Restraint Reduction and Positive Behaviour Support Audit - Care Homes
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- Is there a restraint reduction policy in place that reflects a commitment to least-restrictive, rights-based care?
- Are all staff trained in positive behaviour support (PBS), de-escalation, and alternatives to restraint?
- Are behaviour support plans in place for residents who display behaviours of distress, with proactive and preventative strategies clearly outlined?
- Are behaviour plans developed with input from residents, families, and professionals (e.g., mental health, SALT, psychology)?
- Are incidents of restraint or restrictive interventions recorded accurately, reviewed, and analysed for learning?
- Are physical interventions used only as a last resort, for the shortest duration, and by trained staff?
- Are residents regularly assessed for capacity and supported to make their own decisions wherever possible?
- Are all restrictive practices (e.g., bed rails, door sensors, 1:1 observations) justified, risk-assessed, and reviewed regularly?
- Are staff supported to reflect on and debrief after incidents involving restraint or distressed behaviour?
- Are incident records monitored to identify patterns or environmental factors that may be triggering behaviours?
- Is the use of PRN medication for behavioural control monitored and reviewed by appropriate clinical leads?
- Are there protocols in place for obtaining consent (or best interest decisions) before applying any restrictive measures?
- Is there a focus on understanding unmet needs, trauma, communication challenges, or medical issues behind behaviours?
- Are restrictive practices removed or reduced as soon as safe and appropriate, with evidence of review?
- Are environmental adjustments (e.g., lighting, noise reduction, activity adaptation) used to prevent escalation?
- Is feedback from residents involved in incidents used to inform future support strategies where possible?
- Are families and advocates kept informed of incidents involving restraint or interventions that limit liberty?
- Is PBS discussed regularly in team meetings and supervisions to build staff confidence and shared strategies?
- Are the use of restraint or restriction audited regularly and discussed at governance level?
- Is the care home engaged in sector-wide restraint reduction programmes or learning networks?
- Are outcomes from behaviour support plans tracked to ensure interventions are improving wellbeing and reducing risk?
- Is the language used in care plans, handovers, and reports respectful, non-blaming, and person-centred?
- Are staff able to challenge the unnecessary use of restrictions or escalate concerns appropriately?
- Is there evidence that restraint reduction has led to improvements in quality of life and satisfaction for residents?
- Are restrictive interventions subject to incident reporting and analysis even when planned or low-level (e.g., door alarms)?