Physical Intervention Working Group - Guidance sub group minutes: December 2020

Attendees and apologies

Attendees

Representatives from the following organisations attended:

• Scottish Government (Chair)
• Education Scotland
• Children and Young People’s Commissioner Scotland
• Association of Principle Education Psychologists
• The Association of Headteachers and Deputes in Scotland
• BILD
• Educational Institute of Scotland
• Positive and Active Behaviour Support Scotland
• CALM Training
• First-tier Tribunal, Health and Education Chamber
• NASUWT
• UNISON
• Angus Council

Items and actions

1. Welcome and apologies

Scottish Government officials welcomed everyone to the call, and attendees introduced themselves. Apologies were noted from the organisations below.

• South Lanarkshire Council
• Fife Council

2. Note of previous meeting (29 September 2020)

The following amendments were requested:

• correct reference to Children and Young People’s Commissioner Scotland in item 1.
• review wording for clarity of the record of item 3.
• 3.2 – Whole school approach, fourth bullet point. Change ‘should’ to ‘could’ or note that this was not a unanimous view.

Subject to these amendments, the note will be published on the Scottish Government’s website.

3. Children & Young People’s Input – Update

The Scottish Government provided an update on the proposed engagement sessions to seek the input of children and young people with direct experience of restraint and seclusion in schools. Of the organisations approached, the Scottish Youth Parliament is represented on the physical intervention working group, Children in Scotland and Children’s Parliament advised they would be keen to support engagement during the public consultation stage and Enable Scotland offered to run engagement sessions in January 2021.

The Enable Scotland sessions would involve their existing ACE connect (young people and young adults) and Family Connect networks. The ACE connect networks include members with learning disabilities. These networks were previously involved in Enable Scotland’s In Safe Hands Campaign and are familiar with the topic. Given the sensitive nature of the subject, all members would be supported to engage by Enable Scotland’s staff and have access to help and support before and following each session. Suggested areas for feedback include:

• effective de-escalation strategies for addressing children and young people’s distress in school.
• ways to reduce the negative impacts of restrictive interventions.
• ways of rebuilding relationships and trust after a restrictive intervention.
• positive communication and becoming an equal partner in decisions.

The contributions sought on each of these areas will be solutions focussed, with the aim of developing practical advice for inclusion in the guidance. A feedback report will be produced and shared with sub group members for comment.

Action: Scottish Government

The following comments were made by group members during the discussion:

• potential to ask young people about the trauma experienced when children are restrained or secluded. Perhaps ask the families and young people more about whether they think it has the longer term impact as well as needing immediate post incident support.
• parents and carers play an important role when engaging with children with communication support needs.
• de-escalation plans work best when developed in partnership with parents and carers.

4. Draft guidance chapters

The sub group discussed the following draft chapters.

4.1 Physical interventions

The Scottish Government advised that the physical intervention chapter has been restructured to reflect the differentiation between restrictive and non-restrictive physical interventions.

4.2 Restraint

The following comments were made by members during the discussion:

• the guidance needs to give clarity on what practice would be considered, lawful, unlawful and illegal. This section is to be added. the term unlawful should be used with care. Unlawful could refer to unlawful under the criminal law, but is probably more apt in this context as a reference to unlawful under the civil law e.g. The Equality Act 2010. An act can be unlawful criminally or under civil law.
• restrictive practices are unlawful if the intervention has breached international human rights law, irrespective of domestic law, policy and practice. Therefore the guidance needs to be explicit about the duty to justify a person has complied with the law rests on the person and the public authority.
• consider using the term ‘not in accordance with the law'.
• an assessment of the physical health of the child or young person and a judgement on the risk of physical harm is important when considering the use of restraint.
• the inclusion of mechanical and chemical restraint was discussed. Examples of mechanical restraint include restraining by strapping children to chairs, using a harness on children and straps to wrists.  
• the guidance needs to reflect the healthcare in schools guidance on the administration of medicines.  
• consideration should be given to the inclusion of physiological restraint and soft restraint, although clarity would be needed on the term and its application.
• the power imbalance between a child or young person in school and the adult member of staff, and this has on seeking consent should be reflected in the guidance.
• the human rights principles governing practice in this area need to be reflected.  Article 3 of the European Convention on Human Rights, which prohibits torture and inhuman or degrading treatment or punishment is the key to this and can help inform split second decisions on practice.
• the group discussed the alignment between the schools guidance and the Scottish Government child protection guidance currently out for public consultation. Scottish Government will review and link where appropriate.
• as well as child protection law policy and practice, it may also be helpful when considering whether harm is 'intentional' or not to consider the debate around the Children (Equal Protection from Assault) (Scotland) Act 2019.

4.3 Seclusion

The sub group briefly discussed the draft seclusion chapter. The following comments were made:

• the subtitle ‘appropriate and lawful seclusion’ should be redrafted to reflect the balance of the guidance away from the use of restrictive practices.   
• clarity is needed between the practices of seclusion, time out and isolation.

The sub group agreed to discuss the seclusion chapter at their next meeting.

5. Any other business               

The following items were raised.

5.1 Timescales

The Scottish Government updated the sub group on the timescales for the publication of the guidance.  The public consultation on the draft guidance is expected to issue in spring 2021, with the final guidance being published in autumn 2021.

5.2 Comment on draft guidance chapters

While the meeting focussed on the above chapters, the following comments were made on other draft chapters in the guidance.

• the guidance should outline the principles around training.
• it is important to highlight that the training needs of staff may vary widely depending on their role.
• the communication passport was discussed. These passports support both children, parents and teachers. Where agreed effective methods of communication are not needed, children and young people with communications support needs may use their behaviours to communicate their needs.
• the availability of support from CAMHS, occupational therapists and multi-disciplinary approaches in planning and post-incident support should be referenced.
• it is important to emphasise that by taking an explicit human rights approach, and by  improving the quality of life, protection and promotion of the human rights of all, the guidance can help to avoid alienating staff who may already be suffering from burnout and compassion fatigue.
• duty of care needs expanded as well as the principle of choosing the least restrictive practice. Illustrate examples will be considered.
• any form of intervention needs to be specific to the child and part of a planned report and training should be tailored accordingly. Clarity on how, who, and  when decisions are agreed and added to the plan.
• consider whether a resource section or page could be added to complement the guidance.
• staff time and resources were highlighted as a factor affecting the ability to plan individual approaches for children and young people in schools. The guidance will highlight best practice and emphasise the importance of planning individual approaches, which can be used to inform resourcing discussions at a local level. 

5.3 Written Comments

The Scottish Government welcomed comments on the latest draft of the guidance by Wednesday 20 January.

Action: all    

6. Date of next meeting                                                                           

The Scottish Government will send out an invitation to the sub group members for Thursday 28 January 2021.