Mythbusting claims - Accreditation/Qualifications

Mythbusting Claims About Accreditation and Qualifications in Restraint Training by Bernard Allen Nov 2015

Accreditation cannot take the place of regulation, monitoring and supervision.

Accreditation is about training standards, such as having the correct liability insurance, ensuring that techniques have been medically risk assessed, etc. It is a systems check. It does not ensure that the training is appropriate for the setting in which it will be applied. Nor does it ensure that staff are doing what they are supposed to do. That is the responsibility of management.

The BILD accreditation scheme was originally established in 2001, with the support of the health and education departments. I was a member a departmental advisory group at the time which had called for such a scheme. The intention was for the scheme to take into account the training needs of providers across the full range of agencies and service user groups, including mainstream settings. To this end, I worked briefly with BILD in 2001 and 2003.

In 2008 the authors of the revised BILD policy framework made the following statement of intent:

"We have resisted the temptation to produce a policy framework that applies to all these different agencies and service user groups. Instead, we continue to focus on the needs of adults and children with learning disabilities and/or autism, while recognising that in practice this core group melds into other diagnostic or administrative categories. Learning disability and autism define our own sphere of competence and provide the surest ground for our efforts to revise and update policy and practice in respect of physical intervention."(Page 8 - BILD Physical Interventions - A Policy Framework, 2008)

In my opinion BILD has consistently failed to adequately consider the needs of mainstream schools and providers who specialise outside the field of intellectual disabilities and autism. The BILD accreditation scheme became a commercial operation after the withdrawal of government funding.

BILD is also now a significant player in the commercial market as a provider of training and training materials itself, which places it in direct competition with some of the organisations it is supposed to be accrediting. This potentially represents a conflict of interest.

The Institute of Conflict Management (ICM) accreditation scheme was established with the support of the Health and Safety Executive. The ICM scheme is a much broader based accreditation scheme for training in conflict management and reduction in workplace violence in all settings.

Claims from training organisations cannot be taken at face value. Employers must conduct due diligence to ensure they know what they are buying. Accreditation should at least provide reassurance that the training has been medically risk assessed, in relation to the physical and psychological harm that can be associated with restraint techniques. It cannot guarantee that the techniques being taught are appropriate for the setting. That must be a management decision taken at local level.

1. What is the status of BILD and ICM Accreditation?

“The Government does not give advice to schools or local authorities on their choice of training provider and does not have a preferred provider of restraint training. The provider of the setting must make an assessment as to whether the training that they procure will meet the needs of their staff and children and young people.” (DfE clarification July 2015)

2. Nationally recognised BTEC award, certificate, and diploma Level 3 in Restraint Training for schools and/or residential care settings - Is this true?

“We have no record of such a course.” (Edexel 2014)

A BTEC Level 3 award is equivalent to an As or A level, International Baccalaureate or Advanced diploma.(Compare Different Qualifications - www.gov.uk) Those claiming to hold this qualification only hold a security industry associate (SIA) qualification (1 week SIA course rather than a 1 year full time training)

3. Is prone restraint banned?

The serious case review into abuse at Winterbourne View recommended that supine restraint should be banned, not prone. This has not stopped training organisations who use supine holds campaigning for a ban on prone restraints, which they do not use. Prone has never been banned.

“Guidance provides information and good practice but is not statutory guidance or legally binding.Providers can choose to depart from the Guidance but may be asked (e.g. by court or CQC) to justify their reasons for doing so.”

(NHS Protect consulted DH and HSE; DH provided following clarification “It is accepted that there may be exceptional circumstances where the use of prone restraint will happen…On rare occasions, face down restraint may be the safest option for staff and service users, with few, if any, viable alternatives.” (NHS Protect, March 2015)

4. Can staff stop children from hurting themselves or others?

“If the use of restraint / force on a child / pupil would be a reasonable step to take in order to prevent a foreseeable injury to a third party, we would expect staff to take that step with confidence that they will be acting lawfully by doing so, and we would expect this to be sufficient to avoid any liability for any injury that nonetheless occurs.” (DfE clarification provided to Bernard Allen -personal correspondence -July 2015)

5. Should staff be provided with training in self-protection and restraint?

“Employers have a duty to protect their staff under health and safety legislation. Part of this protection will be to consider the needs of their staff regarding appropriate training to protect themselves in situations involving violence or aggression.”