC Parents / Carers/ social worker were informed YES / NO Date Time By Whom What form of contact Signature of person reporting the incident. Job title.. Headteacher s signature Date Time. NB Heads must sign each entry off as soon as possible after an incident. YOUNG PERSON S VIEW ( Where practical) Signature Date Time (a) White British Irish Traveller from Irish heritage Gypsy Any other White background Italian Turkish (d) Black or Black British Caribbean African Any other Black background (b) Mixed (c) Asian or Asian British White and Black Caribbean Indian White and Black African White and Asian Pakistani Any other mixed background Bangladeshi Any other Asian background (e) Chinese (f) Any other ethnic group

25 Notes: Front Completed by: Sign: Date: Reviewed by: Sign: Date: Notes: Back

26 School: Hertfordshire Physical Intervention Record Form School Number LOG NUMBER Name of Young Person M/F Looked After Child Y/N If LAC send copy to attached social worker Name of Adult reporting When did the incident occur? Date Time Please describe the incident. Be brief. E.g. where, what was happening at the time. Who else was in the vicinity? 4 What other strategies were used before physical intervention? Why was physical intervention deemed necessary? Staff involved Name Designation TCI/ Approach /NAPPI Date of last training or update Involvement Physical (P) Observer (O) Signed What holds were used? Tick as appropriate. Tick only holds you are trained to use. If you have used a hold for which you have not received training make a note under Other Approach 2 person *tuck / bar over / seated / standing / kneeing / seated/ lying on floor *delete as appropriate 2 person escort TCI Team Restraint Small child restraint NAPPI Capture wrap Other Please give details Duration of restraint If young person was held on the ground did they go independently?

27 BEHAVIOUR MANAGEMENT / HANDLING PLAN / ICMP ETC Has the young person been held before Is a Behaviour Management / Handling Plan / ICMP etc in place? Were the pre crisis strategies outlined in the plan followed? If not indicate why? (e.g., there was not time etc.) NB Good practice indicates that schools should review what happened and consider what lessons can be learned, which may have implications for the future management of the young person. These need not be added to this form but should be incorporated in the individual plans for the young person following review. INDIVIDUAL PLAN A young person should have an individual plan clearly detailing proactive and reactive strategies and physical intervention approaches if they have been involved in physical interventions on more than one occasion Does the plan need to be reviewed as a result of this incident If Yes, estimate the period (less than 4 weeks) within which the review will take place..weeks INTERNAL REPORTING To whom was the incident reported? When was it reported? Date/time Date / /. Time INJURIES Name Injury Treatment Please specify any related record forms completed (please tick) Incident Form Accident Book Racist Incident Form ICMP/BMP Body Map (for injuries marks to the young person) Violent Incident Record Other.

28 REPORTING TO PARENTS/CARERS/SOCIAL WORKER IN THE CASE OF LAC Parents / Carers/ social worker were informed YES / NO Date Time By Whom What form of contact Signature of person reporting the incident. Job title.. Headteacher s signature Date Time. NB Heads must sign each entry off as soon as possible after an incident. YOUNG PERSON S VIEW ( Where practical) Signature Date Time (a) White British Irish Traveller from Irish heritage Gypsy Any other White background Italian Turkish (d) Black or Black British Caribbean African Any other Black background (b) Mixed (c) Asian or Asian British White and Black Caribbean Indian White and Black African White and Asian Pakistani Any other mixed background Bangladeshi Any other Asian background (e) Chinese (f) Any other ethnic group

29 Notes: Front Completed by: Sign: Date: Reviewed by: Sign: Date: Notes: Back

30 School: Hertfordshire Physical Intervention Record Form School Number LOG NUMBER Name of Young Person M/F Looked After Child Y/N If LAC send copy to attached social worker Name of Adult reporting When did the incident occur? Date Time Please describe the incident. Be brief. E.g. where, what was happening at the time. Who else was in the vicinity? 5 What other strategies were used before physical intervention? Why was physical intervention deemed necessary? Staff involved Name Designation TCI/ Approach /NAPPI Date of last training or update Involvement Physical (P) Observer (O) Signed What holds were used? Tick as appropriate. Tick only holds you are trained to use. If you have used a hold for which you have not received training make a note under Other Approach 2 person *tuck / bar over / seated / standing / kneeing / seated/ lying on floor *delete as appropriate 2 person escort TCI Team Restraint Small child restraint NAPPI Capture wrap Other Please give details Duration of restraint If young person was held on the ground did they go independently?

31 BEHAVIOUR MANAGEMENT / HANDLING PLAN / ICMP ETC Has the young person been held before Is a Behaviour Management / Handling Plan / ICMP etc in place? Were the pre crisis strategies outlined in the plan followed? If not indicate why? (e.g., there was not time etc.) NB Good practice indicates that schools should review what happened and consider what lessons can be learned, which may have implications for the future management of the young person. These need not be added to this form but should be incorporated in the individual plans for the young person following review. INDIVIDUAL PLAN A young person should have an individual plan clearly detailing proactive and reactive strategies and physical intervention approaches if they have been involved in physical interventions on more than one occasion Does the plan need to be reviewed as a result of this incident If Yes, estimate the period (less than 4 weeks) within which the review will take place..weeks INTERNAL REPORTING To whom was the incident reported? When was it reported? Date/time Date / /. Time INJURIES Name Injury Treatment Please specify any related record forms completed (please tick) Incident Form Accident Book Racist Incident Form ICMP/BMP Body Map (for injuries marks to the young person) Violent Incident Record Other.

32 REPORTING TO PARENTS/CARERS/SOCIAL WORKER IN THE CASE OF LAC Parents / Carers/ social worker were informed YES / NO Date Time By Whom What form of contact Signature of person reporting the incident. Job title.. Headteacher s signature Date Time. NB Heads must sign each entry off as soon as possible after an incident. YOUNG PERSON S VIEW ( Where practical) Signature Date Time (a) White British Irish Traveller from Irish heritage Gypsy Any other White background Italian Turkish (d) Black or Black British Caribbean African Any other Black background (b) Mixed (c) Asian or Asian British White and Black Caribbean Indian White and Black African White and Asian Pakistani Any other mixed background Bangladeshi Any other Asian background (e) Chinese (f) Any other ethnic group

33 Notes: Front Completed by: Sign: Date: Reviewed by: Sign: Date: Notes: Back

34 School: Hertfordshire Physical Intervention Record Form School Number LOG NUMBER Name of Young Person M/F Looked After Child Y/N If LAC send copy to attached social worker Name of Adult reporting When did the incident occur? Date Time Please describe the incident. Be brief. E.g. where, what was happening at the time. Who else was in the vicinity? 6 What other strategies were used before physical intervention? Why was physical intervention deemed necessary? Staff involved Name Designation TCI/ Approach /NAPPI Date of last training or update Involvement Physical (P) Observer (O) Signed What holds were used? Tick as appropriate. Tick only holds you are trained to use. If you have used a hold for which you have not received training make a note under Other Approach 2 person *tuck / bar over / seated / standing / kneeing / seated/ lying on floor *delete as appropriate 2 person escort TCI Team Restraint Small child restraint NAPPI Capture wrap Other Please give details Duration of restraint If young person was held on the ground did they go independently?

35 BEHAVIOUR MANAGEMENT / HANDLING PLAN / ICMP ETC Has the young person been held before Is a Behaviour Management / Handling Plan / ICMP etc in place? Were the pre crisis strategies outlined in the plan followed? If not indicate why? (e.g., there was not time etc.) NB Good practice indicates that schools should review what happened and consider what lessons can be learned, which may have implications for the future management of the young person. These need not be added to this form but should be incorporated in the individual plans for the young person following review. INDIVIDUAL PLAN A young person should have an individual plan clearly detailing proactive and reactive strategies and physical intervention approaches if they have been involved in physical interventions on more than one occasion Does the plan need to be reviewed as a result of this incident If Yes, estimate the period (less than 4 weeks) within which the review will take place..weeks INTERNAL REPORTING To whom was the incident reported? When was it reported? Date/time Date / /. Time INJURIES Name Injury Treatment Please specify any related record forms completed (please tick) Incident Form Accident Book Racist Incident Form ICMP/BMP Body Map (for injuries marks to the young person) Violent Incident Record Other.

36 REPORTING TO PARENTS/CARERS/SOCIAL WORKER IN THE CASE OF LAC Parents / Carers/ social worker were informed YES / NO Date Time By Whom What form of contact Signature of person reporting the incident. Job title.. Headteacher s signature Date Time. NB Heads must sign each entry off as soon as possible after an incident. YOUNG PERSON S VIEW ( Where practical) Signature Date Time (a) White British Irish Traveller from Irish heritage Gypsy Any other White background Italian Turkish (d) Black or Black British Caribbean African Any other Black background (b) Mixed (c) Asian or Asian British White and Black Caribbean Indian White and Black African White and Asian Pakistani Any other mixed background Bangladeshi Any other Asian background (e) Chinese (f) Any other ethnic group

37 Notes: Front Completed by: Sign: Date: Reviewed by: Sign: Date: Notes: Back

38 School: Hertfordshire Physical Intervention Record Form School Number LOG NUMBER Name of Young Person M/F Looked After Child Y/N If LAC send copy to attached social worker Name of Adult reporting When did the incident occur? Date Time Please describe the incident. Be brief. E.g. where, what was happening at the time. Who else was in the vicinity? 7 What other strategies were used before physical intervention? Why was physical intervention deemed necessary? Staff involved Name Designation TCI/ Approach /NAPPI Date of last training or update Involvement Physical (P) Observer (O) Signed What holds were used? Tick as appropriate. Tick only holds you are trained to use. If you have used a hold for which you have not received training make a note under Other Approach 2 person *tuck / bar over / seated / standing / kneeing / seated/ lying on floor *delete as appropriate 2 person escort TCI Team Restraint Small child restraint NAPPI Capture wrap Other Please give details Duration of restraint If young person was held on the ground did they go independently?

39 BEHAVIOUR MANAGEMENT / HANDLING PLAN / ICMP ETC Has the young person been held before Is a Behaviour Management / Handling Plan / ICMP etc in place? Were the pre crisis strategies outlined in the plan followed? If not indicate why? (e.g., there was not time etc.) NB Good practice indicates that schools should review what happened and consider what lessons can be learned, which may have implications for the future management of the young person. These need not be added to this form but should be incorporated in the individual plans for the young person following review. INDIVIDUAL PLAN A young person should have an individual plan clearly detailing proactive and reactive strategies and physical intervention approaches if they have been involved in physical interventions on more than one occasion Does the plan need to be reviewed as a result of this incident If Yes, estimate the period (less than 4 weeks) within which the review will take place..weeks INTERNAL REPORTING To whom was the incident reported? When was it reported? Date/time Date / /. Time INJURIES Name Injury Treatment Please specify any related record forms completed (please tick) Incident Form Accident Book Racist Incident Form ICMP/BMP Body Map (for injuries marks to the young person) Violent Incident Record Other.

40 REPORTING TO PARENTS/CARERS/SOCIAL WORKER IN THE CASE OF LAC Parents / Carers/ social worker were informed YES / NO Date Time By Whom What form of contact Signature of person reporting the incident. Job title.. Headteacher s signature Date Time. NB Heads must sign each entry off as soon as possible after an incident. YOUNG PERSON S VIEW ( Where practical) Signature Date Time (a) White British Irish Traveller from Irish heritage Gypsy Any other White background Italian Turkish (d) Black or Black British Caribbean African Any other Black background (b) Mixed (c) Asian or Asian British White and Black Caribbean Indian White and Black African White and Asian Pakistani Any other mixed background Bangladeshi Any other Asian background (e) Chinese (f) Any other ethnic group

41 Notes: Front Completed by: Sign: Date: Reviewed by: Sign: Date: Notes: Back

42 School: Hertfordshire Physical Intervention Record Form School Number LOG NUMBER Name of Young Person M/F Looked After Child Y/N If LAC send copy to attached social worker Name of Adult reporting When did the incident occur? Date Time Please describe the incident. Be brief. E.g. where, what was happening at the time. Who else was in the vicinity? 8 What other strategies were used before physical intervention? Why was physical intervention deemed necessary? Staff involved Name Designation TCI/ Approach /NAPPI Date of last training or update Involvement Physical (P) Observer (O) Signed What holds were used? Tick as appropriate. Tick only holds you are trained to use. If you have used a hold for which you have not received training make a note under Other Approach 2 person *tuck / bar over / seated / standing / kneeing / seated/ lying on floor *delete as appropriate 2 person escort TCI Team Restraint Small child restraint NAPPI Capture wrap Other Please give details Duration of restraint If young person was held on the ground did they go independently?

43 BEHAVIOUR MANAGEMENT / HANDLING PLAN / ICMP ETC Has the young person been held before Is a Behaviour Management / Handling Plan / ICMP etc in place? Were the pre crisis strategies outlined in the plan followed? If not indicate why? (e.g., there was not time etc.) NB Good practice indicates that schools should review what happened and consider what lessons can be learned, which may have implications for the future management of the young person. These need not be added to this form but should be incorporated in the individual plans for the young person following review. INDIVIDUAL PLAN A young person should have an individual plan clearly detailing proactive and reactive strategies and physical intervention approaches if they have been involved in physical interventions on more than one occasion Does the plan need to be reviewed as a result of this incident If Yes, estimate the period (less than 4 weeks) within which the review will take place..weeks INTERNAL REPORTING To whom was the incident reported? When was it reported? Date/time Date / /. Time INJURIES Name Injury Treatment Please specify any related record forms completed (please tick) Incident Form Accident Book Racist Incident Form ICMP/BMP Body Map (for injuries marks to the young person) Violent Incident Record Other.

44 REPORTING TO PARENTS/CARERS/SOCIAL WORKER IN THE CASE OF LAC Parents / Carers/ social worker were informed YES / NO Date Time By Whom What form of contact Signature of person reporting the incident. Job title.. Headteacher s signature Date Time. NB Heads must sign each entry off as soon as possible after an incident. YOUNG PERSON S VIEW ( Where practical) Signature Date Time (a) White British Irish Traveller from Irish heritage Gypsy Any other White background Italian Turkish (d) Black or Black British Caribbean African Any other Black background (b) Mixed (c) Asian or Asian British White and Black Caribbean Indian White and Black African White and Asian Pakistani Any other mixed background Bangladeshi Any other Asian background (e) Chinese (f) Any other ethnic group

45 Notes: Front Completed by: Sign: Date: Reviewed by: Sign: Date: Notes: Back

46 School: Hertfordshire Physical Intervention Record Form School Number LOG NUMBER Name of Young Person M/F Looked After Child Y/N If LAC send copy to attached social worker Name of Adult reporting When did the incident occur? Date Time Please describe the incident. Be brief. E.g. where, what was happening at the time. Who else was in the vicinity? 9 What other strategies were used before physical intervention? Why was physical intervention deemed necessary? Staff involved Name Designation TCI/ Approach /NAPPI Date of last training or update Involvement Physical (P) Observer (O) Signed What holds were used? Tick as appropriate. Tick only holds you are trained to use. If you have used a hold for which you have not received training make a note under Other Approach 2 person *tuck / bar over / seated / standing / kneeing / seated/ lying on floor *delete as appropriate 2 person escort TCI Team Restraint Small child restraint NAPPI Capture wrap Other Please give details Duration of restraint If young person was held on the ground did they go independently?

47 BEHAVIOUR MANAGEMENT / HANDLING PLAN / ICMP ETC Has the young person been held before Is a Behaviour Management / Handling Plan / ICMP etc in place? Were the pre crisis strategies outlined in the plan followed? If not indicate why? (e.g., there was not time etc.) NB Good practice indicates that schools should review what happened and consider what lessons can be learned, which may have implications for the future management of the young person. These need not be added to this form but should be incorporated in the individual plans for the young person following review. INDIVIDUAL PLAN A young person should have an individual plan clearly detailing proactive and reactive strategies and physical intervention approaches if they have been involved in physical interventions on more than one occasion Does the plan need to be reviewed as a result of this incident If Yes, estimate the period (less than 4 weeks) within which the review will take place..weeks INTERNAL REPORTING To whom was the incident reported? When was it reported? Date/time Date / /. Time INJURIES Name Injury Treatment Please specify any related record forms completed (please tick) Incident Form Accident Book Racist Incident Form ICMP/BMP Body Map (for injuries marks to the young person) Violent Incident Record Other.

48 REPORTING TO PARENTS/CARERS/SOCIAL WORKER IN THE CASE OF LAC Parents / Carers/ social worker were informed YES / NO Date Time By Whom What form of contact Signature of person reporting the incident. Job title.. Headteacher s signature Date Time. NB Heads must sign each entry off as soon as possible after an incident. YOUNG PERSON S VIEW ( Where practical) Signature Date Time (a) White British Irish Traveller from Irish heritage Gypsy Any other White background Italian Turkish (d) Black or Black British Caribbean African Any other Black background (b) Mixed (c) Asian or Asian British White and Black Caribbean Indian White and Black African White and Asian Pakistani Any other mixed background Bangladeshi Any other Asian background (e) Chinese (f) Any other ethnic group

49 Notes: Front Completed by: Sign: Date: Reviewed by: Sign: Date: Notes: Back

50 School: Hertfordshire Physical Intervention Record Form School Number LOG NUMBER Name of Young Person M/F Looked After Child Y/N If LAC send copy to attached social worker Name of Adult reporting When did the incident occur? Date Time Please describe the incident. Be brief. E.g. where, what was happening at the time. Who else was in the vicinity? 10 What other strategies were used before physical intervention? Why was physical intervention deemed necessary? Staff involved Name Designation TCI/ Approach /NAPPI Date of last training or update Involvement Physical (P) Observer (O) Signed What holds were used? Tick as appropriate. Tick only holds you are trained to use. If you have used a hold for which you have not received training make a note under Other Approach 2 person *tuck / bar over / seated / standing / kneeing / seated/ lying on floor *delete as appropriate 2 person escort TCI Team Restraint Small child restraint NAPPI Capture wrap Other Please give details Duration of restraint If young person was held on the ground did they go independently?

51 BEHAVIOUR MANAGEMENT / HANDLING PLAN / ICMP ETC Has the young person been held before Is a Behaviour Management / Handling Plan / ICMP etc in place? Were the pre crisis strategies outlined in the plan followed? If not indicate why? (e.g., there was not time etc.) NB Good practice indicates that schools should review what happened and consider what lessons can be learned, which may have implications for the future management of the young person. These need not be added to this form but should be incorporated in the individual plans for the young person following review. INDIVIDUAL PLAN A young person should have an individual plan clearly detailing proactive and reactive strategies and physical intervention approaches if they have been involved in physical interventions on more than one occasion Does the plan need to be reviewed as a result of this incident If Yes, estimate the period (less than 4 weeks) within which the review will take place..weeks INTERNAL REPORTING To whom was the incident reported? When was it reported? Date/time Date / /. Time INJURIES Name Injury Treatment Please specify any related record forms completed (please tick) Incident Form Accident Book Racist Incident Form ICMP/BMP Body Map (for injuries marks to the young person) Violent Incident Record Other.

52 REPORTING TO PARENTS/CARERS/SOCIAL WORKER IN THE CASE OF LAC Parents / Carers/ social worker were informed YES / NO Date Time By Whom What form of contact Signature of person reporting the incident. Job title.. Headteacher s signature Date Time. NB Heads must sign each entry off as soon as possible after an incident. YOUNG PERSON S VIEW ( Where practical) Signature Date Time (a) White British Irish Traveller from Irish heritage Gypsy Any other White background Italian Turkish (d) Black or Black British Caribbean African Any other Black background (b) Mixed (c) Asian or Asian British White and Black Caribbean Indian White and Black African White and Asian Pakistani Any other mixed background Bangladeshi Any other Asian background (e) Chinese (f) Any other ethnic group

53 Notes: Front Completed by: Sign: Date: Reviewed by: Sign: Date: Notes: Back

54 School: Hertfordshire Physical Intervention Record Form School Number LOG NUMBER Name of Young Person M/F Looked After Child Y/N If LAC send copy to attached social worker Name of Adult reporting When did the incident occur? Date Time Please describe the incident. Be brief. E.g. where, what was happening at the time. Who else was in the vicinity? 11 What other strategies were used before physical intervention? Why was physical intervention deemed necessary? Staff involved Name Designation TCI/ Approach /NAPPI Date of last training or update Involvement Physical (P) Observer (O) Signed What holds were used? Tick as appropriate. Tick only holds you are trained to use. If you have used a hold for which you have not received training make a note under Other Approach 2 person *tuck / bar over / seated / standing / kneeing / seated/ lying on floor *delete as appropriate 2 person escort TCI Team Restraint Small child restraint NAPPI Capture wrap Other Please give details Duration of restraint If young person was held on the ground did they go independently?

55 BEHAVIOUR MANAGEMENT / HANDLING PLAN / ICMP ETC Has the young person been held before Is a Behaviour Management / Handling Plan / ICMP etc in place? Were the pre crisis strategies outlined in the plan followed? If not indicate why? (e.g., there was not time etc.) NB Good practice indicates that schools should review what happened and consider what lessons can be learned, which may have implications for the future management of the young person. These need not be added to this form but should be incorporated in the individual plans for the young person following review. INDIVIDUAL PLAN A young person should have an individual plan clearly detailing proactive and reactive strategies and physical intervention approaches if they have been involved in physical interventions on more than one occasion Does the plan need to be reviewed as a result of this incident If Yes, estimate the period (less than 4 weeks) within which the review will take place..weeks INTERNAL REPORTING To whom was the incident reported? When was it reported? Date/time Date / /. Time INJURIES Name Injury Treatment Please specify any related record forms completed (please tick) Incident Form Accident Book Racist Incident Form ICMP/BMP Body Map (for injuries marks to the young person) Violent Incident Record Other.

56 REPORTING TO PARENTS/CARERS/SOCIAL WORKER IN THE CASE OF LAC Parents / Carers/ social worker were informed YES / NO Date Time By Whom What form of contact Signature of person reporting the incident. Job title.. Headteacher s signature Date Time. NB Heads must sign each entry off as soon as possible after an incident. YOUNG PERSON S VIEW ( Where practical) Signature Date Time (a) White British Irish Traveller from Irish heritage Gypsy Any other White background Italian Turkish (d) Black or Black British Caribbean African Any other Black background (b) Mixed (c) Asian or Asian British White and Black Caribbean Indian White and Black African White and Asian Pakistani Any other mixed background Bangladeshi Any other Asian background (e) Chinese (f) Any other ethnic group

57 Notes: Front Completed by: Sign: Date: Reviewed by: Sign: Date: Notes: Back

58 School: Hertfordshire Physical Intervention Record Form School Number LOG NUMBER Name of Young Person M/F Looked After Child Y/N If LAC send copy to attached social worker Name of Adult reporting When did the incident occur? Date Time Please describe the incident. Be brief. E.g. where, what was happening at the time. Who else was in the vicinity? 12 What other strategies were used before physical intervention? Why was physical intervention deemed necessary? Staff involved Name Designation TCI/ Approach /NAPPI Date of last training or update Involvement Physical (P) Observer (O) Signed What holds were used? Tick as appropriate. Tick only holds you are trained to use. If you have used a hold for which you have not received training make a note under Other Approach 2 person *tuck / bar over / seated / standing / kneeing / seated/ lying on floor *delete as appropriate 2 person escort TCI Team Restraint Small child restraint NAPPI Capture wrap Other Please give details Duration of restraint If young person was held on the ground did they go independently?

59 BEHAVIOUR MANAGEMENT / HANDLING PLAN / ICMP ETC Has the young person been held before Is a Behaviour Management / Handling Plan / ICMP etc in place? Were the pre crisis strategies outlined in the plan followed? If not indicate why? (e.g., there was not time etc.) NB Good practice indicates that schools should review what happened and consider what lessons can be learned, which may have implications for the future management of the young person. These need not be added to this form but should be incorporated in the individual plans for the young person following review. INDIVIDUAL PLAN A young person should have an individual plan clearly detailing proactive and reactive strategies and physical intervention approaches if they have been involved in physical interventions on more than one occasion Does the plan need to be reviewed as a result of this incident If Yes, estimate the period (less than 4 weeks) within which the review will take place..weeks INTERNAL REPORTING To whom was the incident reported? When was it reported? Date/time Date / /. Time INJURIES Name Injury Treatment Please specify any related record forms completed (please tick) Incident Form Accident Book Racist Incident Form ICMP/BMP Body Map (for injuries marks to the young person) Violent Incident Record Other.

60 REPORTING TO PARENTS/CARERS/SOCIAL WORKER IN THE CASE OF LAC Parents / Carers/ social worker were informed YES / NO Date Time By Whom What form of contact Signature of person reporting the incident. Job title.. Headteacher s signature Date Time. NB Heads must sign each entry off as soon as possible after an incident. YOUNG PERSON S VIEW ( Where practical) Signature Date Time (a) White British Irish Traveller from Irish heritage Gypsy Any other White background Italian Turkish (d) Black or Black British Caribbean African Any other Black background (b) Mixed (c) Asian or Asian British White and Black Caribbean Indian White and Black African White and Asian Pakistani Any other mixed background Bangladeshi Any other Asian background (e) Chinese (f) Any other ethnic group

61 Notes: Front Completed by: Sign: Date: Reviewed by: Sign: Date: Notes: Back

62 School: Hertfordshire Physical Intervention Record Form School Number LOG NUMBER Name of Young Person M/F Looked After Child Y/N If LAC send copy to attached social worker Name of Adult reporting When did the incident occur? Date Time Please describe the incident. Be brief. E.g. where, what was happening at the time. Who else was in the vicinity? 13 What other strategies were used before physical intervention? Why was physical intervention deemed necessary? Staff involved Name Designation TCI/ Approach /NAPPI Date of last training or update Involvement Physical (P) Observer (O) Signed What holds were used? Tick as appropriate. Tick only holds you are trained to use. If you have used a hold for which you have not received training make a note under Other Approach 2 person *tuck / bar over / seated / standing / kneeing / seated/ lying on floor *delete as appropriate 2 person escort TCI Team Restraint Small child restraint NAPPI Capture wrap Other Please give details Duration of restraint If young person was held on the ground did they go independently?

63 BEHAVIOUR MANAGEMENT / HANDLING PLAN / ICMP ETC Has the young person been held before Is a Behaviour Management / Handling Plan / ICMP etc in place? Were the pre crisis strategies outlined in the plan followed? If not indicate why? (e.g., there was not time etc.) NB Good practice indicates that schools should review what happened and consider what lessons can be learned, which may have implications for the future management of the young person. These need not be added to this form but should be incorporated in the individual plans for the young person following review. INDIVIDUAL PLAN A young person should have an individual plan clearly detailing proactive and reactive strategies and physical intervention approaches if they have been involved in physical interventions on more than one occasion Does the plan need to be reviewed as a result of this incident If Yes, estimate the period (less than 4 weeks) within which the review will take place..weeks INTERNAL REPORTING To whom was the incident reported? When was it reported? Date/time Date / /. Time INJURIES Name Injury Treatment Please specify any related record forms completed (please tick) Incident Form Accident Book Racist Incident Form ICMP/BMP Body Map (for injuries marks to the young person) Violent Incident Record Other.

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