Impacts of restrictive practice

For this assessment criterion, you will be required to critically analyse the potential impact and outcomes on service users, staff, families and carers of applying restrictive practices.

Carrying out restrictive interventions on service uses can be very distressing for them. They may be confused and upset and the process may make them feel violated and disrespected. A report by the Care Quality Commission (CQC) highlights the lasting and traumatic effects that restraint can have on wellbeing, with one individual explaining:

“I feel absolutely f***ing sh*t about being restrained. It makes me feel …dehumanised. I don’t feel like a real human being.”

Out of sight – who cares? CQC (2020)

Similarly, it can be upsetting for family members, carers and friends that witness their loved one being restrained.

Therefore, restrictive practices must only be used when absolutely necessary and there must be justification fo its use. Also, the least restrictive method must be used. Staff should perform restrictive practices with empathy and compassion, whilst showing respect and maintaining the individual’s dignity as much as possible. Staff should also explain what they are going to do and why they must do it to both the service user and family/carers so they know what to expect. Explaining the practice in advance of it being used is recommended.

Carrying out restrictive practices can also be distressing for staff that must perform them and so they must have a good level of training to ensure their competency and confidence in the role. They will also require frequent and effective supervision to ensure that they are able to discuss any concerns they have about restrictive practices, offload their emotions and be reassured that restrictive practice is the right thing to do in certain circumstances.

Restrictive interventions carried out correctly are unpleasant for everyone involved but sometimes they are necessary. When restrictive practices are performed incorrectly, this can lead to additional negative feelings. Service users and their families/carers can feel traumatised and dehumanized. Staff may feel guilty and lose confidence in their abilities if they have inadvertently made a mistake during a restrictive intervention. This is why it is essential that staff receive appropriate training supervision. Incorrect use of restrictive practices is both unethical and unlawful and can constitute abuse, which can lead to litigation.

Assessment criteria

Learners critically analyse the potential impact and outcomes of applying restrictive practices:

• For those in receipt of care and support services
• For all staff
• For others – families, carers
• If restrictive practice is used incorrectly