Latest news from Ethical Care

Friday, 7 May 2021

BILD ACT Certification Scheme

Certification of training services is now a requirement for NHS commissioned services. In addition CQC expect regulated services to use certified training.

Ethical Care Control & Restraint (UK) Ltd. are an organisation who are working towards certification

Ethical Care have achieved our BS EN ISO 9001:2015 accreditation for the 12th year running

The Quality Management System of Ethical Care Control & Restraint (UK) Ltd has been assessed by The Certification Group for conformance to the requirements of: BS EN ISO 9001:2015

Scope of Registration: The provision of Control and Restraint (C&R) / Physical Intervention (PI) Training, including Conflict management, in the UK

Signed on Behalf of The Certification Group, Certification Manager: Elaine Hanaghan

Ethical Care have achieved our OHSAS 18001:2007 accreditation for the 12th year running

The Occupational Health and Safety Management System of Ethical Care Control & Restraint (UK) Ltd has been assessed by The Certification Group for conformance to the requirements of: OHSAS 18001:2007

Scope of Registration: The provision of Control and Restraint (C&R) / Physical Intervention (PI) Training, including Conflict management, in the UK

Signed on Behalf of The Certification Group, Certification Manager: Elaine Hanaghan

Friday, 26 June 2020

A long-awaited review has concluded

Pain-inducing restraint techniques should only be used on children in custody as an “absolute exception” to save life or prevent serious harm, a long-awaited review has concluded, though it has stopped short of calling for an outright ban.
 
The review, led by the former chair of the Youth Justice Board Charlie Taylor, examined the inclusion of painful techniques in the minimising and managing physical restraint (MMPR) syllabus, the key training programme for officers in youth custody in England and Wales. Among 15 recommendations, the report stated the training programme “should be amended to remove the use of pain-inducing techniques from its syllabus” and that “pain is not permitted to be used to end long restraints”.
 
The report, commissioned by the Ministry of Justice (MoJ), does recommend that pain-inducing techniques can be used in exceptional circumstances to prevent serious physical harm to either children or adults. Taylor criticised the inclusion of such techniques in the MMPR programme, stating: “I believe that this places the use of pain-inducing techniques on a spectrum that makes it an acceptable and normal response rather than what [it] should be, the absolute exception.”
 
He said this had “contributed to the overuse of these techniques that I so frequently witnessed during this review”. Taylor also recommended that restraint not be permitted for “good order and discipline” during children’s journeys to and from custodial institutions, though he did say there may be exceptional circumstances “when a member of staff is acting in self-defence and in an emergency”.
 
A charity, Article 39, started legal action over the authorisation of escort officers from the contractor GEOAmey to use pain-inflicting restraint techniques on children as young as 10 when escorting them to and from secure children’s homes. Such techniques are banned in the homes themselves but can be used in secure training centres (STCs) and young offender institutions (YOIs).
 
The charity said the policy was discriminatory, and it also challenged the lack of legal protection for children who could be restrained during their journeys simply for not following orders. Taylor said this should no longer be allowed. In 2018, the Guardian reported MoJ figures showing that in 2017 there were 97 incidents in which children in custody showed signs of asphyxiation or other danger signs after being restrained, and four serious physical injuries that resulted in hospital admissions.
 
In 2016, the Guardian revealed that an internal risk assessment of restraint techniques had found that certain procedures approved for use against non-compliant children in custody carried a 40-60% chance of causing injuries affecting the child’s breathing or circulation, the consequences of which could be “catastrophic”. A year ago, the independent inquiry into child sexual abuse said these techniques were a form of child abuse which must be prohibited by law. The government has yet to respond to that recommendation.
 
In Hassockfield secure training centre in 2004, Adam Rickwood, 14, was restrained for non-compliance using a tactic called nose distraction technique – a karate-like chop to the nose. Adam killed himself shortly afterwards, leaving a letter saying: “What right do they have to hit a child?” Carolyne Willow, the director of Article 39, said Taylor’s reportwas “a major milestone in child protection, one we have waited 16 years for since Adam Rickwood hanged himself in a Serco-run child prison. It has taken our legal action to finally bring some promise of justice for Adam and other children who have suffered needlessly over many years.  “We need to see the detail of the legal protections which will be put in place to ensure pain-inducing restraint is genuinely prohibited, and that any emergency, self-defence use of pain complies with common law and the UK’s children’s human rights obligations.”
 
The MoJ has accepted all of Taylor’s 15 recommendations

Thursday, 11 June 2020

Ethical Care PMVA COVID-19 Practical Training Update June 15th 2020

Our PMVA Practical training has now been adapted to effectively and safely deliver face-to-face training in line with Government guidance and Health & Safety Standards.
 
We constantly review the current situation and have also taken into account the restrictions in force and the requirements of our clients, in terms of their need to ensure that their essential workers are adequately trained and up-to-date in the key skills required to perform their roles safely.
 
Class sizes have been reduced and risk assessment according to our clients individual need while keeping to government guidance ensures safety procedures are in place.
 
This information is obviously flexible regarding the on going COVID-19 risk and changes that may happen on short notice.

Friday, 10 April 2020

Letter from General Practitoner Sekinat Abisola Oyawa

RE: Ethical Care Training Manual 2020

I have reviewed the ethical care control and restraint training manual for 2020.  It is a detailed and informative manual with clear illustrations on defensive postures which will protect the handler and the client and cause no harm to either.  Importantly, it stresses that the use of physical intervention on any person is only when all other methods have failed, and in that case only approved techniques should be used.

Yours Truly,

Sekinat Abisola Oyawa
General Practitioner

Letter from Dr. Alain Tanoé

RE: Ethical Care Training Manual 2020

As a member of the Healthcare profession I am aware that there are situations when there is a need for physical intervention when all methods have been tried.

Having been taught some of these moves in a previous role I am aware of how important they are and that they are there to protect both staff and the person from serious harm.

On reviewing the manual for 2020 I have found it to be very clear in its instructions and the illustrations are easy to understand.

Yours sincerely

Dr. Alain Tanoé

Monday, 27 May 2019

We have achieved our OHSAS 18001:2007 accreditation for the 10th year running

The Occupational Health and Safety Management System of Ethical Care Control & Restraint (UK) Ltd has been assessed by The Certification Group for conformance to the requirements of: OHSAS 18001:2007

Scope of Registration: The provision of Control and Restraint (C&R) / Physical Intervention (PI) Training, including Conflict management, in the UK

Signed on Behalf of The Certification Group, Certification Manager: Elaine Hanaghan

We have achieved our BS EN ISO 9001:2015 accreditation for the 10th year running

The Quality Management System of Ethical Care Control & Restraint (UK) Ltd has been assessed by The Certification Group for conformance to the requirements of: BS EN ISO 9001:2015

Scope of Registration: The provision of Control and Restraint (C&R) / Physical Intervention (PI) Training, including Conflict management, in the UK

Signed on Behalf of The Certification Group, Certification Manager: Elaine Hanaghan

Thursday, 16 May 2019

'I've lost 24 friends to suicide'

Natasha has battled with anorexia and self-harm from the age of 12 and spent 10 years in mental health units across the country. https://news.sky.com/video/ive-lost-24-friends-to-suicide-11719878

Tuesday, 30 April 2019

Five police officers will face a misconduct hearing after a man lost the tips of three fingers when they were trapped under a toilet rim


Essex Police officers entered the 33-year-old arrested man's cell on 1 May 2015 to remove his foot from a toilet.

The police watchdog said "a number of techniques" were used to remove him, but he grabbed on to the rim and his fingertips were severed as officers tried to restrain him.

The hearings are set to begin on 7 May.

An investigation was launched by the Independent Office for Police Conduct (IOPC) after the injuries to the man's left hand at Colchester Police Station.

The watchdog said it looked at the decision making by officers "when the man, who was a foreign national presenting mental health concerns, was booked in to custody" and "in relation to the techniques and force used to remove the man from the toilet".

It also investigated the first aid the man received and his "continued detention" after his return from hospital.

As a result, an inspector, three police constables and a temporary police sergeant are due to face gross misconduct charges.

The IOPC said a police sergeant had already admitted misconduct, while another officer received "management action".

Wednesday, 17 April 2019

Man prosecuted for hospital assault on nurse and other staff

Mark Gallagher has been placed under night-time curfew and ordered to pay compensation

A patient who left a nurse feeling ‘shaken and nervous’ after assaulting her has been prosecuted under a new law designed to improve protection of emergency workers.

At a hearing on 8 April, Hull Magistrates Court heard how Mark Gallagher had been taken to the emergency department of Hull Royal Infirmary with a head injury after he fell over while drinking with a relative.

He underwent scans, which were clear, but staff allowed him to stay in a cubicle to ‘sleep it off’ in the early hours of 16 February.

Feeling of helplessness

James Byatt, prosecuting, told the court that while a nurse was treating a patient in a nearby cubicle, Mr Gallagher came in and assaulted her, pushing her by the shoulders and grabbing her wrists.

‘She said it had left her shaken and nervous,’ said Mr Byatt. ‘She felt helpless and it has made her more wary of intoxicated patients in the future.’

Security staff were called to escort Mr Gallagher off the premises but he punched one and kicked another before being arrested by police.

Mr Gallagher admitted three counts of assault against emergency workers. Magistrates imposed a night-time curfew for eight weeks, a 12-month community order, and ordered him to pay each of his victims £150 compensation.

Safe workplace


Lynda Carmichael, chair of the magistrates, told Mr Gallagher: 'It is a very, very serious offence.

‘These are people in their workplace and, as such, deserve not only respect but certainly to be safe in their workplace.’

Mike Farr, defending, said Mr Gallagher, who has no previous convictions, had no recollection of the attack and had been taking medication for depression and anxiety, which he believed had reacted with the alcohol he drank.

‘He is extremely remorseful for his stupidity and his actions,’ Mr Farr said.

Mr Gallagher was prosecuted under the Assaults on Emergency Workers (Offences) Act 2018, which came into force towards the end of last year.

Numerous assaults

Hull University Teaching Hospitals NHS Trust security manager Ron Gregory said more than 70 assaults by members of the public had been reported by trust staff in the past 12 months.

‘Anyone who is violent or abusive to any member of staff at our hospitals should be in no doubt they will face the appropriate punishment for their crime,’ said Mr Gregory.

‘Staff do not come to work to be assaulted, abused, spat at or attacked, and we will not tolerate any such behaviour.’

Partnership with police

The trust has teamed up with Humberside Police in an initiative to prosecute offenders who commit crimes at the trust’s hospitals or attack staff.

Chief inspector Lee Edwards said: ‘If anyone thinks they can get away with assaulting an emergency worker, they are sorely mistaken.’

Thirteen prison officers taken to hospital after assault at Feltham youth jail

Thirteen prison officers have been taken to hospital after an outbreak of violence at Feltham Young Offenders Institution at the weekend.

Twenty staff at the youth jail in west London were hurt in separate incidents, said the Prison Service.

The perpetrators will face adjudication hearings over the next few days and could face prosecution by police.

A Prison Service spokesman said: “A completely unacceptable series of assaults on staff at Feltham over the weekend led to 20 officers receiving injuries – with 13 needing hospital treatment.

“Our sympathies are with those hard-working and committed staff, who deserve to be able to carry out their jobs without facing this kind of behaviour.

“We will never tolerate violence against our staff and will push for the strongest possible punishment, which could lead to them spending more time behind bars.”

It is understood the injured officers have since been discharged from hospital, reports Sky News .

The chairman of the Prison Officers' Association, Mark Fairhurst, tweeted: "The violence against staff at HMP Feltham over the weekend is not acceptable.

"Replace the term ‘children' with ‘violent young criminal’ and you more accurately describe what @POAUnion members in the juvenile estate face.

"We will support staff and push for prosecutions."

Feltham Young Offenders Institution is made up of two parts – Feltham A, which holds 15 to 18-year-olds, and Feltham B, which holds young adults aged 18 to 21.

The A unit has capacity for 180 young people, while 360 young adults can be held in unit B.

Prison officer rushed to hospital after inmate cuts his throat at HMP Nottingham

The man was attacked on Sunday at HMP Nottingham, the Ministry of Justice said. The male officer has since been released from hospital. An inspection report published last year found levels of violence at the prison were "very high", with 103 assaults on staff in the previous six months.

Over the same period, there had been 198 incidents where prisoners had climbed onto safety netting between landings.

HM Inspectorate of Prisons said: "This level of disorder contributed to a tense atmosphere at the prison," adding that many violent incidents, including serious ones, were not investigated at all.

Chief inspector of prisons Peter Clarke Clarke said the prison needed to do "much more" to tackle the problem of drugs which was "inextricably linked" to violence in his report.

HMP Nottingham is a category B male prison which expanded in 2010 to hold 1,060 prisoners.

Wednesday, 27 March 2019

The Devon Partnership NHS Trust has indicated that the changes in the training and the positive attitude we have instilled through this has provided a conclusive positive impact.

Email received from Paul Keedwell RMN. BSc (Hons) Health Studies Executive Director
of Nursing and Practice (Honorary Associate Professor, University of Exeter Medical
School. Devon Partnership NHS Trust, Tuesday 26th March 2019.

The Devon Partnership NHS Trust has indicated a considerable reduction in the prone
restraint as figures are down by 51%, rapid tranquilisation are down by 14% and the
use of seclusion down by 52% in the last two years since Ethical Care took over this
contractual service and the need for restraint over this two year period has actually
increased by 12%, although it is difficult to say categorically the ECC&R training is the
only factor we can infer that the changes in the training and the positive attitude we
have instilled through this has provided a conclusive positive impact.

Figures taken from 01/03/2017 to 28/02/2019 Devon Partnership NHS Trust.

Mental Health Units (Use of Force) Act 2018

2018 Chapter 27


An Act to make provision about the oversight and management of the appropriate use of force in relation to people in mental health units; to make provision about the use of body cameras by police officers in the course of duties in relation to people in mental health units; and for connected purposes.

1st November 2018

Be it enacted by the Queen's most Excellent Majesty, by and with the advice and consent of the Lords Spiritual and Temporal, and Commons, in this present Parliament assembled, and by the authority of the same, as follows:

Key definitions

1 Key definitions

(1) This section applies for the purposes of this Act.

(2) "Mental disorder" has the same meaning as in the Mental Health Act 1983.

(3) "Mental health unit" means-

(a) a health service hospital, or part of a health service hospital, in England, the purpose of which is to provide treatment to in-patients for mental disorder, or

(b) an independent hospital, or part of an independent hospital, in England-

(i) the purpose of which is to provide treatment to in-patients for mental disorder, and

(ii) where at least some of that treatment is provided, or is intended to be provided, for the purposes of the NHS.

(4) In subsection (3)(b)(ii) the reference to treatment provided for the purposes of the NHS is to be read as a service provided for those purposes in accordance with the National Health Service Act 2006.

(5) "Patient" means a person who is in a mental health unit for the purpose of treatment for mental disorder or assessment.

(6) References to "use of force" are to-

(a) the use of physical, mechanical or chemical restraint on a patient, or

(b) the isolation of a patient.

(7) In subsection (6)-

"physical restraint" means the use of physical contact which is intended to prevent, restrict or subdue movement of any part of the patient's body;

"mechanical restraint" means the use of a device which-
(a) is intended to prevent, restrict or subdue movement of any part of the patient's body, and
(b) is for the primary purpose of behavioural control;

"chemical restraint" means the use of medication which is intended to prevent, restrict or subdue movement of any part of the patient's body;

"isolation" means any seclusion or segregation that is imposed on a patient.

Accountability

 2 Mental health units to have a responsible person

(1) A relevant health organisation that operates a mental health unit must appoint a responsible person for that unit for the purposes of this Act.

(2) The responsible person must-

(a) be employed by the relevant health organisation, and

(b) be of an appropriate level of seniority.

(3) Where a relevant health organisation operates more than one mental health unit that organisation must appoint a single responsible person in relation to all of the mental health units operated by that organisation.
3 Policy on use of force

(1) The responsible person for each mental health unit must publish a policy regarding the use of force by staff who work in that unit.

(2) Where a responsible person is appointed in relation to all of the mental health units operated by a relevant health organisation, the responsible person must publish a single policy under subsection (1) in relation to those units.

(3) Before publishing a policy under subsection (1), the responsible person must consult any persons that the responsible person considers appropriate.

(4) The responsible person must keep under review any policy published under this section.

(5) The responsible person may from time to time revise any policy published under this section and, if this is done, must publish the policy as revised.

(6) If the responsible person considers that any revisions would amount to a substantial change in the policy, the responsible person must consult any persons that the responsible person considers appropriate before publishing the revised policy.

(7) A policy published under this section must set out what steps will be taken to reduce the use of force in the mental health unit by staff who work in that unit.
4 Information about use of force

(1) The responsible person for each mental health unit must publish information for patients about the rights of patients in relation to the use of force by staff who work in that unit.

(2) Before publishing the information under subsection (1), the responsible person must consult any persons that the responsible person considers appropriate.

(3) The responsible person must provide any information published under this section-

(a) to each patient, and

(b) to any other person who is in the unit and to whom the responsible person considers it appropriate to provide the information in connection with the patient,

unless the patient (where paragraph (a) applies) or the other person (where paragraph (b) applies) refuses the information.

(4) The information must be provided to the patient-

(a) if the patient is in the mental health unit at the time when this section comes into force, as soon as reasonably practicable after that time;

(b) in any other case, as soon as reasonably practicable after the patient is admitted to the mental health unit.

(5) The responsible person must take whatever steps are reasonably practicable to ensure that the patient is aware of the information and understands it.

(6) The responsible person must keep under review any information published under this section.

(7) The responsible person may from time to time revise any information published under this section and, if this is done, must publish the information as revised.

(8) If the responsible person considers that any revisions would amount to a substantial change in the information, the responsible person must consult any persons that the responsible person considers appropriate before publishing the revised information.
5 Training in appropriate use of force

(1) The responsible person for each mental health unit must provide training for staff that relates to the use of force by staff who work in that unit.

(2) The training provided under subsection (1) must include training on the following topics-

(a) how to involve patients in the planning, development and delivery of care and treatment in the mental health unit,

(b) showing respect for patients' past and present wishes and feelings,

(c) showing respect for diversity generally,

(d) avoiding unlawful discrimination, harassment and victimisation,

(e) the use of techniques for avoiding or reducing the use of force,

(f) the risks associated with the use of force,

(g) the impact of trauma (whether historic or otherwise) on a patient's mental and physical health,

(h) the impact of any use of force on a patient's mental and physical health,

(i) the impact of any use of force on a patient's development,

(j) how to ensure the safety of patients and the public, and

(k) the principal legal or ethical issues associated with the use of force.

(3) Subject to subsection (4), training must be provided-

(a) in the case of a person who is a member of staff when this section comes into force, as soon as reasonably practicable after this section comes into force, or

(b) in the case of a person who becomes a member of staff after this section comes into force, as soon as reasonably practicable after they become a member of staff.

(4) Subsection (3) does not apply if the responsible person considers that any training provided to the person before this section came into force or before the person became a member of staff-

(a) was given sufficiently recently, and

(b) is of an equivalent standard to the training provided under this section.

(5) Refresher training must be provided at regular intervals whilst a person is a member of staff.

(6) In subsection (5) "refresher training" means training that updates or supplements the training provided under subsection (1).

Reporting

6 Recording of use of force

(1) The responsible person for each mental health unit must keep a record of any use of force by staff who work in that unit in accordance with this section.

(2) Subsection (1) does not apply in cases where the use of force is negligible.

(3) Whether the use of force is "negligible" for the purposes of subsection (1) is to be determined in accordance with guidance published by the Secretary of State.

(4) Section 11(3) to (6) apply to guidance published under this section as they apply to guidance published under section 11.

(5) The record must include the following information-

(a) the reason for the use of force;

(b) the place, date and duration of the use of force;

(c) the type or types of force used on the patient;

(d) whether the type or types of force used on the patient formed part of the patient's care plan;

(e) name of the patient on whom force was used;

(f) a description of how force was used;

(g) the patient's consistent identifier;

(h) the name and job title of any member of staff who used force on the patient;

(i) the reason any person who was not a member of staff in the mental health unit was involved in the use of force on the patient;

(j) the patient's mental disorder (if known);

(k) the relevant characteristics of the patient (if known);

(l) whether the patient has a learning disability or autistic spectrum disorders;

(m) a description of the outcome of the use of force;

(n) whether the patient died or suffered any serious injury as a result of the use of force;

(o) any efforts made to avoid the need to use force on the patient;

(p) whether a notification regarding the use of force was sent to the person or persons (if any) to be notified under the patient's care plan.

(6) The responsible person must keep the record for 3 years from the date on which it was made.

(7) In subsection (5)(g) the "patient's consistent identifier" means the consistent identifier specified under section 251A of the Health and Social Care Act 2012.

(8) This section does not permit the responsible person to do anything which, but for this section, would be inconsistent with-

(a) any provision of the data protection legislation, or

(b) a common law duty of care or confidence.

(9) In subsection (8) "the data protection legislation" has the same meaning as in the Data Protection Act 2018 (see section 3 of that Act).

(10) In subsection (5)(k) the "relevant characteristics" in relation to a patient mean-

(a) the patient's age;

(b) whether the patient has a disability, and if so, the nature of that disability;

(c) the patient's status regarding marriage or civil partnership;

(d) whether the patient is pregnant;

(e) the patient's race;

(f) the patient's religion or belief;

(g) the patient's sex;

(h) the patient's sexual orientation.

(11) Expressions used in subsection (10) and Chapter 2 of Part 1 of the Equality Act 2010 have the same meaning in that subsection as in that Chapter.
7 Statistics prepared by mental health units

(1) The Secretary of State must ensure that at the end of each year statistics are published regarding the use of force by staff who work in mental health units.

(2) The statistics must provide an analysis of the use of force in mental health units by reference to the relevant information recorded by responsible persons under section 6.

(3) In subsection (2) "relevant information" means the information falling within section 6(5)(b), (c), (k), (l) and (n).
8 Annual report by the Secretary of State

(1) As soon as reasonably practicable after the end of each calendar year, the Secretary of State-

(a) must conduct a review of any reports made under paragraph 7 of Schedule 5 to the Coroners and Justice Act 2009 that were published during that year relating to the death of a patient as a result of the use of force in a mental health unit by staff who work in that unit, and

(b) may conduct a review of any other findings made during that year relating to the death of a patient as a result of the use of force in a mental health unit by staff who work in that unit.

(2) Having conducted a review under subsection (1), the Secretary of State must publish a report that includes the Secretary of State's conclusions arising from that review.

(3) The Secretary of State may delegate the conduct of a review under subsection (1) and the publication of a report under subsection (2).

(4) For the purposes of subsection (1)(b) "other findings" include, in relation to the death of a patient as a result of the use of force in a mental health unit, any finding or determination that is made-

(a) by the Care Quality Commission as the result of any review or investigation conducted by the Commission, or

(b) by a relevant health organisation as the result of any investigation into a serious incident.

Investigation of deaths

9 Investigation of deaths or serious injuries

When a patient dies or suffers a serious injury in a mental health unit, the responsible person for the mental heath unit must have regard to any guidance relating to the investigation of deaths or serious injuries that is published by-

(a) the Care Quality Commission (see Part 1 of the Health and Social Care Act 2008);

(b) Monitor (see section 61 of the Health and Social Care Act 2012);

(c) the National Health Service Commissioning Board (see section 1H of the National Health Service Act 2006);

(d) the National Health Service Trust Development Authority (which is a Special Health Authority established under section 28 of the National Health Service Act 2006);

(e) a person prescribed by regulations made by the Secretary of State.

Delegation

10 Delegation of responsible person's functions

(1) The responsible person for each mental health unit may delegate any functions exercisable by the responsible person under this Act to a relevant person only in accordance with this section.

(2) The responsible person may only delegate a function to a relevant person if the relevant person is of an appropriate level of seniority.

(3) The delegation of a function does not affect the responsibility of the responsible person for the exercise of the responsible person's functions under this Act.

(4) The delegation of a function does not prevent the responsible person from exercising the function.

(5) In this section "relevant person" means a person employed by the relevant health organisation that operates the mental health unit.

Guidance

11 Guidance about functions under this Act

(1) The Secretary of State must publish guidance about the exercise of functions by responsible persons and relevant health organisations under this Act.

(2) In exercising functions under this Act, responsible persons and relevant health organisations must have regard to guidance published under this section.

(3) Before publishing guidance under this section, the Secretary of State must consult such persons as the Secretary of State considers appropriate.

(4) The Secretary of State must keep under review any guidance published under this section.

(5) The Secretary of State may from time to time revise the guidance published under this section and, if this is done, must publish the guidance as revised.

(6) If the Secretary of State considers that any revisions would amount to a substantial change in the guidance, the Secretary of State must consult such persons as the Secretary of State considers appropriate before publishing any revised guidance.

Video recording

12 Police body cameras

(1) If a police officer is going to a mental health unit on duty that involves assisting staff who work in that unit, the officer must take a body camera if reasonably practicable.

(2) While in a mental health unit on duty that involves assisting staff who work in that unit, a police officer who has a body camera there must wear it and keep it operating at all times when reasonably practicable.

(3) Subsection (2) does not apply if there are special circumstances at the time that justify not wearing the camera or keeping it operating.

(4) A failure by a police officer to comply with the requirements of subsection (1) or (2) does not of itself make the officer liable to criminal or civil proceedings.

(5) But if those requirements appear to the court or tribunal to be relevant to any question arising in criminal or civil proceedings, they must be taken into account in determining that question.

(6) In this section-

"body camera" means a device that operates so as to make a continuous audio and video recording while being worn;

"police officer" means-
(a)

a member of a police force maintained under section 2 of the Police Act 1996,
(b)

a member of the metropolitan police force,
(c)

a member of the City of London police force,
(d)

a special constable appointed under section 27 of the Police Act 1996, or
(e)

a member or special constable of the British Transport Police Force.

Interpretation

13 Interpretation

In this Act-

"health service hospital" has the same meaning as in section 275(1) of the National Health Service Act 2006;

"independent hospital" has the same meaning as in section 145(1) of the Mental Health Act 1983;

"the NHS" has the same meaning as in section 64(4) of the Health and Social Care Act 2012;

"responsible person" means a person appointed under section 2(1);

(a) "relevant health organisation" means-

(b) an NHS trust;

(c) an NHS foundation trust;

any person who provides health care services for the purposes of the NHS within the meaning of Part 3 of the Health and Social Care Act 2012;

(a) "staff" means any person who works for a relevant health organisation that operates a mental health unit (whether as an employee or a contractor) who-

(b) may be authorised to use force on a patient in the unit,

(c) may authorise the use of force on a particular patient in the unit, or

has the function of providing general authority for the use of force in the unit.

Final provisions

14 Transitional provision

The Secretary of State may by regulations make such transitional, transitory or saving provision in connection with the coming into force of any provision of this Act.
15 Financial provisions

There is to be paid out of money provided by Parliament-

(a) any expenditure incurred under or by virtue of this Act, and

(b) any increase attributable to this Act in the sums payable under any other Act out of money so provided.
16 Regulations

(1) Regulations under this Act are to be made by statutory instrument.

(2) Regulations under this Act are subject to annulment in pursuance of a resolution of either House of Parliament (other than regulations made under section 17(3)).
17 Commencement, extent and short title

(1) This Act extends to England and Wales only.

(2) This section and section 16 come into force on the day on which this Act is passed.

(3) The other provisions of this Act come into force on such day as the Secretary of State may appoint by regulations.

(4) Regulations under this section may appoint different days for different purposes or areas.

(5) This Act may be cited as the Mental Health Units (Use of Force) Act 2018.

Restraint Reduction Network (RRN) Training Standards 2019 First edition, James Ridley & Sarah Leitch

These Standards provide a national and international benchmark for training in supporting people who are distressed in education, health and social care settings.

The Standards will ensure training is directly related and proportional to the needs of populations and individual people. They will also ensure training is delivered by competent and experienced training professionals who can evidence knowledge and skills that go far beyond the application of physical restraint.

The Standards will

● Protect people's fundamental human rights and promote person centred best interest and therapeutic approaches to supporting people when they are distressed

● Reduce reliance on restrictive practices by promoting positive culture and practice that focuses on prevention, de-escalation and reflective practice to minimise use of restrictive practices

● Increase focus on prevention, understanding of the root causes of behaviour and recognition that many behaviours are the result of distress due to unmet needs

● Improve staff skills and confidence in how to keep people safe in crisis and to better understand how to meet people's needs in order to prevent crisis situations

● Improve the quality of life and protect the fundamental human rights of people at risk of being restrained and those supporting them

● Where required, focus on the safe use of restrictive interventions including physical restraint

These standards are suitable for use within mental health and learning disability NHS commissioned units. They can be used across child and adult services, for people with mental health conditions, dementia, learning disabilities and autistic people.

Used in an accredited certification scheme, these Standards will reduce the number of times restraint is required and help to make those occasions that restraint is unavoidable safer and more dignified.

Certification against these Standards will be mandatory for all training with a restrictive intervention component that is delivered to NHS commissioned services for people with mental health conditions, learning disabilities, autistic people and people living with dementia in the UK. Implementation will be via commissioning requirements and inspection frameworks from April 2020.

Thursday, 10 January 2019

Worse than BROADMOOR: Nurse whistleblower claims he has seen psychopathic serial killers cared for better than the autistic children he has witnessed being violently held down and force-fed drugs at health unit funded by the NHS

Ian Summers spent eight years as a mental health nurse at Broadmoor, the high-security psychiatric hospital holding some of the most dangerous criminals in Britain. So it is chilling to hear him reveal that he saw patients more often violently held down, forcibly drugged and attempting suicide while working in a hospital unit holding vulnerable teenage girls – some of them autistic – than when he looked after serial killers, child abusers and psychopaths.

‘I am ashamed by what I have witnessed,’ he says. ‘It is simply barbaric – worse than Broadmoor. I’ve never seen anything like it. They are destroying the lives of young people in the most desperate need of help.’

Now he and two senior colleagues have blown the lid on what they call ‘shameful institutionalised abuse’ taking place behind the locked doors of Meadow Lodge, a unit in Devon funded by the NHS.

Their shocking claims – corroborated by other staff, patients and families – follow a series of reports by The Mail on Sunday exposing the shameful treatment of children and young adults with autism and learning disabilities. They are taken from their families and held against their will in secretive secure health units and Assessment Treatment Centres (ATUs).
Anger: Ian Summers pictured with Meadow Lodge in the background, has launched a protest since he was sacked

Our reports have led to three official inquiries as more and more families have come forward – some of them breaking gagging orders – to tell how their children have been locked in solitary confinement, fed through hatches like animals, and forcibly medicated. One man, to the dismay of his distraught parents, has been held for 18 years.

Mr Summers, 56, and his fellow whistleblowers say places such as Meadow Lodge show how ‘the whole system is failing people with autism’ when adolescents with serious problems are simply seen as ‘cash machines’ for private firms which can charge up to £730,000 a year for each patient.

Meadow Lodge is operated by Huntercombe, a controversial group owned by a private equity firm run by Guy Hands, one of Britain’s richest men. Huntercombe has handed its best-paid director more than £1 million over the past two years.

Among the allegations made to this newspaper are that:

- Teenage girls were left bruised and distressed after being held down by teams of adults for up to one hour 45 minutes;

- Adolescents were forcibly injected in the buttocks and made to take cocktails of powerful drugs to sedate them;

- Agency staff slept when they were supposed to be monitoring teenagers at high risk of suicide and self-harm;

- Staff were told not to take young patients to hospital after incidents of self-inflicted injuries and a drug overdose;

- Records of restraint and the use of ligatures by patients to hurt themselves were not filled in properly and falsified;

- Unsafe practices included failure to monitor keys properly, inadequate training in life-saving techniques and staff shortfalls;
Ian Summers has staged protests since he was sacked. Pictured: A car draped in protest slogans

- A senior carer was suspended over bullying and harassment charges, including the use of sexually suggestive language in a unit holding victims of child abuse.

l Meadow Lodge staff were transferred from a nearby unit under ‘special measures’, which was then closed amid concerns over dehydration, malnutrition and poor care.

Patients at Meadow Lodge were deeply traumatised by their experiences. One of them, a girl aged 14 when she was locked up there last year, told the MoS: ‘It was horrible. I saw things that really disturb me to this day. Some of the other girls who had been in different units said it was really bad compared to others.’

Her father said she left the unit in a significantly worse mental state than when she entered and became so stressed she attempted suicide. ‘It felt out of control and definitely under-resourced. It was like a prison – there was no help,’ he says.

The whistleblowers raised their concerns with Huntercombe directors, police and the Care Quality Commission (CQC) in August last year. Commission inspectors paid a surprise visit three months later and issued a safety warning notice.

Meanwhile, the whistleblowers were dismissed, and on Christmas Eve received their P45s. The company denies many of their allegations and insists that they were not dismissed for raising concerns.

Huntercombe opened the ten-bed Meadow Lodge in the village of Chudleigh in July 2017, just weeks before the closure of a similar ten-bed unit, Watcombe Hall, in nearby Torquay. It had been placed in special measures after a local hospital raised the alarm over the number of admissions and the state of patients turning up from Watcombe Hall. CQC inspectors discovered one patient had not eaten or had a drink for four days.

There were also concerns over high staff turnover, inadequate training, poor health assessments, overuse of restraints, failure to record incidents and a lack of activities. Inspectors saw one young person abscond over a fence while another had bruises on their upper arm from being held down. The injuries were ignored by staff, some of whom found new jobs at Meadow Lodge. One of the whistleblowers, Jane, 50, a former prison officer who became a senior support worker at Meadow Lodge, says: ‘I would not have joined if I had known any staff came from there [Watcombe Hall]. I don’t put up with abuse of children.’

She and fellow whistleblower Joanne, a mental health nurse with 20 years’ experience, joined Meadow Lodge last January, and soon found that safeguarding concerns similar to those raised at Watcombe Hall were happening again, with children routinely held down by teams of up to three adults.

‘There was one girl with her arm in plaster who was always being restrained,’ says Joanne. ‘When I worked in adult units, there were maybe one or two restraints a month because we de-escalated situations, but this was going on all day long.’

Mr Summers, who joined in April, was also dismayed at seeing how troubled teenagers, bored by the lack of facilities or adequate therapy for traumas such as sexual abuse, were sedated with powerful drug cocktails and routinely restrained.

‘I would compare one week in Meadow Lodge to a year in Broadmoor when it came to restraint, and there was much more use of medication,’ he says. He alleges that teenage girls, some the victims of child abuse, were disturbed when held down violently in bedrooms by teams of four, including men.

Last year a CQC inspection highlighted increasing use of restraint and ‘physical intervention’, with 118 reported incidents in one month alone.

Yet the whistleblowers say they were not given training in specialist child mental health. The CQC found just 66 per cent compliance for basic life-support training, despite it being compulsory, and that ‘few’ agency staff completed mandatory training.

Joanne says that on her third night at Meadow Lodge, five staff had to deal with six girls self-harming. ‘One was head-banging, another throwing herself at the wall, then another started off in the corridor. I’d never seen anything like this and I still feel devastated since we had to leave the one in the corridor.’

Some patients entered the unit voluntarily but ended up being sectioned as their problems escalated. Yet the three whistleblowers say there were often no previous recorded issues of self-harm. ‘It was learned behaviour,’ says Joanne.

Campaigners warn that autism is often detected late in girls and that they mimic others in an effort to fit in, leading to eating disorders and self-harm when locked in psychiatric units instead of getting far cheaper and more effective support in the community. ‘There was one autistic girl who definitely should not have been there,’ says Jane. ‘All we did was restrain her. Autism is not a mental health condition and she could not cope with the screaming, the head-banging, the things she was seeing.’

The whistleblowers say two patients absconded one night while a third banged her head against a wall so badly that the teenager could not open her eyes the next day. ‘Her head was so swollen she looked like the Elephant Man,’ says Joanne.

Yet the whistleblowers claim a senior staff member ordered them not to take the girl to hospital on the bizarre grounds that his own face once swelled up after falling off his bike. The girl was later rushed into hospital, where she suffered a seizure.

Mr Summers, whose son has autism, says on one occasion he tried to take a 16-year-old who claimed to have overdosed to hospital, but was accused of overreacting. He also had to persuade bosses to let him rush a 15-year-old to A&E after she sliced her leg open with glass.

‘Parents would be really angry and shocked if they could see what was going on. They think these are safe places, but their children would be better at home,’ he says.

One support worker was found guilty of misconduct for being sexually explicit – yet was reportedly only briefly suspended.

Huntercombe told this newspaper: ‘The alleged incident of inappropriate language was between colleagues and not directed to young people.’

The whistleblowers also allege that legally binding records of restraint and other incidents were altered or not always filled in properly – claims confirmed to the MoS by staff still working at the unit. This is strongly denied by Huntercombe, which insists it tracks the reports for accuracy.

‘It’s the worst unit I have ever worked in,’ says one veteran care worker, who also complained of ‘liquid coshes’ used to sedate patients. ‘I’m always concerned about the welfare of the children, expecting to hear a coroner has been called. It’s scary.’

A therapist told how he quit after a few months because there were ‘no facilities, no budget, no support, no supervision and no infrastructure. It was difficult to attempt therapy in a room being used by staff for coffee.’

One former patient says she was attacked and bitten by another girl who was supposed to have two carers with her at all times: ‘They were just sitting in the lounge chatting, so I had to restrain her myself.’

Some teenagers were seen as posing a high risk of suicide so needed constant monitoring to stop them swallowing toxic items or tying ligatures made from torn-up clothing or sheets around their necks. Yet the whistleblowers say some untrained agency staff slept while they were supposed to be on duty at night.

Huntercombe says: ‘An incident where some agency staff were alleged to be asleep was investigated and appropriate action taken.’

Jane says that on one occasion, as she fought to save a teenage girl hanging from a shower rail, an agency worker bought a screwdriver rather than a specialist cutter to sever the ligature, saying he had never seen such an incident before.

Yet having raised concerns about the centre, Jane says she was suspended, then fired, for allegedly swearing during the life-saving rescue – something she denies: ‘I was told by one manager to keep my mouth shut or I would be sacked.’ Joanne and Mr Summers say they were dismissed for allegedly stealing documents after they gave patient observation sheets to a manager investigating their claims.

‘This system is all about money,’ says Joanne. ‘But I’m ashamed – these children are like caged animals.’

The CQC says it placed Meadow Lodge under ‘enhanced multi-agency surveillance’ after being ‘made aware of ongoing concerns’, then carried out an unannounced inspection in late November that prompted a patient safety warning notice. ‘Our priority is always the care and wellbeing of people using services.’

Huntercombe, which cares for about 700 patients in 23 units around the country, is part of a care home business that is no stranger to controversy. Stephanie Bincliffe, a 25-year-old with severe autism, died in one of its secure hospitals after staff allowed her weight to balloon to 25st as she spent years in a padded room.

A Huntercombe spokesman said: ‘Certain employees who were dismissed for gross misconduct are presenting themselves as whistleblowers. The reasons for their dismissal were categorically not for whistleblowing.’

He said a previous CQC inspection six months ago found patients and staff to be positive about services and did not raise concerns over ‘excessive’ use of restraint or medication. Potential ligature points had been identified and observations stepped up ‘as a precaution,’ while keys were never in the possession of patients.

He added that the recent CQC surprise inspection ‘was not related’ to the issues highlighted by the MoS: ‘All relevant external authorities have been satisfied the management team acted properly throughout.’

Wednesday, 12 December 2018

Five mentally ill people called police 8,655 times as officers bear the brunt of mental healthcare crisis

Mental health services and other agencies need to stop relying on the 24/7 availability of the police, a
report has said.


Five people with mental health problems called the Metropolitan Police 8,655 times in 2017, according to a new report.

It is an extreme example of the pressure police forces are being put under because of a national crisis in mental healthcare.

Officers often need to step in because more suitable services have finished for the day, HM Inspectorate of Constabulary and Fire & Rescue Services (HMICFRS) said in a report.

This leaves police with tens of thousands of cases that should be dealt with by other agencies.

It comes at a time when they face their own challenges: increasing levels of knife crime and the ever-present threat of terrorism.

The report is based on the response provided by police in England and Wales to people with mental health problems.

It said police in London receive a call about a mental health concern every four minutes and an officer was sent to respond to a mental health call every 12 minutes.

The calls could be from worried relatives or friends, requests from social services or GPs for police to make welfare checks, missing people, suicidal people or supporting victims of crime who have mental health problems.

HM Inspector of Constabulary Zoe Billingham said other services should stop relying on the availability of police.

"Overstretched and all-too-often overwhelmed police officers can't always respond appropriately, and people in mental health crisis don't always get the help they need.

"The police should be the last resort, not the first port of call."

Police funding has fallen 19% in real terms since 2010 and officer numbers are down by more than 20,000 during the same period.

Chief Constable Mark Collins, the National Police Chiefs' Council lead for mental health and policing, said he shared the concerns raised by the report.

He added: "It is right that the police are there to protect those in immediate danger, but they shouldn't become the first point of call for those who need longer-term mental health support and access to prevention measures."

Dr Paul Lelliott, lead for mental health at the Care Quality Commission, said: "People experiencing a crisis with their mental health need expert and prompt help. All too often this isn't available at the time and place that they need it.

"Although police officers generally do a good job in identifying and responding to those with mental health problems, they must never be considered a substitute for expertly trained healthcare professionals."

Tuesday, 23 October 2018

Julian Cole: Three Bedfordshire Police officers sacked

Julian Cole was involved in a scuffle with doormen and police officers outside a nightclub in Bedford in 2013.

The officers were found to have lied in statements about Mr Cole's condition during his arrest.

PCs Nicholas Oates, Sanjeev Kalyan and Hannah Ross were found guilty of gross misconduct and dismissed.

They had failed to ask "basic questions" to check his welfare during arrest, and he needed CPR at the police station, the hearing was told.

Speaking after the verdict, Mr Cole's mother, Claudia Cole, said: "This tribunal decision makes it clear that not only did the officers lie about the event involving Julian, they showed an inhuman indifference to his welfare."

Assistant Chief Constable Jackie Sebire called the case a "tragedy", adding: "I apologise that [the officers'] conduct following the incident fell well short of what we expect at Bedfordshire Police."

She added that the length of time the Independent Office for Police Conduct (IOPC) and the Crown Prosecution Service (CPS) took with their investigations was "simply unacceptable".

Sports science student Mr Cole, then aged 19, had gone to the former Elements nightclub on 5 May 2013 for a night out with friends, but was ejected through a side door.

He was refused a refund by door staff and kept trying to get back in to the club, leading to staff calling the police at 01:34 GMT on 6 May.

During one attempt to enter the nightclub, Mr Cole was taken to the ground by a bouncer, before standing back up, the hearing was told.

He was then "taken to the ground" by PCs Oates, Kalyan and Ross at 01:48 before being cuffed with "his face down on the ground".

The three officers lifted him from the ground, and he was taken via a police van to the police station.

At 02:02 PC Ross called an ambulance, and paramedics arrived at the police station and began CPR on Mr Cole, who was not breathing. Thirty minutes later he was taken to hospital where a broken vertebra was discovered.

The panel found that PC Ross "made up her account" of Mr Cole moving his legs in an "attempt to demonstrate she had taken Mr Cole's report of neck pain seriously when she had not".

The hearing was also told that PC Kalyan tried to "shift responsibility" over what happened to the student.

He was found to have lied in his statement when he stated that he had heard PC Ross ask Mr Cole if he could move his legs, and that he moved them in response.

PC Oates had also said that Mr Cole had walked to the police van during his arrest, which the panel said he knew was not true.

PCs Ross, Kalyan and Oates "did not ask any basic questions concerning his welfare". However, the panel added this was "most unlikely to have changed the outcome for [Mr Cole]".

The panel also said that Sgt Andrew Withey failed to make "any enquiry" when PC Ross asked whether Mr Cole should go directly to hospital or custody, and failed to "react" to hearing Mr Cole say his neck hurt.

Sgt Withey was given a final written warning after being found guilty of misconduct.

    PC 'lied about man's injuries'
    Arrest probe officer 'feared assault'
    Student paralysed after police scuffle

The PCs were found to have breached standards of honesty, while all four were found by the misconduct panel in Stevenage to have breached standards of duties and responsibilities.

An allegation against PC Ross concerning the force she allegedly used with the handcuffs was found not proved.

The IOPC referred its findings of an earlier investigation to the CPS, which decided that no criminal conduct had occurred.

IOPC Regional Director Sarah Green said: "It will never be known exactly how his neck was broken, or if swifter care could have prevented the awful consequences of the break."

She added the officers' "dishonesty has only added to the anguish of Mr Cole's family".