The Restraint Reduction Network (RRN) training standards

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.

Learning Disabilities Theory

Learning Disabilities Theory

Restrictive Interventions should never be used to punish or for the sole intention of inflicting pain, suffering or humiliation.

There must be a real possibility of harm to the person or the staff, the public or others if no action is undertaken.

The nature of methods used to restrict must be proportionate to the risk of harm and the seriousness of that harm.

Any action taken to restrict a person's freedom of movement must be the least restrictive option that will meet the need.

Any restriction should be imposed for no longer than absolutely necessary.

What is done to people, why and with what consequences must be subject to audit and monitoring and must be open and transparent.

Restrictive Interventions should only ever be used as an absolute last resort.

The DOH 2014 Guidance states People who use services, carers and advocate involvement is essential when reviewing plans for restrictive interventions.

Any Restrictive Physical Interventions taught to staff should be appropriate to the needs of the individuals they support or educate and the assessed level of risk and their workplace.

Training in Restrictive physical interventions should prepare staff to manage the assessed risks that are typically found in the service in which they are employed and should not focus on possible extremes of behaviour that are unlikely to happen.

Methods must not conflict with any relevant official guidance.
eg: 'The Welsh Governments prohibition of the use of prone restraint'

The risk assessment of the physical skills taught in training should be subject to independent review every three years, or sooner if the methods change or are modified by the training organisation.

It is accepted that discomfort maybe an unwanted side effect of physical intervention. *However, any methods that deliberately cause pain or that rely on the use of pain in order to be effective or which have been developed with the intention of causing pain, or that use deliberate hyper flexion.
eg: (Where an individual is bent forward in the seated position), are not supported by the *BILD Code of Practice (The RRN standards 2018 have now replaced the BILD code of practice)

Physical Intervention must not involve the deliberate application of pain by staff or as a result of the use of holds whereby movement by an individual will in itself induce pain.