A leading expert has warned that residential childcare providers must explain why they have not adopted national guidelines and policies on restraint.
Ronnie Hill, Director of Children's Services at the Care Commission, was speaking after a recent report revealed concerns about more than half of all Scotland's 236 residential childcare establishments. The report, an analysis of individual inspection reports on all the premises – including council and private children's homes, residential special schools and secure accommodation – looked at three key areas.
These were the protection of children from harm, abuse and exploitation, forward planning for their future in and out of care, and the use of physical restraint.
Some 52% of Scotland's children's homes, which between them provide places for 2418 children, needed to improve in at least one area to meet guidelines and National Care Standards, Hill told Herald Society. He said the use of restraint and "de-escalation" techniques for managing tense situations were a particular area of concern, as established national guidelines in the document Holding Safely, published in 2005, are not always being followed. Incidents where it has been necessary to restrain a young person are not always logged properly either.
"Holding Safely was not written in smoke-filled rooms, but produced by a process of consultation with all the partners concerned," he said. "Why aren't we using it consistently? What is stopping people buying into the guidelines? That's a question I want to raise."
Calming young people is a critical issue, he added. "You have to have staff who are confident, well trained and well supported. Get de-escalation right and you will reduce the incidence of physical restraint. It will always be necessary in some instances but must not be entered into lightly."
The concerns recorded in the Care Commission's report will now be put to a working group set up by the Scottish government to look at the role of residential services for young people, Hill said.
The issue of restraint in children's homes is always a sensitive one, and Holding Safely was intended to give establishments clear guidance to avoid the kind of problems which have affected residential childcare in other parts of the UK in the past, such as the Pindown scandal in Staffordshire in the 1980s.
The plan was always to return and assess how well the guidelines were being implemented once the document was published, Hill said. The scope of the report then grew to include care planning and child protection which he argues are "inextricably linked" to the restraint issue.
The Care Commission claims this report is the first time these three aspects of care have been looked at together. However the Care Commission was also surprised by a lack of forward planning, which is required by law, and training in child protection. "A care placement is not an end in itself, but care planning and after-care reviews were not happening as they should," Hill said. Regarding child protection training, he added: "Continuing professional development was patchy."
Hill said the job done by residential childcare workers was a hard one and praised the work of the Scottish Social Services Council in driving up standards and qualifications in the area.
The Care Commission has also asked for a review of the complaints system for young people in residential care. It is unclear how easy it is for children to complain about conditions in the place where they have to live, and while the Care Commission receives 25 complaints a year from young people, it feels more might come forward if they had better channels of complaint.
Anne Houston, chief executive of Children 1st said the report's findings about restraint could not be ignored. "We support the Care Commission's recommendation of more training in non-violent techniques to help staff spot and deal with a situation as early as possible," she said. "We know that de-escalation techniques – used correctly – can be incredibly effective, and believe that the physical restraint of children and young people should always be a last resort."
Stephen Naysmith
3 June 2008
http://www.theherald.co.uk/features/features/display.var.2313754.0.Restraining_children_in_care.php
