Least Restrictive Options

Why might it be of interest?

This is something that we can all do with having a good awareness as it can be easy to fall in to habits of restricting a young person’s actions without recognising what we are doing.  A restriction doesn’t have to be harmful to be a restriction.  And it is not all about restraint.

Least Restrictive Practice promotes a strengths based and person-centred approach to delivering care and support while minimising the use of restraint.

Before you make a decision or act on behalf of someone who lacks capacity, always question if you can do something else that would interfere less with their basic rights and freedoms. This is called finding the “least restrictive alternative”.

Everything you do that might restrict a person’s freedom of action must be the least restrictive option that will meet the need – it’s not just about letting a vulnerable person do whatever they want, it is about keeping them safe while restricting their rights and freedoms as little as is possible.

A quick look at what this means

This information was written for professionals working with vulnerable people but I think it is informative for parents – not just for their own approaches in supporting their young person but understanding how a professional should be approaching a situation which might involve restricting a young person’s freedoms.

Least Restrictive Practice promotes a strengths based and person-centred approach to delivering care and support while minimising the use of restraint.

Before you make a decision or act on behalf of someone who lacks capacity, always question if you can do something else that would interfere less with their basic rights and freedoms. This is called finding the least restrictive alternative.

The Mental Capacity Act (2005), provides protection to any individual who is deprived of their liberties to safeguard their health and wellbeing through establishing all support to be the Least Restrictive option. That any restriction in place must be proportionate to the need of keeping the individual safe, necessary in terms of all other lesser options have been attempted multiple times and lawful.

Everything you do that might restrict a person’s freedom of action must be the least restrictive option that will meet the need – it’s not about letting a vulnerable person do whatever they want, it is about keeping them safe while restricting their rights and freedoms as little as is possible.

If a young person is becoming distressed and is at risk to themselves or others, before escalating to any form of medication, seclusion or restraint practices, all methods of positive behavioural support should be tried.  This includes identifying trigger(s), seeking to remove or reduce any stressors, supporting positive engagements and emotional resilience, giving time and space in a safe manner, listening, changing the staff working with them, building a joint wellbeing plan to address distress, sensory boxes, exercise, access outside to reconnect with nature and get fresh air etc. A person’s wellbeing and health should always be at the centre of all support, so seeking to understand why a behavioural escalation is occurring and how to safely deescalate in the least restrictive way possible is essential. To do otherwise is against the Mental Capacity Act and their Human Rights.

The use of restrictions on a young person’s movement and/or intrusive observations should always be questioned whether that includes restraint or seclusion or more benign restrictions. This will help us to understand whether this was the best and/or only way to support the young person and keep them safe. We need to know what else has been tried, that the practice is kept under review and that steps are taken to use a less restrictive approach wherever possible.

It is a lot to consider and in an emergency you may need to take action that you perhaps would not otherwise do.  The key here is to plan ahead and have time to work out what will and won’t work for a young person without having to resort to more restrictive practices.

The link is to quite an old document (2016) from the Local Government Association about promoting less restrictive practice and I think the examples it provides can help us think about what constitutes a restriction – it may not be obvious or something we do – or not do – could inadvertently be restricting a young person’s freedom.  A restriction may not be purposely applied to be a restriction.