Appointed as Chief Executive Officer of Eden Futures in July 2019, following four years as the company’s COO, Dawn Berry has worked in health and social care for over 25 years at all levels of support delivery.
Challenging behaviour and the use of restraint
In 2019, there are still hundreds of people with Learning Disabilities or Autism who are being needlessly restrained in settings all over the UK. The recent case at Whorlton Hall shocked the nation again, eight years on from the Winterbourne View exposé, but what progress has been made in moving people out of long-stay services where this sort of abuse – which includes unnecessary restraint – can go unnoticed and unchallenged for too long?
Reducing levels of restraint in health and social care is at last receiving some attention from the CQC in its Thematic Review of restraint, prolonged seclusion and segregation and its interim findings are no surprise to many; so far the review has concentrated on people being restrained in hospital settings, with part two intending to widen its investigation to look at other settings, including community settings. Some of the conclusions drawn so far make for saddening reading; people cannot leave their current environments because there is a lack of provision outside of the hospital wards; there is often poor quality care and support; sadly, that people have displayed behaviour that might challenge others for many years, with no solution being found; and that training and skills of the staff who are supporting people is lacking.
These findings ratify what has surely been known for a long time. BILD (British Institute of Learning Disabilities) has been a loud advocate of the need to reduce restraint of people with Learning Disabilities, and has recently taken over the facilitation and stewardship of the Restraint Reduction Network, publishing a comprehensive set of Training Standards which will be compulsory for all NHS commissioned services to have signed up for by April 2020.
The RRN standards work hand in hand with the premise that restraint of any person should only ever be used as a last resort and that training staff in restraint alone is simply not enough. I’m proud to say that at Eden Futures, we were brave enough five years ago to invest heavily in using Positive Behavioural Support as a means to understand why a person may show behaviour that challenges, and to equip our teams to constantly asses and think about other solutions to reducing challenging behaviour and increase a person’s independence.
I’m proud to be able to say that every single person being supported at Eden Futures has their own tenancy agreement and their own front door, regardless of how complex that person’s behavioural needs are. We have supported scores of people to live in their own home in their own community, and we have achieved that by working alongside them with the cooperation of developers, commissioners and landlords and health professionals. By working in partnership, we are collectively able to identify potential sites where the right accommodation can be built.
The key to ‘Building the Right Support’ is threefold in my opinion; there is a need for increased and readily available housing that meets the robust standards of design for individuals to successfully move from locked environments into the community; we need to invest heavily in the social care workforce and identify them as the professionals that they are; and we need a joined up approach to working so that the focus of care and support for the most vulnerable people is always the number one priority for everyone.