Practice No. Version 3 Page 1 of 3 Last up-dated
104 August 2008
Reference: 10/06 NMC Code of Professional
GSCC Code of Conduct for
Social Care Workers
CSCI Guidance for Inspectors
GENERAL PRACTICE ON RESTRAINT OF A SERVICE USER
It is National policy that users of social care services have the right to decide and
control their own care, and to be treated with respect and dignity. The restraint of a
service user may constitute assault and inappropriate restraint is illegal.
Any type of restraint will only be used in a Hampshire County Council residential or
day care setting, where the following applies :
In an emergency, staff judge that they must intervene to protect an older
person, themselves or a third party, or to prevent the commission of a crime.
When after full discussion with the service user or his/her advocate, together
with an individual Risk Assessment of an activity, the service user or
advocate has agreed that a specific type of restraint is appropriate for the
safety of the service user – and in that case, only following a full multi-
disciplinary consultation which has been signed off and recorded.
That the least restrictive type of restraint, in the best interest of the service
user will always be the paramount consideration in deciding the method to be
Any decision to use restraint must be made in the context of the Mental
Capacity Act 2005, Mental Capacity Act 2005 (Deprivation of Liberty), Mental
Health Act 2007 (Deprivation of Liberty) and Human Rights Act 1998 –
specifically articles 3 & 5.
This summarises the measures to be taken regarding the use of restraint of a service
1. The use of restraint of a service user is not to be considered as a routine or
long term practice. However, it is recognised that under certain circumstances
restraint may be necessary to ensure the safety of a service user or others.
Restraint is generally understood to be against the will of the individual
and preventing them from doing what they want to do.
The above requires that non emergency restraint should be with the
agreement of the individual to enable them to do what they want to do,
or to comply with law. e.g. enabling mobility with the aim of promoting
independence by use of a wheelchair ‘seatbelt’ or a location bracelet;
the use of vehicle seat belts.
Not all types of restraint are obvious or physical and respect must be
given to the effect on the individual, their dignity and freedom. e.g. use
2. Non emergency restraint will only be used where other methods of
management have failed.
The consent of the service MUST be obtained or where the service user lacks
capacity, the recognised advocate must agree on the service user’s behalf.
2. 3.1 Before using restraint:
3.1.1 A senior member of staff will:
assess the behaviour causing concern and, in the individual’s
personal file, will record the cause for concern; any associated
behaviour patterns; known triggers and antecedents; a Risk
Assessment of the behaviour; previous and current methods of
managing the behaviour and the outcomes of previous forms
3.1.2 Management of the service user's condition will be discussed
with the GP, other appropriate professionals; the service user
and/or their advocate. The service user should be fully informed
of the reasons for concern, possible outcomes, types of
restraint which may be considered. Discussions will be
recorded in the service user’s personal file.
31.3 Restraint must NOT be used until a full multi-disciplinary
assessment has been made, signed off and fully recorded in
the service user’s personal records.
3.2 On deciding to use restraint
A senior member of staff must:
3.2.1 Ensure this is the least restrictive method and in the best
interest of the service user.
3.2.1 Fully explain the type of and reasons for the restraint to the
service user and/or their advocate. Obtain the consent of the
service user to its use, or where the service user is lacking
capacity for that decision, the agreement of the individual’s
3.2.2 Amend the service user’s care plan, recording:
Aim of restraint
Type of restraint and how it is to be used
3.2.3 Ensure that staff are trained in the appropriate use of that
method of restraint. (See footnote)
4. Restraint MUST be time-limited and the situation will be reviewed regularly at
agreed and recorded intervals, with the service user, the GP, a senior
member of staff and any relevant others.
5. Bedrails should not be used as a form of restraint
6. Sedatives and Psychosomatic drugs should not be used as a form of
permanent restraint. Use of such drugs must be at the direction of and
subject to regular review by the service user’s GP.
Types of restraint considered by the Commission for Social Care Inspection.
Physical restraint e.g. bed rails, tables, chairs
Physical intervention e.g. holding and blocking movement
Mechanical restraint e.g. Belts
Environmental e.g. locked doors, lack of handrails
Chemical e.g. use of drugs and covert medication
Forced care e.g. medicating
Threat or verbal intimidation e.g. indicating lack of options, fear of repercussions
Electronic surveillance e.g. tagging, exit alarms
Cultural restraint e. g. seclusion, inappropriate bed times
Medical e.g. fixing medical interventions such as catheters, in a way that deliberately