Restrictive Physical Intervention and Restraint

For a small minority of children/young people or at certain times in a child or young person's life, physical intervention or restraint may be needed. However, physical restraint should be avoided as far as possible and should only be used if there are good reasons for believing that immediate action is necessary to prevent a child or young person causing significant injury to themselves or to others, or causing serious damage to property. Other techniques should be used before physical constraint is considered.

The need for physical restraint may arise when a child is engaged in violence towards themselves and/or others, damage to property and if the child's behaviour is out of control and none of the other strategies are working.

It is important to be aware that use of restraint can pose risks to the safety of the child, to the safety of the foster carer applying it, and potentially to others who are present.

It is also important to determine whether there are any medical conditions which might place the child at risk should particular techniques or methods of physical intervention be used. This should be known and recorded in the placement plan.

See also: Positive Relationships and Behaviour Support Procedure.

Physical restraint refers to a situation where you have held or held down a child to prevent the situation from escalating. Minimum force should be used and it should only be used for a short time period. It should be proportionate and the least restrictive to the child. For example:

• A child being held on the floor;
• A child being held by two or more people;
• Any technique involving a child being held by one person if the balance of power is so great that the child is effectively overpowered; e.g. where a child under the age of ten is held firmly by an adult;
• The locking or bolting a door in order to contain or prevent a child from leaving.

You will receive appropriate training in safe use of restraint, including training on the applicable legislative framework. Any use of restraint must be consistent with this training, the Fostering Service's procedures and must at all times be focussed on the need to protect the child and those around them.

Please note that face-down holds are dangerous and should not be used.

At no time should you act unless you are confident of managing the situation safely, without escalation or further injury. 

Holding involves the child being held firmly by one person. The child retains a degree of mobility and can leave if they want to.

This is when you touch the child lightly to lead, guide or stop the child.

This form of control is where you use your presence to try and stop the child leaving by standing in the doorway to negotiate a change in the child's plans or actions.

Any types of restraints or physical interventions which are in place to keep a child safe due to their behaviours and which restrict a child's liberty should be recorded by the child's social worker on the child's placement plan and Educational Health Care Plan. For example wheelchair restraints to stop a child running off when they have no or little road safety sense.

For a young person who is over the age of 16 who has care and support needs, any restrictions or agreed interventions will need to be recorded and a Mental Capacity Act assessment/Best Interest decision will need to be completed.

Principles to be followed:

• The child's breathing should not be affected;
• Others may need to leave the room;
• Move obstacles out of the way if possible;
• The intervention should not be able to be interpreted as sexual;
• Do not inflict pain or injuries or threaten the child in any way;
• Avoid vulnerable parts of the body;
• Do not pull or put pressure on joint areas;
• Interventions should not be used to punish or humiliate the child;
• Try and maintain the dignity of the child and talk to them whilst the intervention is taking place in a calm reassuring way;
• Make sure the intervention takes place for the shortest possible time.

All incidents of restraint will be reviewed, recorded and monitored. When you have applied restraint the Fostering Service must be informed within 24 hours. The child's social worker should also be informed.

An incident report should be sent to the Fostering Service detailing the circumstances around the incident. This is an important tool in understanding what has happened and why. The report should include what has happened, who was present, any triggers before hand, if any injuries occurred and what happened after the intervention. The views of the child must be sought, dependent on their age and understanding, and used in the process of reflecting, understanding and informing future practice.

The Fostering Service and child's social worker should support you and child after an incident has occurred.

Decisions will then be made about how any further situations need to be managed and risk-assessed.

If the police are involved, the Regulatory Authority must also be notified by the Fostering Service. See Significant Events and Notifications – When I need to tell other people about things Procedure.