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Restraint Reduction: Leadership and External Influences

Restraint Reduction: Leadership and External Influences
I wanted to revisit my previous post with regard to the six core strategies that an organisation might need to adopt to reduce the use of restraint. You may remember that the first one was leadership, defined as:
 
The organisation develops a mission, vision and set of guiding values which promote non-coercion and the avoidance of restrictive practice by developing a restraint reduction plan. 
 
This is a key element in the formula for restraint reduction. It can benefit businesses financially because without good treatment, customers disperse. However, the incentives for organisations to do this are much more than merely commercial. The pressure tends to come from external influencers, and I sense, or hope in any case, that we are approaching a perfect storm where those forces coalesce to move organisations to manage challenging behaviour more proactively.
 
The key motivators come from three main areas which are not necessarily independent of each other:
 
Government – The laws regarding the rights of individuals with learning disabilities or mental health problems have evolved considerably over the last 20 or 30 years, forcing organisations to change the way they work. Their responsibilities to the people they care for are much more defined, and inspection and regulatory regimes ensure that, in the main, best practice is followed. Good Leaders will ‘read the runes’ and put in place practice that anticipates rather than responds to new legislation and guidance.
 
Society – You don’t necessarily need to go back a generation to find examples of how society has changed in regards to what is considered appropriate. I grew up in the 70s, and attitudes to, and understanding of, people with learning disabilities and/or mental health issues have changed immeasurably.

Autism, for example, was little known outside professional circles, and behaviours at the least severe end of the spectrum were probably dismissed as those of unruly or disruptive children. In hindsight, I could probably recognise a couple of classmates as being on the spectrum.
 
Even with all the increased awareness and sensitivity in recent years, there is still room for improvement. We must remain vigilant; increasing stigmatisation of people on benefits and sensational tabloid-style reporting proves that like sex, ‘madness’ still sells.
 
Individuals – In a social age, individuals are much more empowered to influence organisations and the great and the good. We do not need or want to tolerate poor treatment of our loved ones and are more willing to expose bad practice. From an organisational perspective, this might be as simple as a family moving a service user to another service. More likely, issues will be reported that could lead to the organisation no longer existing, as happened with the owners of the Winterbourne View home (albeit bad practice was exposed by undercover journalists).
 
A restraint reduction strategy will sometimes be imposed or adopted because of these external prompts. However, it will only work if the organisation, its leaders and the individuals within it are all committed to providing the best Care, Welfare, Safety, and Security℠ for staff and service users alike.
 
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