1.4 Explain what is meant by providing care and support in a least restrictive way

This guide will help you answer 1.4 Explain what is meant by providing care and support in a least restrictive way.

Providing care and support in a least restrictive way means supporting a person to live their life with the maximum amount of freedom possible while still keeping them safe. It focuses on respecting the person’s rights and choices and only placing limits where it is absolutely necessary to protect them or others from harm.

This approach helps people maintain independence, dignity, and control over their lives. It also ensures that any restrictions are kept to the minimum required and are proportionate to the risks involved.

The principle is a key part of health and social care practice in the UK and links to laws such as the Mental Capacity Act 2005, the Human Rights Act 1998, and the Care Act 2014. These laws protect individuals from unnecessary restrictions and promote personal liberty.

Why Least Restrictive Care is Important

The least restrictive way respects a person’s right to make decisions about their own life. It ensures that support is person-centred and based on the individual’s specific needs and wishes.

It is about finding a balance. Workers must weigh up the need to protect the person from harm with the need to allow them to live their life freely. This is especially important for people who may lack mental capacity to make some decisions.

The benefits of this approach include:

• Promoting independence
• Encouraging decision-making skills
• Building self-esteem and confidence
• Protecting human rights
• Supporting well-being and quality of life

Principles Behind Least Restrictive Practice

Several principles guide least restrictive practice in health and social care:

• Respect for autonomy: The person has a right to control their own life.
• Proportionality: Any restriction should be in proportion to the level of risk.
• Necessity: Only use restrictions if they are truly needed for safety.
• Review: Regularly assess whether the restriction is still needed.
• Participation: Involve the person in decisions wherever possible.

These principles are not only good practice but also help organisations stay within the law.

Examples of Least Restrictive Practice

Examples can vary depending on the setting, but common situations include:

• Allowing a person with mobility needs to use an adapted walking aid rather than a wheelchair if they can manage some walking safely.
• Supporting a person with memory loss to make simple day-to-day decisions for themselves instead of taking over completely.
• Using verbal prompts and reassurance to calm a distressed person before considering physical intervention.
• Allowing a person to manage their own medication where safe, instead of staff taking full control.

In each case, the support provided is designed to limit restrictions while still addressing safety needs.

Legal Context in the UK

Several laws in the UK support the principle of least restrictive practice:

Mental Capacity Act 2005
This law applies when a person lacks capacity to make a certain decision. It requires care workers to act in the person’s best interests and to choose the least restrictive option.

Human Rights Act 1998
This protects individuals’ rights to liberty, privacy, and family life. Restrictions must be lawful, necessary, and proportionate.

Care Act 2014
This promotes well-being and independence for adults in need of care and support, and it emphasises personal choice.

Deprivation of Liberty Safeguards (DoLS)
These safeguard people who may need to have their movement or freedoms restricted in care homes or hospitals, applying strict rules so that any limitation is lawful and in the person’s best interests.

Balancing Safety with Independence

A large part of providing care in the least restrictive way is balancing safety with independence. Care providers must carry out risk assessments to make informed decisions.

Risk assessments help you to:

• Identify potential dangers
• Evaluate how likely harm is
• Decide which risks are acceptable
• Put in place the smallest number of restrictions needed

For example, someone with epilepsy may wish to swim alone. This could be dangerous, but banning them from swimming completely may be too restrictive. A safer, less restrictive option might be to arrange for a lifeguard or swimming buddy.

Positive Risk-Taking

Positive risk-taking is part of least restrictive practice. It means supporting people to take part in activities that may carry some risk but are important for their well-being, while putting in place steps to reduce harm.

This lets people gain experiences, learn skills, and enjoy life while staying as safe as possible.

An example could be:

• Supporting a person with dementia to cook, with staff nearby to supervise and prevent accidents rather than banning them from the kitchen completely.

Avoiding Unnecessary Restrictions

Care staff should always think carefully before placing a restriction on a person’s life. Some restrictions that may seem to keep people safe can have damaging effects on independence and dignity.

Questions to ask before applying a restriction:

• Is this restriction absolutely necessary?
• What is the aim of the restriction?
• Is there a safer but less limiting option?
• How will this impact the person’s rights and well-being?
• How will this be reviewed?

For example, locking a kitchen at all times might stop accidents but can prevent people accessing food and drinks when they choose. A less restrictive way might be to supervise access or use safety equipment.

Involving the Individual

Under the least restrictive principle, the person should be actively involved in decisions about their care. This includes:

• Informing them about any risks and options
• Asking for their views and preferences
• Supporting them to express their wishes
• Taking into account their cultural and personal values

Even where a person lacks mental capacity, you should involve them in discussions and listen to their responses as much as possible.

Involving Families and Advocates

Family members, friends, and independent advocates can help to make sure decisions are in the person’s best interests. They can provide valuable insight into the person’s preferences and values.

For example, when planning care for a person with severe learning disabilities, their parents or advocate might share how the person responds to certain situations. This can help choose the least restrictive option.

Monitoring and Reviewing Restrictions

Any restriction should be:

• Documented clearly
• Regularly reviewed
• Removed when it is no longer needed

For example, if a person with dementia was prevented from going outside unaccompanied during a period of confusion, this should be reviewed when they show signs of improved awareness. If it is safe, the restriction should be lifted.

Reviews help to prevent restrictions becoming permanent when they are no longer necessary.

Application in Different Care Settings

Residential Care
In a care home, least restrictive practice might involve allowing residents to decorate their rooms how they wish, choose their meal times, and take part in activities outside the home where safe.

Domiciliary Care
For people living at home, least restrictive practice often focuses on supporting independence in daily tasks, like shopping or cooking, rather than taking over completely.

Hospitals
In hospital settings, least restrictive practice can mean letting patients move about the ward if safe, and involving them in decisions about treatment.

Supported Living
Here, least restrictive practice is often about supporting tenants to manage their own home and finances while providing help only where needed.

Common Challenges

Staff may find it difficult to apply least restrictive principles when:

• There is high risk of harm
• The person’s wishes go against professional advice
• There are legal restrictions such as court orders
• Limited resources affect care options

In these situations, effective communication, team discussion, accurate risk assessment, and record-keeping are vital.

Skills Needed by Workers

To apply least restrictive practice, workers need to be able to:

• Communicate effectively with a wide range of people
• Understand and apply relevant laws and policies
• Carry out person-centred risk assessments
• Record and review any restrictions
• Work collaboratively with the person and others
• Remain calm and objective under pressure

Training in safeguarding, mental capacity, and equality and diversity will also help to support this approach.

Final Thoughts

Providing care and support in the least restrictive way is about respecting the person you support as an individual. It means keeping them safe but also allowing maximum freedom, independence, and control over their life. Restrictions should only be used when necessary and for as short a time as possible.

This approach benefits the person by promoting confidence, self-worth, and quality of life. It also ensures that care practice follows the law and respects human rights. Every interaction is an opportunity to choose the least restrictive option and help the individual live as fully and freely as possible.