Physical restraint in residential child care and other care settings
Children and young people have the right to feel safe, secure and protected in all aspects of their lives. The Holding Safely guidance for residential child care practitioners and managers, published in Scotland 2005 and updated in 2014, refers to physical restraint as “an intervention in which staff hold a child to restrict his or her movement and should only be used to prevent harm”. This guidance says that physical restraint should only be used when there is a risk of “serious imminent harm” and as a “last resort”.
References to physical restraint, seclusion, physical intervention and restrictive practice on this webpage are made in the context of the definitions outlined in Scotland’s Care Inspectorate guidance Records that all registered children and young people’s care homes must keep and guidance on notification reporting. These definitions were collated and recommended for use by the Scottish Physical Restraint Action Group. The Holding Safely guidance was written to help reduce occasions when practitioners felt the need to restrain a young person when they or others were at risk; to prepare practitioners for the times when restrictive practices were felt to be absolutely necessary; and for practitioners to effectively meet children and young people’s needs and uphold their rights in Scotland.
Understanding the complexity involved in the consideration, or use, of restraint is critically important given the potential for:
- misuse (considered from a children’s rights perspective)
- traumatisation and/or re-traumatisation
- other psychological damage
- damage to relationships
- physical injury
- death
The Scottish Physical Restraint Action Group
In 2019, Dr Laura Steckley, Senior Lecturer in Social Work and Social Policy at the University of Strathclyde, led a plenary presentation session at the Scottish Institute of Residential Child Care Conference (SIRCC) exploring some of the complexities around the practice of physical restraint.
Following this, a group of people with care experience, practitioners, leaders, managers, policy leads and researchers came together and formed the Scottish Physical Restraint Action Group (SPRAG), hosted by CELCIS. Since then, the Group has been examining what is happening now, what else needs to be known, and what else needs to happen in children's houses, services, policies, and wider systems, to ensure the eradication of harm caused by physical restraint.