3.1 Explain what is meant by ‘restrictive practice’

This guide will help you answer 3.1 Explain what is meant by ‘restrictive practice’.

Restrictive practice refers to any action that limits a person’s freedom or rights. In health and social care settings, it is a way of managing the behaviour of individuals in situations where there is a risk to themselves or others. This can include preventing harm, ensuring the safety of staff and others, or managing challenging behaviour.

Restrictive practice should always be a last resort. Before using it, care workers must consider less restrictive approaches. It should also adhere to legal and ethical frameworks, ensuring the rights of individuals are respected.

Recognising restrictive practice is important for ensuring the wellbeing and dignity of those receiving care.

Types of Restrictive Practices

Restrictive practices can vary based on the actions taken or the environment where care is delivered. These might include:

Physical Restraint

This involves physically holding or guiding an individual to control their actions. For example, staff may use physical restraint to stop a person from harming themselves or others.

Mechanical Restraint

Using equipment to restrict a person’s movement is called mechanical restraint. It might include using items like belts, harnesses, or cuffs to limit mobility.

Chemical Restraint

The use of medication to manage someone’s behaviour can be classified as chemical restraint. This happens when drugs are given primarily to calm or control rather than treat a medical condition.

Environmental Restraint

This refers to changes made to the person’s environment to restrict their movements. For example, locking doors, using stair gates, or removing access to certain areas.

Seclusion or Isolation

Separating an individual from others by placing them in a specific room or area is considered seclusion. This might happen if someone becomes a danger to others.

Restricting Choice or Movement

Preventing a person from making decisions about their life or stopping them from going where they want can also be restrictive. For example, not letting a resident leave the care home without a valid reason.

Why Are Restrictive Practices Used?

Restrictive practices are often used for safety. They aim to:

• Prevent self-harm
• Protect others from being harmed
• Avoid property damage
• Maintain the safety of the individual or others in the care setting

These practices should not be used to punish or control people unnecessarily. They must be applied with care, consideration, and respect for the individual’s human rights.

Legal Frameworks for Restrictive Practice

In the UK, there are laws and guidelines for using restrictive practices in care settings. These ensure that practices are legal, ethical, and used appropriately.

The Human Rights Act 1998

This law protects the rights and freedoms of individuals. Restrictive practices must not violate basic rights, such as:

• The right to liberty (Article 5)
• The right to be treated with dignity (Article 3)

The Mental Capacity Act 2005

If restrictive practices are used, they must comply with the Mental Capacity Act. This law applies to adults who lack the capacity to make decisions. It also includes the Deprivation of Liberty Safeguards (DoLS). These safeguards ensure that people are not unlawfully deprived of their freedom.

The Care Act 2014

This law focuses on the wellbeing of individuals receiving care. It encourages care providers to promote independence and reduce the need for restrictive practices.

The Equality Act 2010

Restrictive practice must not result in discrimination. Care workers must treat individuals fairly and equally, considering their specific needs.

Children’s Legislation

For children, laws like the Children Act 1989 and 2004 apply. These laws ensure that restrictive practices are only used to protect and safeguard children.

Guidance from Professional Organisations

Many organisations provide advice on the ethical use of restrictive practices. For example:

• NICE (National Institute for Health and Care Excellence) offers guidelines for managing challenging behaviour in health and social care. It encourages alternative approaches before using restrictive measures.
• Skills for Care promotes training and awareness of rights-based care.
• The Restraint Reduction Network supports reducing the use of restrictive practices in the UK.

Good Practice in Using Restrictive Practices

Good practice involves using restrictive strategies responsibly. Focus should remain on respecting the individual’s rights and maintaining their dignity.

Principles of Good Practice

1. Use as a last resort: Try de-escalation and alternative methods first.
2. Be proportional: Match the level of practice to the risk present.
3. Timely review: Monitor and end the restriction as soon as it is safe.
4. Document and report: Record incidents accurately for accountability and learning.
5. Seek consent, where possible: Explain what is happening and why, even if the person lacks full capacity.

Training and Awareness

Care workers need training in recognising and applying restrictive practices safely. Understanding positive behaviour support (PBS) can help workers reduce challenging behaviour before it escalates.

Negative Impacts of Restrictive Practices

Restrictive practices can have negative effects, particularly if used improperly:

• Physical injury or pain
• Emotional distress or trauma
• Damage to trust and relationships
• Reduced independence
• Reduced quality of life

For this reason, it is essential to use restrictive interventions cautiously and only when absolutely necessary.

Reducing the Use of Restrictive Practices

In modern care settings, there is a growing emphasis on limiting restrictive practices. Focus is shifting towards preventative measures like:

• Building trust with service users
• Promoting positive behaviour through PBS
• Involving individuals in their care plans
• Encouraging independence and choice
• Providing effective staff training

Active listening and understanding the needs of service users can help reduce the need for restrictions. Involving families and advocates ensures that care decisions are person-centred.

Final Thoughts

Restrictive practices refer to any action taken to limit a person’s rights or freedom in a care environment. While their primary aim is safety, they also raise ethical and legal considerations. It’s always better to use alternative, less restrictive approaches first. When restrictive practices are necessary, they must be done with transparency, responsibility, and respect for individual rights.

By understanding what restrictive practice means, care workers can deliver safer, more person-centred care. This protects not just the people they care for, but their own professional responsibilities as well.