Control, Discipline and Restrictive Physical Interventions

Transcription

1 Control, Discipline and Restrictive Physical Interventions SCOPE OF THIS POLICY This document outlines the policy of the Solihull Fostering Service on acceptable forms of control, discipline and restrictive physical interventions. It must be carefully read and retained by all staff and foster carers. No two children/ young people or carers are identical and in applying this policy carers will need to be mindful of the individual needs of specific children. They will also need to be aware that avoiding confrontation and rewarding good behaviour rather than punishing bad are often the most successful techniques available. The policy seeks to provide all parties involved with a framework within which necessary boundaries can be maintained, whilst safeguarding children, staff and foster carers. The main purpose of the policy is: a. To set out a clear policy on acceptable measures of discipline and restrictive physical interventions with children and young people placed with foster parents as required by regulation 13 of the Fostering Services Regulations b. To ensure that: 1. No form of corporal punishment is used on any child placed with a foster carer. 2. No child placed with foster carers is subject to any measure of control, restraint or discipline which is excessive or unreasonable. 3. Physical restraint is used on a child only where it is necessary to prevent injury to the foster child or other persons or likely serious damage to property c. To offer positive advice to carers on the discipline and control of often children and young people with complex needs d. To protect children and young people in care from inappropriate sanctions while giving them a firm structure in which they can develop e. To protect carers and their families, where necessary, from the effects of children and young people s behaviour and also from the consequences of action which has not been agreed f. To give social workers and support staff a framework for assisting carers in the care, discipline, and control of children and young people g. To ensure that children and young people who move between different forms of accommodation do not experience variations in discipline 1

2 OTHER RELEVANT DOCUMENTS Safe Care Policy Contents 1. Statutory Framework 2. Underlying Principles 3. Risk Assessment and Planning 4. Training and Support 5. When Discipline or Sanctions may be imposed 6. Non Permitted Discipline or Sanctions 7. Permitted Discipline or Sanctions 8. Restrictive Physical Intervention 9. Recording and Post Incident Management 10. Monitoring of Restrictive Physical Interventions 1. Statutory Framework The Fostering Service is required by Regulation 13 of the Fostering Services Regulations 2002 to prepare and implement a written policy on acceptable measures of control, restraint and discipline of children placed with foster parents. Regulation 28 - Schedule 5 and Standard 9.4 of the National Minimum Standards for Fostering Services requires that it is made clear to foster carers that corporal punishment is not acceptable. This is clearly set out in written information provided to foster carers and is part of the Foster Carer Agreement that all approved foster carers enter into with the Solihull Metropolitan Borough Council Fostering Service. In accordance with: Regulation 13 of the Fostering Services Regulations, 2002 Regulation 28 of the Fostering Services Regulations, 2002 Requirements/Specifications The fostering service provider needs to prepare and implement a written policy on acceptable measures of control, restraint and discipline of children placed with foster carers. The fostering service provider needs to enter into a written agreement with all approved carers (The Foster Care Agreement) covering the matters specified in Schedule 5 of the regulations. These include the requirement Not to administer corporal punishment to 2

3 any child. Standard 9.4 of the National Minimum Standards for Fostering, 2002 Section 3 Children Act, 1989 Fostering Service need to make it clear to carers that corporal punishment is not acceptable and set this out clearly in written information for carers. Parental Responsibility A person who (a) does not have parental responsibility for a particular child; but(b) has care of the child, may (subject to the provisions of this Act) do what is reasonable in all the circumstances of the case for the purpose of safeguarding or promoting the child's welfare. 2. Underlying Principles It is the duty of Fostering Service and foster carers to ensure that children and young people being cared for should have a positive experience of family life and be given the same access to opportunities and boundaries as other children and young people. The setting of appropriate boundaries and good order is a necessary aspect of family life to enable children and young people to develop in a safe and secure environment. Foster carers need to consider the individual needs of the children and young people maintaining safe, consistent and understandable boundaries encouraging positive behaviour. Staff will work with our children and young people, building strong positive relationships, empowering children and young people to take responsibility for their actions. Expectations of behaviour for staff, foster carers and children will be influenced by the care environment. In day to day decision making, staff or foster carers must demonstrate an appropriate balance between: The needs of individual children and young person; The needs of the group of children and/or young people living in the foster home; The protection of others (including the public) from harm; And specifically each member of the household's wishes and preferences. Staff and foster carers must make clear to children and young people the consequences of unacceptable behaviour. Any measure applied must be relevant to the incident, reasonable and carried out as close to the time of the incident as possible. The measures taken to respond to unacceptable behaviour must be proportionate and appropriate to the age, understanding and individual needs of the child. Relationships between Children Services staff, foster carers and children should be based on mutual respect and understanding. Clear professional and personal boundaries must be in place. All children and young people must be treated equally, without favouritism or prejudice. Staff, foster carers and children must be aware that each individual has rights and responsibilities in relation to the others that they live with, and the wider community. 3

4 All children and young people should be encouraged to develop an awareness of their rights and responsibilities and must be given information appropriate to their home environment. Specific information to provide includes: Children's guide on how to contact Children Rights Director for England. Solihull MBC complaints leaflet; NYAS and how to contact them;. 3. Risk Assessment and Planning 3.1 Prior to Placement Start Prior to the placement all information available about the child and young person, including information pertaining to behaviour and causes of any behavioural issues should be shared. A risk assessment must be completed by the social worker for each child prior to moving into the placement which will include any difficult or challenging behaviour, and whether or not restrictive physical intervention needs to be considered in exceptional circumstances. When a child or young person is moving into a foster care home, a risk assessment must be undertaken by the foster carer, supervising social worker and the child s social worker to consider the impact of the child moving into the placement and the children/ young people living in the home. When the placement is planned, a pre-placement planning meeting will be held to share information, plan introductions, complete the necessary paperwork and draw up the child/ young person s Placement Plan. The Placement Plan should be consistent with, and support by, the carers Safe Care Policy. This is also an opportunity for foster carers to be given any information known about the child/ young person. Where the placement has been made within a short time scale and a pre-placement meeting has not been held, a meeting must be held within 72 hours of the placement of the child/ young person. If a child or young person's behaviour regularly endangers them or others and restrictive physical intervention needs to be part of the plan for the child this must be subject to: A foster care placement risk assessment as part of the household safe care plan must involve the foster carers and lead professionals involved with the child; Foster Carers are trained in de-escalation strategies and techniques. For any physical interventions, it must be reported and recorded by foster carer, supervising social worker, fostering team manager, child s social worker. 4

5 3.2 After Placement Start If the challenging behaviour develops in the placement, a risk assessment and management plan should be completed and incorporated within the Safe Care Policy. It is also important to determine whether there are any medical conditions which might place the child/ young person at risk should particular techniques or methods of restrictive physical intervention be used. If so, this must be documented and drawn to the attention of those working with or looking after the child/ young person. If in doubt, medical advice must be sought. All foster carers must have a Safe Care Policy for their home and all the people living in it. Part of the policy must address how boundaries, discipline and behaviour will be managed in the foster home. The policy should be shared with the child/ young person before the placement commences and referred to in the Placement Plan. The Safe Care Policy must be reviewed when a new child enters the foster home and if the placement is permanent the policy must be reviewed annually with the supervising social worker. Where the child is being supported by the foster carer as part of the Short Breaks service, the Safe Care Policy must be discussed and agreed with the child's parents/primary caregivers and the supervising social worker at the Placement Planning Meeting. Short break carers will adhere to the foster care role and if there any restrictive physical interventions needed, alternative short break services must be considered. 4. Training and Support Training is provided to all foster carers. Foster carers are given on strategies for de-escalating, avoiding or diffusing difficult behaviour. 5. When Discipline or Sanctions may be imposed Sanctions can be very effective but, before imposing them, think about it. Most looked after children have come to view themselves, and are viewed, as failures. They may have had substantial experiences of sanctions, usually imposed inconsistently, unfairly or as acts of revenge. Before imposing sanctions, carers should do all they can to support and encourage children and young people to do well. If children or young people do not behave acceptably, strategies should be adopted that are encouraging and rewarding. Rather than noticing and sanctioning misbehaviour it is always better to notice and reward good behaviour - or any step in the right direction. For example, it may be more effective to allow a child to have use of a video or TV at bedtime for getting up on time; rather than taking the TV away for getting up late. The former is discouraging and causes resentment; the latter is encouraging, can improve self esteem and relationships between children and carers. Be creative, think outside the box! If children continue to behave in unacceptable ways, they should be reminded about what is expected and given further encouragement to get it right. If misbehaviour persists or is serious, effective use of reprimands can act as a disincentive or firm reminder. If this does not work, or may not, sanctions may be effective. 5

6 Where sanctions are used they must be reasonable and the minimum necessary to achieve the objective. Also, there should be a belief that the sanction will have the desired outcome - increasing the possibility that acceptable behaviour will follow. If sanctions are imposed, carers should apply the following principles: Sanctions must be the exception, not the rule. A Last Resort; Sanctions must not be imposed as acts of revenge or retaliation; Think before imposing the sanctions; don't apply it in the heat of the moment; Sanctions may only be imposed upon children for persistent or serious misbehaviour; where reminders and reprimands have already failed or are likely to fail; Sanctions should only be used if there is a reasonable chance they will have the desired effect of making the point and in reducing or preventing further unacceptable behaviour; Before applying any sanction, make sure the child is aware that his/her behaviour is unacceptable and, if possible, warn him/her that sanctions will be applied if the unacceptable behaviour continues; It is the certainty not the severity of sanctions that is important; Sanctions should only last as long as they need to and allow the child the opportunity to make a fresh start as quickly as possible. Discipline and sanctions should be discussed with managers, staff, foster carers, children and young people. Before any sanction is imposed, supervising social workers, foster carers and the child s social worker must be satisfied of the following: a. That the child/ young person was capable of behaving acceptably and understands (age appropriately) what was required of him/her. Short breaks carers must be aware of the impact of disability on the child's behaviour. Some conditions, such as autistic spectrum disorders, may predispose the child to misunderstanding social cues. Children with a learning disability may not understand abstract concepts and may need very clear and concise messages about what is required; b. Supervising social workers must monitor all sanctions to ensure they are used appropriately. 6. Non Permitted Discipline or Sanctions Solihull MBC expects all its foster carers to comply with The Children Act The following forms of discipline would all be in contravention of the Act: Corporal punishment, i.e. any intentional application of force as punishment, including slapping, punching, rough handling, squeezing, pinching, shacking and throwing missiles. Deprivation of food and drink. Restriction on visits to or by a child or young person, or any restriction or delay in agreed levels of communication by telephone or post with: o o o A parent Any person who is not a parent but who has parental responsibility Relatives or friends identified within the PIR and subsequent care planning documentation 6

7 o o o o Any Independent Visitor appointed for a child or young person A child or young person s social worker A guardian ad litem of the child or young person Any solicitor for the time being acting for a child or whom a child wishes to instruct. Any requirement that a child or young person wears distinctive or inappropriate clothes Inappropriate use (e.g. changing the quantities of the prescribed medication without checking it out with a health professional) or withholding of medication or medical or dental treatment Use of accommodation to physically restrict a child or young person Intentional deprivation of sleep The withholding of any aids or equipment needed by a disabled child Any measure which punishes more than one child for the behaviour of an individual child Imposition of fines (except by way of repayment or compensation) Intimate physical examination of a child or young person It is important that sanctions are relevant used sparingly time limited justified follow the behaviour as quickly as possible Unacceptable sanctions include those that humiliate a child or young person, cause them to be ridiculed, and have been experienced under different circumstances at home. At the point of approval foster carers are asked to give a formal written undertaking Not to use corporal punishment on any child placed. This forms part of the Foster Care Agreement. 7

8 7. Permitted Discipline and Sanctions Individual carers will need to discuss the forms of discipline and sanctions to be used within their home with assessing and supervising social workers. These will vary from carer to carer and sometimes from placement to placement. Factors that need to be taken into account include: the usual forms of discipline and sanctions used with the carer s own children the carer s experience of what works well for them the carer s own experience of discipline and sanctions as a child the age and ability of children/ young person to be placed the foster child s history, including any experience of abuse any needs of foster children arising from a disability religious and cultural issues. Children should be informed about the range of sanctions that may be imposed upon them and the possible circumstances which may result in sanctions. Sanctions must be set out in writing in the child's risk assessment and/or safe care policy as appropriate to the placement type. 8. Restrictive Physical Interventions 8.1 Definition Restrictive physical interventions or restraint is an act or the quality of holding back, limiting, or controlling something or somebody. Physical restraint is by definition against the child/ young person s stated will. Its aim is to take control from the child or young person, to stop them from doing whatever they are doing, using the minimum amount of force and therefore the minimum amount of time necessary. 8.2 Underlying principles The ethos of the fostering service is that restraint will not be used with children and young people and the alternative strategies will be promoted. Exceptional circumstances requiring the use of restraint should be carefully monitored and restricted. Care should be taken to ensure that a culture where restraint is permissible does not develop. There is a scale of physical interventions, which could range from a physical prompt, through physically leading a child/ young person away from a situation, to actually holding a child and thereby restricting their freedom of movement. Whilst some children, particularly those with learning disabilities, may need a physical prompt to assist them in daily activities physically restrictive interventions should not be used. 8

9 Carers could face either criminal or civil proceedings if they commit an act against a child or young person that amounts to a civil wrong or criminal act. These acts include assault and/or battery and false imprisonment of the young person. Liability in civil law can also arise if a person causes injury to another by their negligence. This policy is designed to safely protect children and young people and minimise the risks of an allegation being levelled at a carer and proper recording of incidents will afford some protection. If carers are confronted with allegations about their behaviour, it is important that they seek legal advice. 8.3 Recognising restraint Carers have to bear in mind that the legal duty of care that applies to all those working with children and young people means that doing nothing may be construed by the law as negligence in terms of this duty. There are circumstances when it would be appropriate to intervene physically to prevent behaviour that is harmful to the child or others. Examples of such circumstance might include: to prevent one child/ young person attacking another a younger child refusing to dress appropriately, such as refusing to wear shoes to go outside a child refusing to leave another person s room to prevent a young child from running away (e.g. running onto a busy road, getting to close to the edge of railway platforms) In such circumstances: Physical intervention without contact, such as standing in the way or some forms of intervention with contact, such as holding the child s hand or placing a hand on their shoulder, may well be appropriate Some forms of physical intervention may have a positive impact on the child, such as holding or cuddling a distressed child, or holding a child for their own safety. In themselves, none of the above interventions require any particular recording although carers must always be mindful of the circumstances of their intervention and if in doubt follow the instructions below for recording physical constraints. Physical restraint must only be used: If a child is in immediate danger of harming themselves, others or causing significant damage to property. To defend yourself and others from physical violence or threatened violence. Restraint should never be used: To establish control over a child or to demonstrate who is in charge 9

10 To punish a child In a situation where it is possible for the foster carer to remove the other children and themselves out from danger 8.4 Guidance on use of restraint Carers should: Use physical restraint as a measure of last resort Ideally involve more than one carer, even if the second carer does not physically intervene but witnesses the intervention Always seek to avoid the need for physical restraint through dialogue or diversion Where possible pre-warn the child that a restraint might take place if their behaviour continues Have sound reasons for believing that other methods of intervention would not be appropriate or would fail. Give consideration to the age and understanding of the child Take into account disability and cultural factors that might also be significant in determining the type of intervention. Be mindful at all times of a child s previous experiences. A child who has been physically or sexually abused may experience any form of physical contact differently from how it was intended. Not attempt any intervention if they do not think it is achievable. Give consideration to the involvement of the emergency services, the timing and the place of the restraint, paying attention to minimising the involvement of other children, as to witness a restraint may be distressing for any child. Not use restraint to force compliance on the child s part or when there is no immediate risk involved, or as a means of punishment. Record any use of restraint as soon as possible after incident. Verbally advise the child s social worker of the use of restraint within one working day at the latest. 8.5 Medical Examination In any care environment where physical intervention has been used, the child, staff/carers and others involved must be given the opportunity to see a medical practitioner, even if there are no apparent or reported injuries; The medical practitioner, if seen, must be informed that any injuries may have been caused from an incident involving physical intervention; 10

11 Whether or not the child or others decide to see a medical practitioner this must be recorded, together with the outcome. 9. Recording and Post Incident Management Recording of very difficult or challenging behaviour will be kept by the foster carer in their foster carer diary and in daily and weekly recording sheets. This is discussed with the child's social worker and their supervising social worker who will keep appropriate records. If a child/ young person s behaviour regularly seriously endangers themselves or others and restrictive physical intervention needs to be part of the plan for the child/ young person this should be subject to: A risk assessment involving the foster carers and professionals involved with the child/ young person All other interventions should have been considered including involving the Children s Disability Team (for disabled children), or CAMHS (Child and Adolescent Mental Health Team) in making a behaviour management plan for the child/ young person The carers having attended specialist course All incidents involving physical restraint must be recorded on an Incident Report Form. However, the first consideration needs to be whether medical attention is required for the child/ young person or anyone else involved. Carers will need to exercise their own judgment as to when other forms of control and discipline warrant recording. Some of the issues carers need to take into account include: Did the child/ young person view the action taken as fair and appropriate? Was the action taken discussed with and/or witnessed by others? Was the action taken agreed by the child s social worker and/or birth parents? Could any other party misunderstand the action taken or view it as inappropriate? If the carer is in any doubt about whether any action taken should be recorded or not, then this is probably an indication that it should. In such circumstances the carer should record the incident and bring it to the attention of the child s and fostering social worker at the earliest possible opportunity. The Incident Report Form must be completed by the person making the restraint and sent to the child or young person s social worker and the Fostering Social Worker. The report must be placed on the child or young person s and the foster carer s files. Post incident/restraint management must give consideration to: Initiating or updating the risk assessment concerning the child/ young person and whether changes need to be made to their individual care and/or placement plan 11

12 Wherever necessary the allocated Fostering Social Worker should organise a Post Incident/Restraint Debrief meeting for carers led by the Fostering Social Worker. Time and space will also be needed for the child s social worker to talk through the incident with the child or young person to allow for the expression of feelings and decide upon next steps, and identify any post incident support which may be necessary. If this meeting does not take place the reasons for such decision must be clearly recorded on the Incident Report Form. 10. Monitoring of Restrictive Physical Interventions The Fostering Team Manager should be provided with copies of all written incident reports following physical interventions by foster carers. The Fostering Team Manager will include a summary of these reports in the Fostering Service Annual Report which will be given to the Head of Service and the Fostering Panel. 12