What Is Restrictive Practice?
A restrictive practice involves making someone do something they don’t want or even stopping someone from doing something they want to do. Furthermore, a restrictive practice can also be explained as a type of practice that limits people with disabilities and their freedoms.
This type of practice is defined as intervening by restricting the rights of movement of people with disabilities with the primary goal of protecting them or others from harm. However, today, these types of practices are less commonly used due to their nature. Instead, they are used within a positive behaviour support (PBS) framework that includes outcome-based and person-centred approaches.
Can Restrictive Interventions Be Harmful?
Restrictive practices can’t address the underlying causes of the behaviours that challenge. Trying to control behaviour using a restrictive practice has been shown to lead to other behaviours that challenge or even put people at more significant risk.
Restrictive practices may even be triggering for people with a history of trauma and abuse. It can also cause a certain degree of psychological distress and possibly lead to losing dignity. This type of practice has its base principles in limiting one’s freedom and ability to engage in day-to-day activities. Also, they are known to reduce meaningful interactions with family, support staff and carers.
The prolonged use of a restrictive practice may ultimately lead to over-reliance, which means people lose their ability to live independent and active life. That’s why it is essential to always focus on the people’s unique needs, skills, and abilities and have a positive approach so people can feel safe and secure.
Positive Approaches to Reduce Restrictive Practices in Health and Social Care
Positive approaches are based on the sole principles of outcome-based solutions and person-centred care, which entails getting to know every individual and their specific needs.
Through the positive approach, family, friends, and carers can learn what their close ones like or dislike, what kind of skills and abilities they have, and how to respect and value their backgrounds. Also, they can learn how to communicate and understand the environment’s impact on their loved ones by consistently looking for other ways of support in every aspect of care.
A positive approach involves working with people and their support systems to try and understand how they are feeling, what needs to be changed in their day-to-day life, and what needs planning and order to help the individual feel relaxed, organised and organised to reduce other behaviours that challenge. The positive behaviour support plans are created to allow carers and providers to understand and manage every aspect and situation of care positively and eliminate restrictive practices by creating an alternative behaviour management strategy.
Positive Behaviour Support (PBS)
New methods have been developed to reduce restrictive practices using positive behavioural support.
PBS has been developing for the past 30 years. It involves a multi-component framework for supporting people with behaviours that challenge and people at risk of developing ones. The main focus of PBS is to improve quality of life by learning all the reasons why and how people use their behaviour to communicate and meet their needs. By learning, we can all start understanding how to build better support, work towards positive outcomes and improve the services that people receive.
The positive behaviour support plan is always created with the person being supported and their family and carers. A PBS plan will be built upon person-centred strategies and will assist in building alternative behaviours that can reduce or eliminate the need for a restrictive practice. At Nurseline Community Services, our care plans are tailored to the needs of each individual and are rooted in PBS principles to deliver person-centred support.
Person-Centred Approach
A person-centred approach is a type of approach where the person is supported to lead the way to care and recovery. The focus is solely on the person and what that person can do, not on their disability or challenges. The support provided is focused on achieving people’s aspirations so it can be tailored to their specific needs and unique abilities.
Person-centred approaches are used to ensure that the focus is placed on what matters to the people receiving support and their families. It also ensures that people are always seen as unique individuals with unique talents, contributions and gifts. The approach is a toolbox to help people while enabling them to choose their path to a positive outcome. This approach’s core principle is always to ensure that people are always listened to and kept at the core of the decision-making process.
Outcome-Based Approach
An outcome-based approach is one of the fundamental approaches in health and social care as it supports people to live their best lives by valuing their needs and building upon their strengths. Once people feel supported and listened to, they are more likely to improve their well-being and physical and mental health.
Supporting people through an outcome-based approach and developing person-centred plans makes them much more likely to succeed. The positive outcome results from progress and hard work in care delivery. It is all about making real improvements in the quality of life.
Principles of Reducing Restrictive Practices
Human rights are the foundation of people’s freedom and belong to everyone. They are based on core principles like equality, respect, dignity and independence. Human rights protect the freedom of people to control their life and take part in all decision-making processes that impact their right to receive equal services.
Providing a safe environment for everyone alongside human rights is another fundamental principle of reducing restrictive practices. It ensures that people are treated with respect and dignity. Also, a safe environment includes a space where behaviours that challenge are managed in ways that show humanity and respect. At the same time, restrictive interventions are used as compassionately as possible as a last resort when all other options have been considered.
Respect and Dignity
Dignity is a fundamental human right and a long-established principle in healthcare. Policies, procedures and rules ensure that people’s dignity is maintained and respected while receiving care.
Healthcare providers ensure that they provide care in a way that ensures people are well respected and their dignity is protected. This includes allowing for privacy when people need and want it, treating everyone equally, and providing the support they might need to become as independent and involved in the local community as possible.
Providing a Safe Environment
Providing and maintaining a safe environment reflects care and compassion for people’s welfare and is as vital as any other aspect of healthcare.
The goal of providing a safe environment is to prevent and reduce risks or harm that can occur to people during the provision of care. The basis of the discipline is to allow for continuous improvement by learning from past experiences. A safe environment is crucial in delivering effective, high-quality services focusing on people’s strengths, needs and wishes.
Recovery-Oriented Practice
Recovery-oriented practice is a massive element in ongoing healthcare reforms that spotlight the personal journey of people living with a disability.
The principles of a recovery-oriented approach include getting to know each person and learning that everyone is different and should be supported to make their own choices. This approach puts people first and understands that each individual knows best about their own life and what are the best ways to assist them in achieving their goals and aspirations.
Recovery means different things to different people. For some, it means getting support in controlling their own life; for others is acknowledging individual differences and accepting these differences. Also, focusing on recovery means that each person’s journey will unlikely be a straight path but will include setbacks and significant achievements. Being optimistic and working towards an end goal helps people with disabilities live a life based on their choices, abilities and strengths.
Respect for Individual Rights
Human rights set a framework of clear principles for respecting people’s wishes, needs, choices and differences. In healthcare, a human rights-based approach includes evaluating care policies and targeting discriminatory practices that lead to unequal outcomes.
By respecting people’s human rights, strategies and methods are designed to improve people’s lives and their rights to choose how they want to receive care.
Restrictive Interventions as a Last Resort
Restrictive practices should only be used as a last resort to prevent further harm to the individual or others. These practices should only be used when there is an immediate risk of harm for a person displaying behaviours that challenge. Still, there has to be an opportunity to de-escalate first.
Providing reassurance and allowing individuals with behaviours that challenge space and time before imposing a restrictive practice should always be considered a first port of call before applying any restrictive intervention.
Nurseline Community Services Is Dedicated to Preventing Unnecessary Hospital Admissions and Restrictive Practices
Nurseline Community Services aims to reduce unnecessary hospital admissions and focus on providing care to people in their own homes.
With our person-centred and humanised approach, we focus on what people can do. We have expert teams for crisis management and de-escalating crises, which entail a fast response to every individual we support.
Our team’s compassion and continuity of care rooted in positive behaviour support practices are the core recovery principles for the people we serve. Through partnerships and collaboration, we learn about people’s needs and develop care plans based on our assessments.
Our Community Transitional Services are designed to support people as they move from hospital or acute care settings back to their home environments. This service bridges the gap, offering consistent and compassionate care tailored to each person’s needs. Our team works closely with each person, their families, and healthcare providers to ensure a smooth transition. We provide practical support, emotional reassurance, and a detailed, person-centred care plan that focuses on long-term well-being and stability in the community. Through our transitional care approach, we help people build confidence and independence as they settle into their own homes.
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