3.3 Identify how to raise concerns when restrictions appear out of proportion with evident risk

This guide will help you answer 3.3 Identify how to raise concerns when restrictions appear out of proportion with evident risk.

In health and social care, restrictions are sometimes placed on individuals to manage risks, protect their safety, or ensure the safety of others. These restrictions may include limits on their movement, access to certain items, or participation in specific activities. While restrictions aim to prevent harm, it’s important to ensure they are fair, necessary, and proportionate. If you identify restrictions that appear excessive compared to the actual risk, you must raise your concerns appropriately. This is a vital part of promoting an individual’s rights and freedom within a care setting.

Why Proportionate Restrictions Matter

Proportionate restrictions balance protecting individuals from harm with maintaining their rights to autonomy and dignity. The principle of proportionality means any restrictions must directly match the level of risk present. For example, a person who has a mild risk of falling may not require full movement restriction but could instead benefit from supervised mobility.

Excessive restrictions can harm individuals psychologically, emotionally, and socially. They may feel oppressed, lose trust in their care providers, or experience reduced quality of life. The law, such as the Human Rights Act 1998 and the Mental Capacity Act 2005, protects individuals against unnecessary restrictions. These laws provide legal frameworks to ensure that restrictions are always justified and proportionate.

When to Raise Concerns

You should raise concerns if you notice restrictions that do not seem to match the identified risks or if alternative, less restrictive measures have not been explored. Examples include:

• Preventing an individual from going outside when there is no evidence of risk.
• Using physical restraints without urgent or clear justification.
• Denying access to personal items without proper explanation.
• Enforcing isolation when other support measures could safely allow interaction.

Such scenarios highlight the need to advocate on behalf of the individual and make sure their rights and needs are prioritised.

Steps to Raise Concerns

Raising concerns involves clear communication and adherence to organisational policies. Here is a step-by-step guide:

1. Gather Evidence

Before raising concerns, collect clear evidence about the unnecessary restriction. This includes:

• Observing the situation yourself.
• Reviewing the care plan or risk assessments to identify documented reasons for the restriction.
• Talking to colleagues to gather additional information.
• Noting the potential impact on the individual’s rights and well-being.

For example, if someone is being restricted from leaving their room, note how this affects their emotional state or daily routine.

2. Review Relevant Policies

Familiarise yourself with your organisation’s policies on restrictive practices, risk assessments, and safeguarding. This will ensure you understand what is expected and help you determine if the restriction breaches policy or legal guidelines.

Consider related legislation including:

• The Human Rights Act 1998 – Protects freedom of movement, privacy, and autonomy.
• The Mental Capacity Act 2005 – Ensures decisions made on behalf of individuals lacking capacity are in their best interest.

3. Document Your Concerns

Write down your concerns, keeping your account factual and evidence-based. Include:

• A description of the restriction and how it is applied.
• Why you believe it is disproportionate to the risk.
• Any alternatives you feel would be less restrictive but equally effective.
• The potential consequences for the individual if the restriction continues.

Accurate and detailed documentation strengthens your case when raising the issue with managers or safeguarding leads.

4. Speak to Your Line Manager

Report your concerns to your line manager or a relevant senior staff member. You can explain your observations, provide evidence, and suggest alternative approaches. Managers can review the situation and take steps to address it, such as revising the care plan or holding a team discussion.

5. Follow Whistleblowing Policies if Necessary

If your concerns are not addressed or you feel they are being ignored, use your organisation’s whistleblowing policy. Whistleblowing involves reporting a serious risk, wrongdoing, or neglect to higher management or external organisations, such as the Care Quality Commission (CQC). Whistleblowing policies protect you from unfair treatment for raising valid concerns.

6. Seek Advice from External Authorities

If you feel individuals continue to face unnecessary restrictions and your concerns remain unresolved, you can contact external bodies for additional support. These include:

• The CQC
• The Local Authority Safeguarding Team
• Solicitors specialising in health and social care law
• Advocacy agencies supporting individuals’ rights

Relevant external authorities investigate serious concerns to ensure practice complies with industry standards and laws.

Communicating Your Concerns Effectively

Effective communication is key when addressing disproportionate restrictions. Approaching the issue confidently and professionally can lead to better outcomes.

Here’s how to do this effectively:

• Be clear and concise – Avoid using overly complex language. Focus on explaining your observations and concerns simply and directly.
• Express your concerns objectively – Avoid expressing emotions such as anger. Present facts and evidence without blaming others.
• Stay focused on the individual’s needs – Highlight how removing or modifying the restriction will improve the person’s well-being and reduce harm.
• Listen to feedback – Managers and colleagues may provide explanations or different perspectives. Be open to discussion and collaborative problem-solving.

Understanding why effective communication matters is important for supporting advocacy and achieving positive outcomes.

Rights of Individuals and Legal Considerations

Whenever restrictions are placed on individuals, their legal and human rights must be upheld. The need to challenge excessive restrictions stems from these rights, which include:

• Right to liberty and freedom – Protected under Article 5 of the Human Rights Act, liberty must not be restricted without lawful evidence.
• Right to respect for private and family life – Article 8 ensures individuals can maintain their dignity and make their own choices wherever possible.
• Right to least restrictive intervention – The Mental Capacity Act mandates that care providers use the least restrictive intervention available.

As a care worker, knowing individuals’ legal protections and using them as a foundation for raising concerns helps you provide better care.

Final Thoughts

By raising concerns about disproportionate restrictions, you contribute to better practices and improved quality of care. You help ensure care is delivered ethically, fairly, and responsibly. Your action safeguards the rights of individuals, prevents unnecessary distress, and fosters an environment where everyone feels valued and respected.

Striving for balance between risk management and freedom is critical in health and social care work. Raising concerns professionally and with the support of your organisation’s policies benefits everyone involved.