Methods for defining and monitoring restraint by setting

Young offender institutions

The method of restraint used in YOIs is control and restraint (C&R), which was originally designed for adults.

Its techniques are based on the martial art of aikido and it is a pain-compliant technique which immobilises the arms by using arm and wrist locks. There is a series of manoeuvres, depending on the circumstances and young person’s response, including taking the individual to the floor in a face-down position. It was designed for use by a minimum three members of staff.

The Youth Justice Board’s service specification for YOIs states that physical restraint must be used only as a last resort. Minimum necessary force must be applied and force must only be used after all de-escalation techniques “reasonable in the circumstances” have been exhausted.

C&R is designed to ensure staff can cope with violent prisoners and “potentially disruptive situations”. While judgements about what constitutes violence may be reasonably uncontentious, “potentially disruptive situations” could be open to a range of interpretations.

As well as physical restraint, YOIs also use segregation or solitary confinement, and mechanical restraints can also be used.

All incidents must be documented, recorded and audited.

Secure training centres

STCs use physical control in care (PCC). This is based on the Price (Protecting Rights in the Care Environment) technique, designed for children aged 12 to 14. It has four phases: prevention, restraint, holding and breakaway.

PCC was designed by the Prison Service. It is described as non-pain compliant. However, it has three escalating phases of distraction methods based on a series of holds, with increasing numbers of staff involved in each phase. These are basically pain-inflicting techniques, which involve bending the thumb forwards and down towards the palm of the hand pushing the knuckles into the lower rib or pushing the outside of the hand against the child’s septum. Systematic de-escalation of these holds is said to be central to the technique.

Since July, staff in STCs have had the power to restrain children to ensure good order and discipline as well as to prevent harm, escape or damage to property. STCs also have the option of single separation, where a child is confined to their bedroom for up to three hours in any 24, with observation every 15 minutes.

Incident reports must be completed for each restraint and copied to the YJB monitor within 12 hours.

Secure children’s homes

There is no single recommended system and a range of restraint methods is used. This includes Price, Therapeutic Crisis Intervention (TCI), Crisis and Aggression Limitation and Management (Calm) and C&R. However, these methods have not been systematically evaluated and, apart from Price and PCC, there is no indication that they have been medically approved for use on children.

Physical restraint should seldom be used and only to prevent a child harming himself or others or from damaging property. One of the seven guiding principles relating to the use of physical restraint in an SCH is that it should be an act of care and control, not punishment.

Minimum necessary force must be applied and incidents documented, recorded and audited. Medication should never be used as a method of control.

Children’s homes

There is guidance about situations when restraint should be used (to prevent harm to self, others or serious damage to property), but not on specific methods to use.

Advice on methods is contained instead in a training pack issued by the Department of Health in 1996. This says that physical restraint techniques should:

● Be used only where there is an ethos of anticipating and defusing children whenever possible.
● Not rely on threatening or inflicting pain.
● Not involve holds that apply pressure that works against the joints.
● Not rely on routinely taking a young person to the floor but preferably to a seated position.
● Minimise movement, particularly the risk of toppling over.
● Enable staff to continue talking to the young person while restraining them.
● Involve approaching the young person from the side, not face to face.
● Allow staff to phase down the hold or restraint as the young person regains control.
● Allow staff to break away at any time, so they are not tempted to escalate the restraint using inappropriate techniques.

Schools

Under the Education and Inspections Act 2006, schools have new statutory powers to discipline pupils. Before this, teachers were allowed to restrain pupils under common law, with the same authority as parents. But teachers complained that the guidelines were unclear and they were unsure whether they had the law on their side.

The 2006 act strengthens the legal power for teachers and other school staff to use “reasonable force” to prevent pupils committing a crime or causing injury, damage or disruption. However, there is no legal definition of reasonable force. In exceptional circumstances, a member of the school staff may take action to prevent a pupil from doing something where there is an immediate risk of injury.