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Positive and Proactive Care Meeting the New National Guidance on Reducing Seclusion

Tuesday 20 October 2015
Hallam Conference Centre, London

Positive and Proactive Care Meeting the New National Guidance on Reducing Seclusion

This event has now past, but there may well be news on the event including presentations and quotes from the day at our News pages here, a full list of our forthcoming events is available here.

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On the 29th May 2015, NICE released new guidance on safeguarding NHS staff from violent and aggressive patients. The guideline includes a number of recommendations with regard to seclusion. The guideline recommends that physical restraint should only be used as a last resort, once all other methods of preventing or calming the situation have failed. Professor Tim Kendall, Director of the National Collaborating Centre for Mental Health, who was also involved in developing the guideline, added: “We now want to see a culture of tolerance towards people with mental health problems, helping health and social care professionals to de-escalate difficult situations and help service users get the support they need when circumstances in the health service can make things worse...We want to reduce the times when we restrict people who are wound up by mental health problems and placed in restrictive environments. We are recommending that every trust has a restrictive interventions reduction programme. We also want to develop a culture of learning, such that service users and professionals together can review every time we restrain or restrict a person’s freedom; and give as much attention to human rights as we do to safety.” 29th May 2015

The NICE guidance follows on from the Department of Health Guidance “Positive and Proactive Care – reducing the need for restrictive interventions” states that “Only people detained under the MHA should be considered for seclusion. If an emergency situation arises involving an informal patient and, as a last resort, seclusion is necessary to protect others from risk of injury or harm, then it should be used for the shortest possible period to manage the emergency situation and an assessment for detention under the MHA should be undertaken immediately”.  This supported the recent Care Quality Commission report in October 2014 which stated that “Although adherence to most aspects of the MHA and its Code of Practice was good, we found that in some wards, staff were secluding patients without acknowledging that this was the case and without proper monitoring being in place. We were also concerned that not all staff working in intensive care units fully understood best practice in the use of seclusion.” CQC State of Care Oct 2014

The Care Quality Commission also found that safeguards for people in seclusion were not always implemented, and recording was often insufficient to give a clear picture of the use of seclusion and longer-term segregation. A range of different terms were used to describe circumstances in which people might be, in practice, detained in seclusion: “Nursed in his room”, “Placed in the low-stimulus area for a sustained period” or “Chose to be in the safe-care suite”. If the circumstances of a person’s care resemble seclusion, it is seclusion whatever it is called locally.

This conference focuses on meeting the new national guidance and reducing seclusion, ensuring that seclusion is only used as a last resort in emergency situations. The conference will provide delegates with an update on national policy in seclusion, understanding the legal context and ensuring that all instances of seclusion and reported and that seclusion is not happening in their organisations under another name. The conference will include case study sessions on Eliminating seclusion in practice and ensuring any instance of seclusion is reported and investigated, alternatives to seclusion, and the importance of de-escalation and understanding the root causes of challenging behaviour.  

“Restraint and seclusion of patients must be used with extreme care.” Care Quality Commission 

Also of interest:

Safe Staffing for Nursing in Mental Health Inpatient Units
Monday 16 November 2015 
Hallam Conference Centre, London

Information Sharing in Mental Health
Friday 27 November 2015 
Hallam Conference Centre, London

Violence and aggression: short-term management in mental health, health and community settings: Implementing the New NICE Guideline
Friday 27 November 2015 
Hallam Conference Centre, London

Masterclass: The Use of Restrictive Interventions: The legal framework
Tuesday 7 June 2016 
Hallam Conference Centre, London

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