Reducing restrictive practice

The Trust has been working hard to improve the experience of inpatient service users, and longer term, to reduce restrictive practice.

We spoke to Miriam Blackburn, Practice Development Nurse from Acute Inpatient Services to find out more.

The ‘safe wards model’

Miriam began by telling us how this work came about. “We put an action plan in place in 2015, part of which was to introduce the ‘safe wards model’. This was designed to minimise potential triggers for individuals that may lead to traumatic incidents or restrictive practice.”

The ‘safe wards model’ means:

  • Patients have their own bespoke care plan
  • Care is focused on positivity and safety
  • Wards look and feel safer, more positive and more comfortable for each patient

Miriam added: “The success of the ‘safe wards model’ has been endorsed by external organisations who visited the wards and saw that patients were feeling more comfortable and empowered.”

Collaborative care planning

In July 2018, a local audit looked into what helps service users to remain calm and relaxed on the wards and how staff can effectively support them as individuals.

Miriam said: “The idea is to work directly with patients to reduce some of the frustrations that can come about from being on a ward. For example, how they prefer to be addressed, how and when they prefer to be spoken to, and whether there are any triggers to be avoided that the patient might associate with a negative memory of a previous stay on the ward or a previous traumatic experience elsewhere. Making sure that staff and patients are working together on care plans should also reduce the amount of restrictive practice needed in the longer term.”

Success so far

  • A number of wards have reached 100% compliance so all their service users have a bespoke care plan that is collaborative and has a positive and safe plan to manage agitation
  • General ward improvements have taken place across the board
  • Wards are documenting best practice and sharing with other teams
  • There has been a reduction in violence and aggression since the introduction of the safe wards model

Staff engagement

Raising awareness amongst staff has been a big part of this work. From posters to away days and staff forums – work continues to keep positive environments at the heart of care planning.