Terminology relating to restrictive practice

For this assessment criterion, you will be required to explain what is meant by the following terms:

Mental capacity

Mental capacity refers to an individual’s capability for being able to make decisions for themselves. Conditions such as learning disabilities, mental illness and brain injuries may prevent an individual from being able to make decisions, in which case their mental capacity should be assessed.

Restraint and restrictive practice

Restraint and restrictive practice or restrictive interventions are defined by Skills for Care and Skills for Health as:

Making someone do something they don’t want to do or stopping someone doing something they want to do.

A positive & proactive workforce (2014)

Restrictive interventions should only be used when absolutely necessary and the least restrictive methods should always be used. Individuals that are subject to restrictive practices should always be treated with dignity and respect. There are several methods of restraint including:

• Physical restraint (e.g. holding an individual in a particular position against their will)
• Mechanical restraint (e.g. a lap belt on a wheelchair)
• Chemical restraint (e.g. the use of sedatives)
• Seclusion (e.g. locking an individual in a room)

Hidden restraint

Hidden restraint refers to restrictive practices that are unintentional. For example, bed rails may be used to prevent an individual from falling out of bed but they may also prevent them from getting out of bed on their own.

Risk and risk-averse culture and practice

Risk-averse cultures and practices restrict individuals from taking risks with the objective of keeping them safe. Whilst we should always have the safety of the individuals that we care for at the forefront of our minds, this should be balanced against the positive benefits of taking risks.

For example, an individual with dementia may wish to play bridge with their friends once a week. However, a risk-averse care provider may recommend against this because of the risks associated with the individual accessing the community on their own. But this does not take into account the positive effects that maintaining relationships has on the individual’s well-being.

Positive risk-taking

Positive risk-taking promotes an individual’s rights of choice and independence by looking at the positive aspects of risk-taking. As in the example above, going out with friends will have a positive impact on an individual’s quality of life and so the care provider and individual would agree on ways that the activity could go ahead in the safest possible way.

Assessment criteria

Learners explain what is meant by the terms:

• Mental capacity
• Restrictive practice
• Restraint
• Hidden restraint
• Risk and risk-averse culture and practice
• Positive risk taking