PCC INSTRUCTORS MANUAL Dec 2005

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PPPHYSICAL

CCCONTROL

IIIN CCCARE

TRAINING

MANUAL

DDDECEMBER 2005

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PHYSICAL CONTROL IN CARE

IIINTRODUCTION

PHYSICAL CONTROL IN CARE (P.C.C.) training has been created and developed by the National Instructors at the Prison Service College, to meet specifically the needs of the young person in care and those employed to care for them.

The Secure Training Centre Rules require that the only methods of physical restraint used in Secure Training Centres are approved by the Secretary of State. The only method that has this approval is Physical Control in Care, a method developed by the Prison Service specifically for use on children and which the Home Office subsequently adopted for use in Secure Training Centres

All techniques are approved by the Secretary of State for use in all secure trainings centre in the United Kingdom. Those people employed to escort young people in care also approve the techniques for use.

PCC is a system of holds designed to be used on young people that does not rely on pain compliance to regain control. It is vital to impress upon staff that physical contact to resolve situations is a last resort. Staff should be encouraged to promote dialogue with the young person and de-escalate the situation as the young person regains control.

PERSONAL SAFETY

It is important that the safety of the young person is not gained at the expense of the care worker. The safety of the young person and the member of staff warrant equal consideration. Many of the risks associated with working with young people in care are foreseeable and as such can be catered for within the training package.

Breakaway techniques should form an integral part of the physical handling system adapted for use. To this end PCC Training has incorporated

RESTRICTED - PHYSICAL CONTROL IN CARE - RESTRICTED breakaway techniques from potential attacks the young person may make whilst being held by a member of staff and the more common forms of attack they may possibly encounter in the course of their duties. These techniques offer a structured response to attacks within the care environment, giving the minimal risk of injury to staff and the young person.

The PCC Training package does not depend on the size or strength of the care worker for its effectiveness although these factors will always play a part in the equation. When the situation demands a physical response, staff need to assess the situation, consider their own safety and capabilities before deciding on the appropriate course of action.

We do not consider that there is any such thing as an absolutely safe restraint. Consequently staff considering the application of force will need to be aware of all the risks associated with laying hands on young persons, including factors inherent in both the young person and the holds themselves that may present risks.

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TTTRAINING

All staff requiring PCC training will initially attend a 5 day Initial Course. On successful completion the member of staff will be authorised to use PCC in the approved manner, following the guidelines set out in Secure Training Centre Rules 37 & 38.

The initial course will comprise of the following:

• An introduction to PCC and the Use Of Force Policy. (Including the relevant Rules and Regulations. • Dealing with the conflict • The effects of stress • Use Of Force Report Writing • Medical advice • The role of the PCC supervisor • The FULL PCC syllabus

The course is competence based and all students must be competent before receiving accreditation. All staff must receive a minimum of 1day Refresher Training per year in order for them to be validated to continue to be authorised to use PCC techniques

Any staff not requiring the full PCC training will receive training in personal protection / breakaways at the earliest opportunity. They will receive the entire initial course without the PCC holds.

Training will only be delivered by accredited instructors

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IIINSTRUCTOR TTTRAINING

Selected staff will initially attend a pre-selection at their establishment. This will determine their suitability and potential to successfully complete the instructor’s course.

Factors to consider are • Technical ability • Teaching experience / potential • Experience in the childcare environment • Knowledge of the Rules and Regulations • Long term ambitions • Appearance, demeanour, attitude

The Initial Instructors Course will be a 10-day pass or fail format, at either of the Prison Service Training Colleges.

PSC Hatfield Woodhouse PSC Kidlington Bawtry Road Evenlode Crescent Hatfield Kidlington Doncaster Oxfordshire (South Yorkshire) OX5 1RF DN7 6PQ

The course will cover the following:

• A full revision of the PCC syllabus • Introduction to teaching skills • Awareness of Health and Safety and Safe Systems Of Work • Warm-ups, briefing and de-briefing

All candidates must demonstrate competence in technical ability, instructional ability, underpinning knowledge and attitude. On successful completion, candidates will be certified to instruct for 12 months. All instructors must attend an annual validation course of 4 days to re-qualify. Failure to attend will deem the instructor no longer eligible to instruct PCC. They are given up to 6 months to re-qualify and failure to do so will result in them having to complete the full PCC Instructors Initial Course again.

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1.1.1. USE OF FORCE

The use of force to restrain a trainee must always be viewed as the final option available to Custody Officers. All other methods of resolving the situation must be tried or deemed inappropriate in the prevailing circumstances. Staff should use the reasonable force necessary to resolve the incident.

Any person using force must be prepared to establish that the force used was reasonable in the circumstances. This means that they must be able to show that it was necessary to use force and the force used was proportionate to the threat presented.

2.2.2. ASSESSMENT

In deciding to use physical force to restrain a trainee, staff must quickly assess the following factors:

a) Their own ability b) The physical ability of the trainee c) Known history of trainee d) The minimum intervention phase required to successfully resolve the situation e) The availability of other staff f) The presence of other trainees g) The environment

Having considered the above factors will determine whether or not staff can intervene.

3.3.3. INTERINTER----PERSONALPERSONAL SKILLS

The Use of Physical Force must never be used as a first option. The Use of Force must not be used to replace the ability and willingness of staff to use their inter-personal skills to successfully resolve difficult confrontational incidents.

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4.4.4. A NONNON----DECKINGDECKING POLICY

Within the P.C.C. system there are no techniques, which deliberately take trainees to the floor. Physical restraint within the system aims to maintain the trainee in a standing position. Where there is a likelihood of the trainee or staff being taken to the floor during restraint, the hold(s) will be maintained and the trainee brought to a standing position at the earliest opportunity (within 3 minutes), or released. Within the system provision is made to physically hold the trainee who is already on the floor. The trainee will only be held on the floor for up to 3 minutes then the trainee must be released.

5.5.5. DEDEDE-DE ---ESCALATIONESCALATION

The de-escalation of physical holds placed on the trainee by staff is of paramount importance. The P.C.C. system permits and promotes the hold(s) to be systematically down graded and eased as an integral part of the techniques used. The ultimate aim is to release all physical holds on the trainee as soon as practical and safe for all concerned.

6.6.6. HOLD RELEASE OPTION

Where continued application of physical holds by staff on a trainee becomes unsafe for the trainee or staff the hold(s) must be released. Safety of all involved with the restraint is the priority. All P.C.C. holds and systems have the hold release option included.

7.7.7. ESCALATION

Where staff are having trouble controlling the trainee, they have the option to escalate the physical restraint used by moving to the next phase of holds within the system provided if it is safe to do so.

With any escalation (including handcuffs), the force used must be necessary and proportionate to the threat presented.

8.8.8. TEAMWORK

The success of resolving difficult physical situations depends very much on a team approach to the resolution of these incidents. Staff should always bear in mind the effect that physical restraint may have on other trainees not involved and the potential for them to influence the proceedings. Staff not involved in

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Theory and Law surrounding the use of force

The use of force by any member of staff in an establishment is lawful.

The use ooff force by one person on another without consentconsent is unlawful unless it is justified.

The use of force will be justified, and therefore lawful, only:

If it is reasonable in the circumstances If it is necessary If no more force than is necessary is used If it is proportionate to the seriousness of the circumstances

Reasonable In The Circumstances

The interpretation of reasonable is a key issue concerning a use of force. The issue of reasonableness is a matter of fact to be decided in each individual case. Each set of circumstances is unique and are to be judged on their own merits. Factors to be taken into account when deciding what is ‘reasonable’ will be things such as the size, age and sex of both the trainee and the member of staff concerned in the use of force and whether any weapons are present.

Necessary

The action taken must have been necessary. The first distinction to make is between force used in ‘self defence’ (can more easily be demonstrated to be ‘necessary’) and force used because someone has refused to obey a lawful order. It is not enough that a trainee be given any ‘lawful order’ to do something and has refused to do so.

It is important to take into account the type of harm that the member of staff is trying to prevent – this will help to determine whether force is necessary in the particular circumstances they are faced with. ‘Harm’ may cover all of the following risks:

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Risk to life Risk to limb Risk to property Risk to the good order of the establishment It is clearly easier to justify force as ‘necessary’ if there is a risk to life or limb.

Deciding whether force is ‘necessary’ in order to maintain the good order of the establishment may be complicated – the member of staff must take into account the consequences of the trainee not complying with his/her lawful instruction.

No More Force Than Is Necessary

No more force than is necessary shall be used. Any greater force than is necessary could be deemed as unlawful.

Proportionate In The Circumstances

Staff should demonstrate a reasonable relationship of proportionality between the means employed and the aim pursued. Action taken is unlikely to be regarded as proportionate where less injurious, but equally effective alternatives exists.

Where the use of force is necessary, only approved PCC techniques should be employed unless this is impractical.

• The nature of incidents are so diverse that it is not realistic to cover every possible scenario. For this reason, there will always be occasions when individual officers resort to techniques that are not taught in a training session on the use of force. In such circumstances, the actions of the officer will not necessarily be wrong or unlawful, provided that they have acted reasonably and within the law. In all circumstances where force has been employed the individual concerned must be able to account for their own decisions and actions. • A report justifying the use of any type of force must be completed in all cases.

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Relevant Legislation

What rules govern the use of force?

• STC rules 37 & 38 • Children’s Act 1989 • Criminal Law Act 1967 section 3 (1) • European Convention on Human Rights • Guidance on permissible forms of control in children's residential care (Department of Health 1993) • Criminal Justice and Public Order Act

Use Of Force ––– Secure Training Centre rules

Rule 37 (1) An officer in dealing with a trainee shall not use force unnecessarily and when the application of force to a trainee is necessary, no more force than is necessary shall be used. (2) No officer shall act deliberately in a manner calculated to provoke a trainee.

Rule 38 (1) No trainee shall be physically restrained save where necessary for the purpose of preventing him from - a) Escaping from custody b) Injuring himself or others c) Damaging property or d) Inciting another trainee to do anything specified in paragraph (b) or (c) above, and then only where no alternative method of preventing the event specified in any of the paragraphs (a) to m (d) above is available. (2) No trainee shall be physically restrained under rule except in accordance with methods approved by the secretary of state and by an officer who has undergone a course of training, which is so approved. (3) Particulars of every occasion on which a trainee is physically restrained under this rule shall be recorded within 12 hours of it occurrence.

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The Children’s Act 1989

Guidance and Regulations Volume 4 Residential Care Annex A 8. (3). B

Nothing in this regulation shall prohibit the taking of any action immediately necessary to prevent injury to any person or serious damage to property

Criminal Law Act 1967

Section 3 (1)

Any person may use such force as is reasonable in the circumstances in the prevention of a crime, or in effecting or assisting in the arrest of offenders or suspected offenders unlawfully at large

Common Law

The common law develops from the decisions made in higher courts

A substantial proportion of common law is termed as case law

Common law is the law as determined by legal cases that are heard before judges. ‘Precedence’ is determined by the most recent decision taken by the highest court i.e. in the UK, the House of Lords.

“The common law has always recognised a persons right to act in defence of themselves or others. If they have to inflict violence on another in doing so such action is not unlawful as long as their actions are reasonable in the circumstances as he sees them.

The test to be applied for self-defence is that he acted reasonably in the circumstances, as he honestly believed them to be in the defence of himself or another.

The use of force must be based on an honestly held belief that it is necessary, which is perceived for good reasons to be valid at the time.

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Regina Vs Beckford 1988

“The common law has always recognised a persons right to protect themselves from attack and to act in the defence of others.”

“If it is necessary to inflict violence on another in doing so if no more force is used than is reasonable to repel the attack such force is not unlawful.”

“Further more, a man about to be attacked doe not have to wait for his assailant to strike first blow or fire the first shot, circumstances may justify a pre-emptive strike.”

“The test to be applied for self defence is that a person may use such force as is reasonable in the circumstances as he honestly believed them to be in the defence of himself or another.”

Human Rights Act 1988

The Human Rights Act has two basic purposes.

1. The law of the European Convention on Human Rights (E.C.H.R.) and specifically the rights and freedoms set out in the convention will be actionable before the UK courts. 2. Courts and tribunals, public authorities and Government Ministers will have to act in a way that is “compatible” with the law of convention. Failure to do so may be unlawful, although not a criminal offence.

Use of force and human rights

When making a determination as to whether the level of force used was lawful in any particular instance the courts will take cognisance of the articles under the E.C.H.R. The rights, which are most likely to be directly interfered with in situations where force is used, are:

Article Two: The right to life

Article three: prohibition from torture, inhumane or degrading treatment

Article Eight: the right to respect for private and family life

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ArticArticlele Two: The Right to Life

1. Every ones right to life shall be protected by law. No one shall be deprived of his life intentionally save in the execution of a sentence of a court following his conviction of a crime for which this penalty is provided by law 2. Deprivation of life shall not be regarded as inflicted in contravention of this article when it results from the use of force which is no more than absolutely necessary: a) In defence of any person from unlawful violence b) In order to affect a lawful arrest or to prevent the escape of a person lawfully detained. c) In action lawfully taken for the purpose of quelling a riot or insurrection

Article Three: Prohibition from Torture, Inhumane or Degrading treatment.

The activities prohibited by article three were characterised by the European Court in Ireland v UK (1978) as:

Torture Deliberate inhumane treatment causing very serious and cruel suffering.

Inhumane Treatment Treatment that causes intense physical and mental suffering.

Degrading Treatment Treatment that arouses in the victim a feeling of fear, anguish and inferiority capable of humiliating and debasing the victim and possibly breaking his or her physical or moral resistance.

Where extreme or excessive force is applied, or where the application of force is maintained for longer than necessary (even if its use is to achieve a lawful aim) this may amount to torture, inhumane or degrading treatment. This may include the unnecessary / prolonged use of ratchet handcuffs.

Article Eight The right to respect foforr private and family life

1. Everyone has the right to respect for his private and family life, his home and correspondence. 2. There shall be no interference by a public authority with the exercise of this right except such as is in accordance with the law and necessary in a

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democratic society in the interests of national security, public safety or the economic well-being of the country, for the protection of health and morals, or for the protection of the rights and freedom of others.

As can be seen from the above, Article Eight provides a qualified right, which can be interfered with, providing one of the conditions in paragraph two applies.

Article Eight is not just a right to privacy. It has been held to include respect for an individual’s physical and moral integrity. For this reason, an assault may amount to a breach of Article Eight.

In relation to all the above articles the use of force must be based on an honestly held belief that it is absolutely necessary, which is perceived for good reason to be valid at the time.

On each occasion in which force is used it should be reported how, why, when and to whom.

Criminal Justice and Public Order Act 1994

Powers and Duties of Custody Officers

Section 9.

• (1) A custody officer performing custodial duties at a contracted out secure training centre shall halve the following powers, namely – (a) to search in accordance with secure training centre rules any offender who is detained in the secure training centre and (b) to search any other person who is seeking to enter the secure training centre, and any article in the possession of such a person. • (2) The powers conferred by subsection (1)(b) above to search a person shall not be constructed as authorising a custody officer to require a person to remove any of his clothing other than an outer coat, headgear, jacket or gloves. • (3) A custody officer performing custodial duties at a contracted out secure training centre shall have the following duties as respects offenders detained in the secure training centre, namely – (a) to prevent their escape from lawful custody; (b) to prevent, or detect and report on, the commission or attempted commission by them of other unlawful acts; (c) to ensure good order and discipline on their part; and (d) to attend their well-being.

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• (4) The powers conferred by subsection (1) above, and the powers arising by virtue of subsection (3) above, shall include power to use reasonable force where necessary.

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When faced with violent or confrontational situations staff will be faced with feelings that are unusual to them, it is vital that they accept and recognise them in order to deal with not only the situation but also themselves

How will your staff be feeling prior to being deployed?

• Anxious • Excited • Apprehensive • Worried • Frightened • Nervous

All adjectives to describe feelings, they describe the effects of the body’s natural response. The fight or flight response is the body’s natural mechanism for dealing with confrontation and it strongly favours flight as it’s primary option. Unfortunately many situations dictate that flight is not the option, therefore a third option may take precedence – freeze. If staff freeze in these situations then they are at high risk of becoming a victim. Therefore it is important that training prepares staff to deal with confrontation and that they are aware of what course of action is required:

• Escape • Verbal reasoning • Use of force

When we perceive a threat:

• Heart rate increases • Breathing rate accelerates • Blood vessels dilate • Blood diverts from the digestive system • Glucose and fat are released • Brain releases stimulants • Endorphins are released

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Physiological effects of confrontation:

When we perceive a threat the body releases adrenal chemicals. The positive effects are:

• Heightened awareness • Additional strength • Increased pain threshold

The negative effects of adrenal response:

• Loss of fine motor skills (clumsiness) • Tunnel vision • Time distortion • Auditory exclusion

Loss of fine motor skills

• Due to the acceleration of nerve impulses controlling muscle contraction, hand / eye co-ordination becomes impossible • This clumsiness prevents a person performing any complex motor skills

Tunnel vision

• Under stress an individual will lose part of their peripheral vision as they focus on the direct threat.

Time distortion (tachyphycia)

• Visual slow down • The speed of events seem to be distorted, what happens in seconds seems to last for minutes • Temporary memory loss • Unable to recall key events

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Conflict of perceptions

• The person involved cannot remember large parts of an incidents but they can remember small details • Witnesses however can remember what happened generally but cannot remember minute details.

Auditory exclusion

• This occurs when the blood vessels in the ears are dilated by the adrenal hormones making it difficult to hear • High-pitched sounds are predominant; other sounds fade into the background.

The Adrenal Map

When staff anticipate confrontation they may experience a slow release of adrenaline. Although the release is not as intense as a fast release of adrenaline it can tire and affect the member of staff. It is possible that working in a hostile environment may have this long-term effect on staff that can go unnoticed.

Fast release (adrenal dump) occurs when staff are not anticipating a confrontation and it happens without warning.

To combat the effects staff should attempt to remain in a constant state of readiness and be prepared to deal with all forms of conflict. This can lead to a combination of both releases and staff will need to develop methods for releasing the stress they are faced with (i.e. gym, sport, relaxation techniques etc.) Adrenal reactions: • Shakes • Dry mouth • Voice quiver • Tunnel vision • Sweaty palms • Nausea • Bowel loosening • Auditory exclusion

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• Tachypsychia

Conflict Resolution

When faced with a conflict situation we should have one of three objectives, these are:

Avoid danger Defuse the situation Control the situation

Avoid Danger

Awareness of a threat is an essential aspect of evading a problem as it “buys time”. The earlier a member of staff perceives a possible threat the more time they have for assessment and action. Awareness of surroundings will also help the member of staff to form a decision on how to deal with a situation i.e. exits, alarm bells, other colleagues or trainees.

Due to the physiological changes that take place when faced with a potentially dangerous situation on of three reactions normally occurs; FIGHT, FLIGHT OR FREEZE.

Defuse the situation

It has always been recognised that the best defensive weapon that staff have is their verbal and nonverbal communication skills. Staff who successfully adopt effective communication strategies and interpersonal skills will find that they are usually able to defuse a potential conflict.

However, even when adopting the reasonable approaches, it is recognised that a member of staff may at times have no other option than to use force.

Control the Situation

Adopting an approach that is positive, assertive and confident will help to reduce the likelihood of becoming a victim of unwelcome attention.

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Controlling a conflict that has escalated beyond verbal reasoning may entail using force. However, all staff must make their own decision about how to act in particular situations.

When the use of force has become necessary P.C.C. techniques are always the preferred option.

Where PCC techniques aren’t practical staff must resort to other means of protection.

DeDeDe-De ---escalationescalation and interpersonal / communication skillsskills

Definition of Violence for the Prison Service:

‘Any incident in which a person is abused, threatened, or assaulted. This includes an explicit or implicit challenge to their safety, well being or health. The resulting harm may be physical, emotional or psychological’.

Managing aggression

The effective handling of aggressive trainees is one of the most demanding aspects of working in an establishment. It is an area where good interaction and communication skills are required.

The majority of situations, where there is a potential for violence, can be handled through communication.

“Aggression can be defined as any behaviour that is perceived by the victim as being deliberately harmful and damaging either psychologically or physically”.

Our objective when dealing with an aggressive trainee is to prevent the aggression escalating into actual physical violence.

Signs of aggression: • Standing tall • Red faced • Raised voice • Rapid breathing • Direct prolonged eye contact • Exaggerated gestures

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Why does aggression occur? • Frustration • Perceived unfairness • Feelings of humiliation • Immaturity • Excitement • Learned behaviour (it gets results) • Reputation • Means to an end • Decoy

Assessing the risk of violence and aggression:

Consider the following questions, the more often the answer is “yes”, the greater the risk of violence or aggression: • Is the trainee facing a high level of stress? (e.g. a recent bereavement, a pending court date) • Does the trainee seem to be drunk or on drugs? • Does the trainee have a history of violence? • Does the trainee have a history of psychiatric illness? • Has the trainee verbally abused staff in the past? • Has the trainee threatened staff with violence in the past?

Recognising potential aggression at an early stage:

The following signs may indicate aggression: • Any major change in behaviour that varies from what is normal for the trainee. • Pale or flushed face. • Rising voice. • Focusing / narrowing of gaze. • Tensing of muscles • Increased agitation and disturbance in behaviour (e.g. pacing)

Communication

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Communication is a two way process that relates to verbal interaction (listening, speaking and hearing), non-verbal interaction (interpretation and observational skills – looking and seeing).

Many communication problems could be avoided by: • Using more appropriate language • Taking more time to communicate the message • Checking for understanding • Encouraging feedback • Choosing a more appropriate time /place

There are many factors to consider when we communicate with others, we should be aware that all “messages” will contain facts, feelings, values and opinions.

Facts – are real and objective. We believe them because they can be verified.

Feelings – are our emotional responses to situations

Values – are the norms, which exist in society at large. They can be deep- seated beliefs about what is right or wrong.

Opinions – are our ideas about particular issues, events or situations. They are subjective and normally limited to the immediate environment.

Communication problems often occur in our environment when we, or “trainees” get confused; perhaps interpreting an opinion as fact. So we must be aware that a message consists not only of content (facts) but also of values, opinions, assumptions and feelings.

Some of the common inhibitions to effective communication are: • Noise • Language • Perception and prejudice • Intrusion of personal space

We cannot necessarily avoid or overcome all these barriers but we need to find ways of minimising them.

Noise:

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Noise is a major distraction when trying to communicate. It’s hard to hold a discussion against a noisy background.

Language: Officers need to express themselves in as direct and explicit manner as possible and avoid emotive language (for example – avoid power words)

Perception and prejudice: Everybody has a unique background and history with influences and experiences that form our way of looking at the world. It is important to recognise our prejudices for what they are and to work round the prejudices of others. We have to maintain a professional attitude by not allowing our own perceptions to get in the way of our duties and responsibilities towards others, particularly in promoting equal opportunities, or to let our prejudices influence the way we communicate.

Intrusion of personal space: Avoid standing next to the person

NonNon----verbalverbal Communication

In any interaction with other people it is impossible not to communicate on one way or another. Most people give off signals through “body language”. About a third of the meanings in communications are supplied by the spoken word. Some of the key areas to observe are: • Facial expression • Eye contact • Posture • Gesture • Proximity • Paralinguistics

Many of the points above encourage you to make judgements about personality and emotions on a subconscious level, leading to positive or adverse behaviour.

Defusion Strategies

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Before anything else happens we need to defuse the situation. A trainee who is out of control will be under the influence of the adrenal cocktail. Our strategy should be to do nothing to escalate their state of mind whilst being prepared to defend ourselves if necessary.

Our actions should include: • Appear confident, give the impression you are capable of dealing with the situation • Displaying calmness, be aware of your body language • Create some space, allow then to feel safe • Speak slowly gently and clearly • Lower your voice, they are more likely to lower theirs • Don’t stare, keep averting your gaze • Ask questions • Don’t argue • Listen and show you are listening • Don’t try to solve the problem prior to calming the trainee

Adopting a non threatening body posture: • Use a calm, open posture (sitting or standing) • Reduce direct eye contact (as it may be taken as a confrontation) • Allow the trainee adequate personal space • Keep both hands visible • Avoid sudden movements that may startle or be perceived as an attack • Avoid audiences – as an audience may escalate the situation

Never Threaten: Once you have made a threat or given an ultimatum you have ceased all negotiations and put yourself in a potential lose situation.

DeDeDe-De ---escalationescalation techniqutechniqueseseses

Explain your purpose or intention • Give clear, brief, assertive instructions, negotiate options and avoid threats. • Move towards a ‘safer place’, i.e. avoid being trapped in a corner

Encourage a reasoning (for their behaviour) • Encourage reasoning by the use of open questions and enquire about the reason for the aggression

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• Questions about the ‘facts’ rather than the feelings can assist in de- escalating (e.g. what has caused you to feel angry) • Show concern through non-verbal responses • Listen carefully and show empathy, acknowledge any grievances, concerns or frustrations. Don’t patronise their concerns.

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IMPACT FACTORS REASONABLE RESPONSE SUGGEST OPTIONS

• Observe behaviour • Ask trainee to comply with instructions Passive Resistance • Explain why compliance is required • Explain the consequences of nonnon----compliance.compliance. Trainee offers no resistance but (Placed on report, staff may have to use force refuses to comcomplyply with reasonable etc.) requests or direct orders. • Ask if there is ananythingything we can reasonably say or do to make them comply • Use planned P.C.C.

• Observe behaviour Active resistance • Use defusion / dede----escalationescalation strategy • Use planned P.C.C.

Violent Behaviour

Trainee is causing concern i.e, • Use defusion strategy or withdraw their behaviour is deemed as • If no other practical option use reasonable thrthrthreatening,thr eatening, either verbally or nonnon---- force to prevent assault verbally. This could escalate to • If practical use P.C.C. techniques actual violence towards a person or property.

TTThreatThreat to Limb

• Withdraw or use defusion strategy Weapons may be present. A • Use reasonable force to protect trainees’ behaviour is likely to • cause injury to others if no action Use P.C.C. if practical is taken

• Withdraw • Use defusion stratstrategyegyegyegy Threat to life • Use planned P.C.C. if practical • Use reasonable force to protect

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Impact Factors

At times the judgement of staff can be affected by the situation they are in. When deciding if a member of staff acted lawfully these factors have to be considered: • Relative sex, age, size, strength, skill level • Special knowledge • Numbers involved • Drugs, alcohol • Perceived danger / disadvantage • Cultural differences

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Use of Force Report Writing

A report is always completed by the member of staff involved in the use of force explaining the circumstances in which force was used and justifying the actions of that member of staff in using force.

• Whenever a member of staff has found it necessary to use force on a trainee they must record the circumstances that lead up to the use of force that was used and why. • The “Use of Force” includes any and all types of force that may be used against a trainee – this includes the use of planned and unplanned PCC and the use of any type of force in order to give effect to a lawful order. • The purpose of the member of staff writing the report is to justify their actions and to demonstrate that the use of force was:

Reasonable in the circumstances. Necessity. No more force than necessary Proportionate to the seriousness of the situation.

Outcome

The Use of Force Report Form is completed and stored correctly.

• Copies of the Use Of Force Report Form may be produced for internal or external investigations. It is important that when a written statement is given it creates as full a picture as possible in order to justify the actions that have been taken.

The Supervisor

The supervisor is responsible for ensuring completion of the Use Of Force Form. When an incident is spontaneous it is not always possible for the supervisor to be present at the beginning of an incident. However, the Supervisor is till responsible for the completion of the Use of Force Form.

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The supervisor must complete their own version of events.

All staff iinvolvednvolved in the Use of Force

It is important that all staff who were involved in the use of force complete a Use of Force Form. The purpose of completing this form is for each member of staff to justify and explain their actions and the circumstances in which they took them. They must make as clear a picture as possible as to the facts as they saw them.

• Where the member of staff was when they became aware of the incident • Details of any briefing given to them by the supervisor • What circumstances they are aware of that led up to the use of force • Instructions given to the trainee prior to force being used – this must include that the trainee was made aware of the consequences on non- compliance • Their perception as to the behaviour of the trainee and what he/she was saying and doing • The names of others present (both staff and trainees) • What their role was • A detailed description of how they applied force • How the member of staff felt about the incident • Their perception of the resistance offered by the trainee • Quote any instructions given to the trainee and the response received • De-escalation efforts made (try to quote the words used) • Whether ratchet handcuffs were applied (and who authorised their use) • Where the trainee was relocated to and how the relocation took place e.g. in holds, walking, in ratchet handcuffs • Any injuries observed to staff and / or trainee

Duty Manager

The Duty Manager is ensuring that:

1. The Use of Force Form is completed in full 2. Every officer who was involved in any use of force has completed an Officers Statement 3. An Injury Report has been completed on any trainee involved in the incident

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4. The Director has been informed 5. All Use of Force incidents are recorded within 12 hours of occurrence 6. The incident must be properly recorded and all paperwork stored appropriately 7. All reports are completed individually in a secure area with restricted access. All reports should be made available when requested for the purpose of investigations or for collative statistics on the use of force.

Staff should complete a Use of Force Report at the earliest opportunity, however, should any information come to light at a later stage, additions can be made to the initial statement

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MEDICAL ADVICE

Background

The system of restraint used in Secure Training Centres is being reviewed. In the meantime, it is essential that all staff are aware of the potential dangers associated with restraints, understand their mechanisms and can recognise early warning signs.

A number of adverse effects are possible following the application of restraints. These include being unable to breathe, feeling sick or vomiting, developing swelling to the face and neck and development of petechiae (small blood-spots associated with asphyxiation) to the head, neck and chest. This advice sheet serves to remind staff of the dangers of restraint and signs of impending asphyxiation.

Mechanics of breathing

In order to breathe effectively, an individual must not only have a clear airway but they must also be able to expand their chest, since it is this that craws air into the lungs. At rest, only minimal chest-wall movement is required, and this is largely achieved by the diaphragm and the intercostals muscles between the ribs. Following exertion, or when an individual is upset or anxious, the oxygen demands of the body increase greatly. The rate and depth of breathing are increased to supply the body these additional oxygen demands. Additional muscles in the shoulders, neck and chest wall and abdomen are essential in increasing lung inflation. Failure to supply the body with the additional oxygen demand (particularly during or following a physical struggle) is dangerous and may lead to death within a few minutes, even if the individual is conscious and talking.

PositioPositionalnal asphyxia

Any position that compromises the airway or expansion of the lungs may seriously impair a subject’s ability to breath, and can lead to asphyxiation. This includes pressure to the neck region, restriction of the chest wall and impairment of the diaphragm (which may be caused by the abdomen becoming compressed in seated, kneeling or prone positions). Some

RESTRICTED - PHYSICAL CONTROL IN CARE - RESTRICTED individuals who are struggling to breathe will ‘brace themselves’ with their arms – this allows them to recruit additional muscles to increase the depth of breathing. Any restriction of this bracing may also disable effective breathing in an aroused physiological state.

There is a common misconception that, if an individual can talk, they are able to breath. This is not the case. Only a small amount of air is required to generate speech in the voice box, a much larger volume is required to maintain adequate oxygen levels around the body, particularly over the course of several minutes during a restraint. A person dying from positional asphyxia may well be able to speak before collapse.

When the head is forced below the level of the heart, drainage of blood from the head is reduced. Swelling and blood spots to the head and neck are signs of increased pressure in the head and neck, which are often seen in asphyxiation. A degree of positional asphyxia can result from any restraint position in which there is restriction of the neck, chest wall or diaphragm, particularly in those where the head is forced downward towards the knees. Restraints where the subject is seated require particular caution, since the angle between the chest wall and the lower limbs is already decreased. Compression of the torso against or towards the thighs restricts the diaphragm and further compromises lung inflation. This also applies to prone restraints, where the body weight of the individual acts to restrict the chest wall and the abdomen, so restricting diaphragm movement. J

Risk factors for positional asphyxia

Any factors that increase the body’s oxygen requirements (for example, physical struggle, anxiety and emotion) will increase the risk of positional asphyxia. A number of specific risk factors are listed below:

• Restriction of or pressure to the neck, chest and abdomen • Prolonged restraint after physical struggle causing fatigue • Restraint of an individual of small stature • Any underlying respiratory disease (i.e. asthma) • Obesity • Alcohol, or drug intoxication (alcohol and several other drugs can affect the brain’s control of breathing, and intoxicated individuals are likely to reposition themselves to allow effective breathing) • Unrecognised organic disease • Psychotic states

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• Recent head injury • Presence of an excited delirium state (a state of extreme arousal often secondary to mania or schizophrenia, or use of drugs such as cocaine, characterised by constant purposeless activity, often accompanied by increased body temperature. Individuals may die of acute exhaustive mania, and this may be precipitated by restraint asphyxia • A combination of chest-wall or abdominal restriction in a seated, kneeling or leaning forwards position (this is particularly dangerous). The figure of our basket holds should, where at all possible, not be used in the seated or leaning forwards positions. Trainees must be kept as erect as possible when they are being restrained in a seated position. Trainees must be meticulously observed and monitored according to the advice in this sheet.

Important warning signs

There are a number of important warning signs:

• An individual struggling to breathe • Complaining of being unable to breathe (trainees may complain of being unable to breathe to get staff to release the restraint. Staff should never presume this to be the case, and should release / modify the restraint to reduce a body / wall restriction) • Evidence or report of individual feeling sick / vomiting • Swelling, redness or blood spots to face or neck • Marked expansion of veins in the neck • Subject becoming limp or unresponsive • Change in behaviour (both escalative and de-escalative) • Loss of, or reduced levels of consciousness • Respiratory or cardiac arrest

Actions

The actions to be taken are as follows:

• Immediately release or modify the restraint as far as practicable to effect the immediate reduction in body wall restriction • Immediately summon medical attention and provide appropriate first aid in line with the policy of the Secure Training Centre

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• If subject is not breathing, administer rescue breaths • If subject has no pulse, initiate CPR (cardio-pulmonary resuscitation) • Complete report • Attend post incident de-briefing

Psychosis

Psychosis is a general term used to describe mental conditions in which there is loss of contact with reality and gross loss of insight, the person may be extremely suspicious. Their fears can seem so real that they may believe their personal safety is under threat, i.e. that others are intent on causing them harm. Occasionally they develop the belief that their life is directly threatened, they then become physically aggressive and violent. Persons suffering from psychosis are to be regarded as seriously ill and in urgent need of medical attention.

It may be dangerous to use C& R techniques to control psychotic patients without the benefit of medical support, because the trainees responses to pain may be abnormal, resulting in them struggling violently against persistent attempts to bring them under control through restraint. The effect of such struggling may make them so exhausted that when they finally come under control, their body systems may suddenly enter a state of virtually complete collapse. In this condition the person may have insufficient remaining strength to support the vital respiratory movements of the chest that are essential for life, and death may then rapidly ensue,

Excited Delirium

Excited delirium is both a mental state and a physiological arousal. Excited delirium can be caused by drug intoxication (including alcohol) or psychiatric illness or a combination of both. Cocaine is a well known source of drug induced excited delirium. Differentiating someone in excited delirium from someone who is simply violent is often difficult. People suffering from excited delirium may: • Have unexpected strength and endurance, apparently without fatigue • Show an abnormal tolerance of pain • Feel hot to touch • Be agitated • Sweat profusely • Be hostile

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• Exhibit bizarre behaviour and speech

It may only become apparent that a trainee is suffering from excited delirium when they suddenly collapse: beware of sudden tranquillity after frenzied activity, which may be caused by, sever exhaustion, asphyxia or drug related cardiopulmonary problems (problems with the heart and lungs).

Sickle Cell Disease

Sickle cell disease is common in African black populations, throughout the Mediterranean and Middle East and in some parts of India. It is essentially an inherited disease/trait in people originating from these regions or in their descendant ethnic groups. The nature of the disease/trait is such that if a person is put in a situation where they have reduced oxygen content within their body, blood vessels may become blocked. It is not however a problem exclusive to sickle cell sufferers, there may be other people who might suffer similarly if they experience a reduction of oxygen in their blood.

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Staff must use force that is reasonable and proportionate in the circumstances, as they perceive them. Staff must be aware that certain areas of the body are more sensitive, and a blow to these areas may result in serious or long-term damage. Blows to the following areas of the body can distract or disable (temporarily) or unbalance an attacker – however force used in certain areas may result in long-term or fatal injuries

BODY AREA MEDICAL IMPLICATION

• Bruising, shock or trauma EARS • Rupture to the eardrum, concussion or unconsciousness

• A kick to the knee may cause tears or sprains to the ligaments or KNEE JOINT fracture of the patella.

SHIN • A powerful kick may fracture one or both bones in the lower leg (Tibia and fibula). Even if this does not occur a kick will cause intense pain.

• A hard stamp on to the instep may cause displacement or IN-STEP fracturing of the metatarsal bones.

• Nose bleed, trauma fracture. NOSE • Split lip, chipped or dislodged teeth.

SOLAR PLEXUS • Nausea and shock. (Central Upper Torso) • Strikes to this area may affect the normal movement of the diaphragm, which could stop a person from breathing momentarily.

COMMON PERONEAL NERVE • As these areas are muscular the risk of fracturing bone is FEMORAL NERVE reduced. RADIAL NERVE • A blow to these nerve clusters could cause a motor dysfunction MEDIAN NERVE where the limb becomes temporarily paralysed. TIBIAL NERVE

FINGERS • The fingers may be dislocated or fractured.

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In the most extreme circumstances, the following areas may be targeted, however staff must be able to justify their actions.

• Pressure or blows to the throat may cause asphyxiation due to NECK & THROAT AREA bruising of the windpipe. Death can occur very quickly. • Pressure to the side of the neck can reduce blood flow to the brain and unconsciousness can follow. • Cardiac complications can occur due to stimulation of related nerves.

• Fracture to the skull HEAD • A solid blow can cause one to collapse • A strike to this area may result in a haemorrhage

• BLURRED VISION EYES • TEMPORARY OR PERMANENT BLINDNESS CAUSED BY RUPTURE TO EYEBALL OR DETACHED RETINA

• A blow to this region may cause shock, nausea, or unconsciousness GROIN • A solid blow may cause a rupture to the bladder • A hard kick to this region may fracture the pubic bone

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GUIDELINES

FOR

INSTRUCTORS

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It is essential that Instructors, and the staff they instruct, should always have at the forefront of their minds that the techniques being taught are only one part of a range of possible responses to threatened or actual violent behaviour.

Such techniques are to be used only when other methodsmethods not involving use of force have been tried and ffailed,ailed, or are judged unlikelyunlikely to succeed, and actioactionn needs to be taken to prevent injury to young person’s, to staff, to other person’s or damage to property.

THESE TECHNIQUES MUST ALWAYS BE SEEN IN THE CONTEXT OF THE TOTAL RELATIONSHIP BETWEEN CARE STAFF AND YOUNG PERSON’S.

Any suggestion that the appropriate response to disruptive or threatening behaviour is necessarily the use of force – or that violence should necessarily be met by violence – must be discourageddiscouraged.

Instructors must always be conscious of the fact that, by what they say and do, they influence the attitudes and actions of trainees. Instructors must at all times be mature and balanced in the attitudes and actions, which they present to trainees. The presentation of a ‘macho’ approach is likely to be carried across into the manner in which trainees perform their duties – to the serious detriment of their performance, their inter-personal relationships with young person’s and ultimately to the reputation of the Service.

APPROACH, ATTITUDE

Instructors teach skills which are vitally important to trainees, to their establishments and to the Service at large. Only the very best will be acceptable.

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Instructors will be instructing men and women of varying ages, physical competence, operational experience and aptitude to learn. Some may be over-confident, others apprehensive. The Instructor’s task is to assess, reassure, teach and produce at the end of the course a group both confident and competent to cope with violent situations, on different scales, which may arise in the course of performing their normal duties.

Each PCC course depends on the instructor’s sensitivity, powers of observation, skill and ability to draw together all who take part in a shared objective. The instructor should always remember that a good course is much more than the sum of its parts. The importance of teamwork should be constantly stressed.

Often in the early stages of training courses members may discount PCC techniques in favour of a more physical approach towards resolving physical handling situations. The task of the instructor is to enable these staff to use their physical competence in a disciplined and controlled way for the common good.

It is important for instructors to bear in mind that all members of a course are colleagues and not recruits to be ‘knocked into shape’.

No distinction of rank or sex is made on a PCC course. It is, and must always be seen as, a shared and unifying enterprise.

PRESENTATION

Instructors need to be in the training area well before the arrival of course members.

Their turnout must be exemplary.

An Instructor constantly represents the standards, which he/she expects, and will almost certainly get - for better or worse - from the course members.

Regardless of an instructor’s own disposition on the day, or the number of occasions on which he/she has taught the same skills, an instructor must always present enthusiasm to pass on these skills. This is not without difficulty. If an instructor cannot manage it, then perhaps he/she is not suited to be an instructor.

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PREPARATION

FAIL TO PREPARE ––– PREPARE TO FAIL

The instructor should have thought about the session in advance and mapped it out with due regard to what is known about the skill of the trainees and the time available.

The session timetable is merely a guide, and the instructor should not feel they must stick rigidly to it. Each course is different and the instructor must use judgement and experience to decide how best to use the time available to the best advantage of the course members. It is none the less important that instructors cover the full lesson programme where possible and not get entrenched in delivering only certain aspects of the course.

LESSON PLAN

It is not possible to reproduce within this manual all the teaching points that instructors must necessarily relate to trainees as only a brief description of the techniques and systems of PCC training is given. Instructors should expand on the outlined points by producing a comprehensive lesson plan for each session they are to take.

INSTRUCTORS SHOULD NOT MAKE ANY CHANGES TO THE PROGRESSION IN WHICH PCC TRAINING IS TAUGHT, NOR MAKE ANY ADJUSTMENTS TO THE TECHNIQUES OUTLINED IN THIS MANUAL.

INSTRUCTION

Effective training must be demanding, reproduce so far as is possible the operational situations within which the techniques will be used. Instructors must ensure that this is not achieved at the expense of course member’s safety.

TEACHING TECHNIQUE

Instructors should ensure that they are accompanied by another instructor whenever they are instructing. Class numbers should be relative to the facilities available and the number of instructors that can be used.

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Instructors should be enthusiastic but avoid excess verbal.

Five minutes of practice are worth an hour of talking. As a general rule instructors should:

Demonstrate the full technique; Break into parts (talk through) Demonstrate once more Use progressions to facilitate learning Allow the course to practice Circulate amongst the course

Instructors must always bear in mind that the purpose of training is to prepare staff to manage real-life situations and not re-create it exactly.

It follows that it is the responsibility of the instructor and their training managers to ensure that the degree of realism simulated in training is no more than is necessary to achieve the training objective. Training simulations should reflect operational circumstances.

Instructors need to take every possible precaution to minimise injury and, in legal terms, to ensure that there can never be any question of negligence on the part of the instructor or their employer.

When use of physical handling skills are used in training scenarios an instructor must supervise the event and act as a safety officer. Should a safety problem arise the training should be stopped immediately.

COACHING

Instructors must also satisfy themselves on a number of important points, which are presented below in checklist form:

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Instructors should: -

Draw attention to the main faults

Avoid identifying individuals (faults are shared)

Follow this with more practice

Discuss any operational difficulties

Ensure that the demonstration can be seen by everyone

Speak clearly and distinctly

Encourage and allow questions

Maintain careful observation

Stop activity immediately if there is any likelihood of injury

Be on the lookout for signs of boredom and fatigue

Be prepared to modify your lesson to meet the needs of the class

Return to basics if the need arises

EQUIPMENT

Ensure that all equipment used in training is in good order, regularly maintained, sufficient to meet the needs of the class and in the right position!

Ensure the class members wear correct equipment when they are required to do so.

SAFETY PRECAUTIONS

No training that is effective, challenging, involves physical contact can be entirely free of risk of injury....

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DRESS

Instructors should ensure that course members are appropriately dressed for the activity. Potentially dangerous items such as belts, watches, and jewellery should not be worn during training sessions. Suitable footwear should also be worn.

VENUE

Instructors are responsible for ensuring that the venue for use has sufficient space for the activity, has an appropriate covering on the floor and any structural problems that might effect the running of the course are catered for.

ORGANISATION

Instructors should ensure that the best use of the area available is made. Working the course in pairs, threes, fours or groups requires pre-planning and good organisation.

DISCIPLINE

In general P.C.C. training imposes its own discipline. However instructors need to be observant and continually ask themselves

“Are things in control?”

“Are members of the group likely to prejudice this control through lack of effort, apathy, irresponsible behaviour or sheer lack of interest?”

FEMALE YOUNG PERSONS

Where necessary instructors should give advice to staff regarding specific issues that effect the physical handling of female young person’s. In particular the possibility of pregnancy has a direct bearing on several techniques within the package e.g. Basket Hold, Side Hug Hold.

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DEDEDE-DE ---BRIEFINGBRIEFING

Following the end of each session, each instructor should ask themselves;

• Did the session achieve it’s objective? • Could the session be improved? • Does there need to be a review of the progressions? • Did I take account of the course member’s comments? • Were there any salient operational points to take away from the session?

MONITORING OF INJURIES

At the end of every session involving physical handling, instructors must ask course members if anyone has been injured.

Injuries should be recorded in the Accident Report Book and a report obtained from the injured person plus any witness statements.

The frequency and type of injuries should be monitored. This information should be used to identify possible ways of reducing injuries and improving the delivery of training.

Each injury must be fully investigated and fully recorded.

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Before SStartingtarting

• Make a note of your start and finish time. • Remove your watch and place it on the desk • Make a note of the visual aids and handouts (if you want to use them) and make sure they are ready • Do not prepare too much material • Have some questions ready in case you have time to fill

OHPs / Power Point / Flip chart / Whiteboard

• Don’t walk in front of the projector light; it can damage your eyes • Ensure print is large enough to be seen by all candidates • If you need to mask some of the print use 2 sizes of masks • Use bullet points on the OHP/Power Point and read from your notes • Use upper case and lower case text.

Starting your presentation

• Introduce yourself and your subject • State the aims and objectives of the presentation • State if you want questions during or after your presentation • Don’t rush your presentation

During the Presentation

• Maintain eye contact with candidates • Use humour, but don’t over do it • Illustrate any points made by examples • Get feedback

End

• Ensure you have achieved your aims and objectives • Ask for questions

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Physical Control in Care Basic Training

General

1) Only approved techniques contained in the Physical Control in Care Manual will be taught, demonstrated and practised. 2) Only qualified Physical Control in Care Instructors will deliver this training. 3) No Physical Control in Care training will take place without the correct amount of Instructors present i.e. • 1 to 16 pupils require a minimum of 2 Instructors. • For each additional 8 of part of, an extra Instructor will be required

4) Before any training session takes place, the Instructor will check the following;

• That the training area is safe i.e. there are no tears or rips on the crash mats and it is of adequate size for the numbers being trained. • The equipment to be used is safe and adequate • The location of the First Aider, if there is not one present in the actual training room • The location of the First Aid Kit, First Aid Room and be aware of local Fire Rules and Muster Points. • All staff will be asked by the instructors if they have a medical condition, disease or injury that would prevent them from participating in this training, or that such training would cause more distress. Those that have should be excluded until such time as they are fully fit to do so.

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• All staff will remove jewellery, watches, rings, chains and belts etc. • All staff will be correctly attired i.e. training shoes, appropriate comfortable clothing.

5) All students will take part in the ‘warm up’. The ‘warm ups’ although not requiring a high level of fitness, will be sufficient as to prepare all muscle groups for the activity they are about to practise. 6) All techniques will be taught and practised in progressive stages taking account of the capabilities of the class. 7) Instructors will ensure that pupils are not using excessive force when practicing Physical Control in Care techniques and that if they hear the word ‘OXO’OXO’ everyone must stop and release any holds immediately. 8) Staff will be reminded of Home Office Rules and the rules governing the use of force. 9) At the end of each session, all staff will be asked if they have any injuries. Any reported injury, however small, will be correctly recorded and documented. Students will be advised of reporting procedures for injuries that are a direct result of the training but not diagnosed at the time of training.

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Prior to any P.C.C. session the Instructor must physically prepare the students for the session. This promotes good practice & ensures that the Instructor is adhering to the Safe Systems of Work of the P.C.C. Manual.

The warm up should be effective & specific, taking no longer than necessary & taking into consideration the students age & physical condition.

OBJECTIVE

The objective is to ensure that Instructors plan & deliver a safe warm up.

TYPES OF WARM UPS

A general warm up involves rhythmic body movements unrelated to the proposed activity. A specific warm up relates to the area of the body to which attention is needed.

THE COMPONENTS OF A WARM UP

1. Pulse raising exercises

2. Body weight exercises

3. Mobility exercises

4. Stretching exercises

PULSEPULSE----RAISINGRAISING EXERCISES

The purpose of the pulse-raiser is to warm the body & gradually elevate the heart rate. Graduation of the exercise intensity is important as it provides the heart with time to increase stroke volume & cardiac output. Just as important is the time needed to establish vasodilatation, (dilation of the blood vessels) within the muscles. The capillary beds within the muscles dilate; this enables more blood, heat, nutrients & oxygen to be circulated through the muscles.

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Sudden exertion without a gradual build up can lead to an abnormal heart rate & inadequate blood flow to the heart. This could be potentially dangerous to an unfit person. To avoid suddenly stressing the cardiovascular system, the pulse-raiser should be of low to moderate intensity.

BODY WEIGHT EXERCISEEXERCISESSSS

The purpose of body weight exercises is to enable the warm blood to flush into the muscle groups within the body. By utilising exercises such as press ups & free standing squats, Instructors can ensure that the majority of the primary & secondary muscle groups have been prepared for any further physical activity.

MOBILITY EXERCISES

Before an exercise session it’s advisable to mobilise & prepare the specific joints to be used in that activity. These activities refer to slow & gentle rhythmic joints movements. For example, shrug your shoulders & gently roll them back & repeat in the opposite direction. This would be an example of a mobility exercise for the shoulder girdle.

From the point of preparing the body for an activity, it makes sense that all the major joints are mobilised.

For example, preparation for a P.C.C. session may include the following mobility exercises.

JOINT MOBILITY EXEEXERCISERCISE

Ankles Ankle circles

Knees Knee bends & rolls

Hips Hip circles

Thoracic spine Trunk Twists

Shoulder Girdle Shoulder rolls & circles

Elbows Elbow bends

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STRETCHING EXERCISES

The purpose of a preparatory stretch is to ready the large muscle groups which are to be used throughout a P.C.C. training session. The stretches should be held for up to ten seconds. Remember the objective of a preparatory stretch is to ready the muscles & not to develop flexibility.

Although there is no significant scientific evidence to state that you need to stretch in a warm up. It’s both logical & appropriate to do so to fully prepare the body for the training session. A cold muscle has a reduced blood flow and as such is relatively inelastic which would increase the potential for muscle strain.

Notice that the sample short stretch plan on the following page includes a brief description of stretches & muscle groups worked, avoiding contra-indicatory exercises.

KEY POINTS

• Stretching should not be performed prior to the pulse-raiser.

• Duration of the warm up should be between 5 – 10 minutes.

• De-conditioned, sedentary & unfit staff will require a longer & more gradual approach & will fatigue quicker on a training session.

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PPPHYSICAL

CCCONTROL

IIIN CCCARE

HOLDS

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Staff may be deployed only with the necessary authority.

Wherever possible every incident should be overseen by a supervisory member of staff. It is recognised that in some circumstances the staffing levels, or the need to resolve the incident quickly, may preclude the appointment of a supervisor. In these circumstances the number 1 of the team must undertake the responsibility of the supervisor.

A supervisor must be appointed for every planned removal prior to the deployment of staff to resolve the incident. Incidents requiring the use of PCC must be supervised by an officer who will be accountable for the management of the incident until the trainee is under control (“the supervising officer”). Experience and knowledge are key factors in determining who fulfils this role.

The supervisor must make every reasonable effort to persuade the trainee to terminate the incident peacefully.

The team will be deployed by the supervisor after all reasonable efforts at persuasion have failed or are judged unlikely to succeed, or if it is necessary to prevent injury to staff, trainee, or damage to property.

Preparation

The supervisor is in overall charge of the incident and will usually be the most suitable person available present. Ideally the supervisor will take no active part in the resolution of the incident but will remain accountable for the management of the incident.

The supervisor having attempted to terminate the incident by persuasion must:

i. Assemble the staff and sufficient replacements ii. Ensure that those staff participating are PCC trained and are currently qualified and fit to carry out the tasks iii. Make arrangements to assemble such support services as may be needed (time permitting) e.g. health care and other specialist staff iv. Brief the staff;

• Regarding the trainee • The current situation

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• Consider the use of video evidence • Arrange for evidence gathering & Scene Of Crime Officer in the incident scene following the removal • Route and relocation site

v. Ensure the staff are properly attired and that articles that might cause injury to themselves or others during the resolution of the incident, e.g. obtrusive rings, necklaces, and security keys are removed vi. Where protective equipment is used, ensure that it is in good operational condition, and type approved by Police Scientific Development Branch vii. Consult health care staff where time permits (medication, pregnancy, etc.) viii. Brief support group staff as to their function ix. Ensure the incident area is cleared of other trainees and staff not involved.

The Removal

The supervisor must

i. Unlock any door(s) to facilitate the entry of the team(s) ii. Monitor the condition of the trainee and staff involved in the incident iii. Be prepared to replace staff who show signs of fatigue of who have been injured iv. Where appropriate ensure that protective equipment is removed prior to moving the trainee through the establishment v. Be prepared to release a trainee immediately if necessary

The role of the health care staff

A member of the health care staff must attend, whenever reasonably practicable, every incident where staff are deployed to restrain violent or disturbed trainees.

When health care staff are on duty they must attend a planned PCC intervention.

The member of health care staff must monitor the trainee and members of the PCC team, and provide clinical advice to the supervisor and/or team in the event of a medical emergency. Any clinical advice offered must be adhered to by the supervisor and/or team.

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Any decision of the health care to release holds due to the potential health implications of continued restraint must be adhered to by the staff involved.

Moving a trainee

The role of the supervisor

i. Inform the team and ancillary staff where the trainee will be relocated ii. Decide on the route to the relocation area iii. Delegate staff to ensure the route is clear of other trainees and staff not involved iv. Ensure that all gates/doors are unlocked/locked to aid the smooth passage of the team(s) through the establishment v. Continue to monitor the condition of the trainee and the staff involved in the incident vi. Ensure that communications between the number 1 of the team and the trainee take place in an attempt to de-escalate the incident vii. Work in conjunction with the number 1 of the team, continuously assessing whether restraints are still necessary and ensuring that no restraint is used once it is no longer necessary.

Relocation of a Trainee

The role of the supervisor

1. Remain throughout and oversee the relocation of the trainee 2. Work in conjunction with the number 1 of the team, continuously assessing whether restraint is used once it is no longer necessary 3. Ensure that only those required in the relocation process are in the immediate vicinity 4. Ensure that any member of staff vacate the area and that the room is secured 5. Ensure that after the room has been secured the trainee has been observed 6. Ensure that any member of staff injured during the incident is offered medical attention 7. Ensure that the trainee is seen by a medical officer as soon as possible. If a medical officer is unavailable, the trainee should be seen initially by a professional health care worker and by a medical officer as soon as is practicable.

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8. Debrief all staff involved and collate the use of force reports (the use of force reports should be completed by staff independently of any other staff involved in the incident). Offer care services to all staff involved. Complete an injury form for the trainee, even if no injury is visible or reported 9. Ensure that all equipment is returned to the appropriate store and is checked for any damage. 10. Collate video evidence and witness statements. 11. Consider Polaroid photos for any reported injuries 12. Debrief the trainee at the most opportune moment

RESTRICTED - PHYSICAL CONTROL IN CARE - RESTRICTED BASIC GUIDELINES FOFORR USING VIDEO CAMERA RECORDING DURING INCIDENTS

This guide is to assist staff at establishment when video camcorder equipment is being used to record incidents. All recorded video film can be called upon at any time for evidence. All precautions must be taken by staff involved in the operation of video camcorder equipment to follow basic precautions.

Hand held Video Camcorders It appears that there are a number of various makes and types of video camcorders being used at present in establishments. This will continue until new equipment is purchased locally in line with the normal replacement program in operation at establishments. All types of video tapes VHS. VHS C and Hi 8 are acceptable. When establishments purchase new hand held video camcorders, the advice is to buy the Hi 8 tape system. This system is being used by most professional evidence gathering units.

General Maintenance of Equipment Always have two extended batteries with at least two hours recording time available. The camcorder with a side view screen will draw extra battery power. We recommend that if a side view screen is available then it should be used by the operator. Check the batteries camera and new film cassettes weekly to make sure batteries are fully charged and the camcorder is working. In the kit should be three sealed in their packets, new 1hr videotapes. If tapes are used during an incident then they should be replaced with NEW sealed tapes as soon as possible. Remember, another incident may arise the same day.

Incident RecorRecordingding with a Camcorder

The following actions must be taken

1. That it is a new tape in sealed packaging. All packaging should be retained and placed in the evidence bag along with the videotape at the end of the recording. 2. The tape can only be used for that one incident. 3. When the tape is put into the camcorder and recording has started, the recording must continue until the end of the incident. The recording must not be switched off at any time during the incident. This includes

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periods of inactivity during the incident. 4. At the start of the recording the operator should state their I.D. Name and Number, time, date, establishment, location of the incident and type of incident into the sound recording microphone of the camcorder. 5. When the incident has been resolved or the videotape is replaced during a protracted incident, the used videotape must be placed into an official evidence bag along with the packaging. The person removing the videotape from the camcorder will place it into the evidence bag, seal it and then complete the information questions printed on the bag. They are now responsible for the continuity of evidence for the videotape. The evidence will be recorded in an Evidence Log Book and secured in the establishments Evidence Locker. If another person is in charge of the evidence locker then they should complete the Continuity of Evidence information on the evidence bag immediately the videotape is given to them. No video tapes used in any incident should be handed out to Police or other bodies without the correct authority from the Area Manager or HQ 6. Take into account the ECHR RIPA regulations when using any type of video recording.

Basic tips when using a Camcorder to record and Incident

1. Always explain to staff involved in an incident that you are video recording the events continuously and that it may be used at a later date for evidence. Enforce the reason for the video recording is to protect staff from false allegations being made against them. 2. Try to fill the picture frame with the view of the incident. 3. Obtain a close up of the trainees face and a full-length view of their clothing. Ask the trainee their name, number and if they have any injuries, if the circumstances allow you to do so. 4. If you are video recording a removal or transfer of a trainee try and remain in front of them while walking backwards. This can be done with the aid of another officer guiding you backwards by holding onto your shoulder. This does require practice. 5. Remember the Health and Safety aspect at all times. Do not put yourself at risk to obtain a better view of the incident. 6. Do not get in the way of staff dealing with the incident. Remember their task comes first.

CCTV camera systems in Visits, ECR and House Block Units

There are a number of CCTV systems in a wide variety of locations inside

RESTRICTED - PHYSICAL CONTROL IN CARE - RESTRICTED establishments that are used to monitor security sensitive areas. The majority of these systems include video recording machines. The advice is that new videotape should be used to record all incidents captured on the CCTV system. The tapes should not be used in a continuous daily loop system if the film is going to be used for evidential purposes later. This especially concerns video evidence captured in visits area of illegal items being passed by visitors to inmates.

Guidance can be obtained through the advice line at N.O.U or the NDTSG.

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SECTION 1: PHASE 2

1.11.11.1 PROTECTIVE STANCE

To minimise the risk of injury, staff will adopt a protective stance when dealing with potentially dangerous situations.

When dealing with a potentially violent situation staff will initially turn side on to the trainee.

This stance will:

• Reduce the target area • Allow good balance • Provide ease of movement in all directions

The member of staff will adopt a side position with either left leg or right leg leading. Although each individual will have preference, it is important that they practice in both stances as many of the techniques taught dictate which stance is required.

The hands at this stage will be at waist level with an open gesture. If the situation escalates and force is required then the member of staff will bring their hands up between the waist and shoulders with the elbows tucked into the sides. The hands remain open throughout. This position offers maximum protection and allows a smooth transition to approved holds.

Teaching points

• Students to turn side on, hands at waist level with an open gesture • Students bring the hands up between waist and shoulders. Hands open. • Students move forward using a step and glide foot movement. • Students practise with alternate legs leading.

STUDENTS WILL PRACTICE MOVING FORWARD AND BACK, USING A ‘SLIDING ACTION’ PAYING PARTICULAR ATTENTION TO AVOID CROSSING THE FEET.

RESTRICTED - PHYSICAL CONTROL IN CARE - RESTRICTED 1.21.21.2 DOUBLE EMBRACE

The Double Embrace holds are the most frequently applied Phase 2 holds. All other Phase 2 and Phase 1 holds escalated, ultimately end in a double embrace.

The first scenario, and the preferred option is for two staff to approach from the rear of a trainee whose focus of attention is to the front.

The member of staff at the front acts as a distraction by engaging the trainee in dialogue and attempts to negotiate a peaceful solution.

When all attempts to resolve the situation have failed, staff will control the trainee in the following manner: -

The staff will approach the trainee in protective stances; they will be back to back i.e. one left leg lead, one right leg lead.

HAND POSITION FROM REAR

The lead hand is passed across the trainee’s back with the palm facing outward thumb toward the floor. This will avoid the risk of the hand becoming caught in clothing. Take hold of the trainee’s upper forearm ensuring that the thumb is on top of the arm and pull the arm into the trainee’s body just above the hip with the trainees palm toward the floor.

The trail hand takes hold of the lower forearm on the opposite arm using an under handgrip. When both members of staff have control of the arms they will position their hips alongside the trainee with their heads away.

Staff must take care not to place their hands on the trainee’s wrist.

FINAL POSITION

From this position staff can move the trainee away whilst attempting to calm the situation down.

If they need to change direction one member of staff will give the command ‘on me’, at this point they will pivot on their inside leg with the other member of staff continuing to move in the direction required.

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STAFF WILL PRACTISE THIS TECHNIQUE ONE TO ONE UNTIL THE INSTRUCTOR IS SATISFIED THAT ALL STUDENTS ARE COMPETENT.

STAFF WILL PRACTISE IN GROUPS OF THREE.

1.31.31.3 FIGURE OF FOUR ARM HOLD

When it is not possible for two staff to approach from the rear, the next option is for:

• One member of staff in front • One member of staff from rear

The member of staff at the front will take up a protective stance; this will dictate which arm they control.

The member of staff at the rear will adopt a protective stance to control the opposite arm.

The member of staff at the rear will apply a Figure Four Arm hold in the following manner: -

Making contact first, the lead hand blocks the trainee’s elbow and the trail hand extends between the arm and torso and is placed over the trainee’s forearm, locking off onto the trail hand forearm area.

Once control of the arm is gained the member of staff moves alongside the trainee placing their inside hip and leg against the trainee, from this position they can drive the hip in and tilt their head away.

STAFF TO PRACTICE ONE ON ONE.

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1.41.41.4 WRAP AROUND ARM HOLD

Having described in the previous section the role of the member of staff approaching from the rear we now concentrate on the role of the member of staff at the front.

From the protective stance move towards the trainee and block the trainee’s upper arm/shoulder area with forearms.

Once contact has been made wrap both arms over the trainees arm taking care that the elbows avoid contact with the trainees head.

From this position ensure that the elbow and wrist are not impeded with.

The student must maintain an upright posture keeping their backs straight and step back slightly with their weight distributed evenly, wrapping the trainees arm across their body.

STUDENTS TO PRACTICE ONE ON ONE.

STUDENTS THEN PROGRESS TO PRACTICE ONE FROM FRONT, ONE FROM REAR, APPLYING BOTH FIGURE FOURFOUR----ARMARM HOLD AND THE WRAP AROUNAROUNDD ARM HOLD.

1.4.1 TRANSFER TO DOUBLE EMBRACE

Once both members of staff are in control of their respective arms the holds need to be converted into a double embrace.

The student in the Figure Four Hold will take the lead, as they are in a position to view both trainee and the person in the Wrap Around Arm hold. From there they will give the following instruction: -

On the command ‘PRESENT’PRESENT’ the student in the wrap around arm hold will place the trainees arm into the body in preparation for the other student to apply a double embrace.

The student in the figure four will move their inside arm across the back into the double embrace.

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The student who ‘presented’ the arm will now bring their inside hand to the lower forearm of the trainee whilst maintaining hold with the outer hand ensuring that they have a ‘thumb to thumb’ grip. In transferring this grip you must move to the outside of the trainee, from this position the inside arm moves across the back to apply the double embrace.

THE STUDENTS WILL PRACPRACTICETICE THIS ONE ON ONE FROM THE WRAP AROUND ARM HOLD.

ONCE THE INSTRUCTOR IS SATISFIED ALL STUDENTS ARE COMPETENT IN THE CONVERSION THEY WILL PRACTICE IN GROUPS OF THREE, ENSURING ALL STUDENTS PRACTICE BOTH ROLES.

1.51.51.5 DOUBLE WRAP AROUND ARM HOLD

When it is not possible for the staff to approach from the rear and the only option is to approach with two staff from the front.

Although this is the worst case scenario it is important that students become competent in this technique as there are many potential situations whereby it is impossible to resolve by other means.

Two members of staff will approach from the front in protective stance ensuring they are back to back.

Both staff will apply a double wrap around arm hold as previously taught.

It is important that both staff maintain an upright position so as to keep the trainees head between their backs, this will prevent the trainees head from sustaining injury or injuring staff.

This hold is not to exceed one minute. Within that period staff are to move into the transition to double embrace.

STUDENTS TO PRACTICE THIS TECHNIQUE IN GROUPS OF THREE

RESTRICTED - PHYSICAL CONTROL IN CARE - RESTRICTED 1.5.1. TRANSFER TO DOUBLE EMBRACE

From this position one member of staff will need to convert their hold into a figure four arm hold.

From the wrap around arm hold the student will place the trainees arm into their body with the hand palm downwards above the hip. They then move to the outside of the trainee placing their outside hand onto the trainees lower forearm alongside the inner arm, thumb to thumb.

The inside arm will then move over the top of the trainees arm and apply the figure four arm hold with the hips in alongside the trainee and their head angled away.

The technique is then as previously taught, one from front one from rear.

STUDENTS TO PRACTICE THE CONVERSION ONE TO ONE

STUDENTS TO PRACTICE IN GROUPS OF THREE.

1.61.61.6 DOUBLE EMBRACE LIFT

INSTRUCTORS NOTES:

Before allowing students to practice this technique explain correct lifting technique utilising kinetic lifting techniques, i.e. keep back flat, using legs to lift. Keep a good firm base with the feet.

Anyone with existing injuries to back, knees, shoulders etc are NOT to participate in this session.

This technique is only to be used as a last resort and only over a short distance.

Both members of staff must be in agreement prior to the lift and will only use it if confident of its success.

Never attempt this if the disparity in size and strength between the staff and trainee is too great.

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Split working groups into equal size/strength avoid performing too many lifts. From the Double Embrace it is possible to lift a trainee if: -

• They are continually dropping their body weight thereby hindering the movement process.

• Hooking their legs around furniture/fixtures.

• Preventing staff moving them through narrow doors/corridors.

• Or, in any way compromising the safety of themselves or staff.

Prior to using the Double Embrace Lift staff may use any other authorised techniques, e.g. Nose Distraction if escalated to a Phase Three Hold.

If left with no alternative option then the Double Embrace Lift will be used in the following way:

The inside leg will step back allowing the staff to be facing inwards towards the trainee. The outside hand will be removed from the trainees nearside arm, at this and all subsequent times, the inside arm will maintain contact across the trainees back onto the far arm. The member of staff’s outside arm will be placed behind the trainee’s knee.

On the command ‘LIFT’ both members of staff will lift the trainee using correct lifting skills.

They link hands avoiding interlocking the fingers.

From this position the trainee can be carried over a short distance or until they comply with staff instructions, and the lift can be safely released.

This technique can be used several times if necessary, however it may be necessary to replace staff as this technique can be physically demanding.

STUDENTS TO PRACTICE IN GROUPS OF THREE.

INSTRUCTORS NOTE:

ENSURE ALL WORKING GROUPS ARE OF SIMILAR BODYWEIGHT

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If the trainee continues to be disruptive then the hold can be escalated to include a third and fourth member of staff, this will only be used when releasing the hold could result in further escalation of the incident or injury to the trainee or staff.

THIRD MEMBER OF STAFF

From the Double Embrace Lift position the third member of staff can take control of the trainee’s head in the following way:

Approaching in a protective stance from the trainee’s head side the lead hand will cup the trainee’s chin avoiding the mouth and throat area, the trail hand will be placed against the base of the neck to prevent the head from snapping back.

The use of the head support should be carefully monitored. It is the responsibility of the person controlling the head to ensure that the spinal column is maintained in a straight line and that breathing is not impaired. The trainee should be observed constantly by a health care staff and risk assessed every 30 seconds to ensure that it is medically safe for the restraint to continue. If breathing is compromised the situation ceases to be a restraint and becomes a medical emergency.

At any time the head support staff can apply the Nose Distraction technique described in Phase Three, Head Support Position, providing it can be fully justified and it’s use documented.

STAFF TO PRACTICE IN GROUPS OF FOUR.

FOURTH MEMBER OF STAFF

If required a fourth member of staff can support the lift by controlling the trainee’s legs in the following manner:

Approaching in a protective stance from the trainee’s leg side, ensuring that they are facing away from the trainee, encircle the trainee’s legs with their lead arm then interlock their hands to prevent the trainee’s legs from kicking out.

The leg member of staff can now direct the team as they are in the best position to evaluate any hazards.

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STAFF TO PRACTICE IN GROUPS OF FIVE

DEDEDE-DE ---ESCALATIONESCALATION

At any time as the trainee begins to comply with staff instructions then the additional staff can be dismissed.

Remember this technique is a last resort and only to be used over a short distance.

When the lift is no longer required then the trainee is placed back on the ground and the Double Embrace Hold re-applied.

1.71.71.7 HOLD RELEASE OPTION

At any time should the situation deteriorate to such an extent that the continued application of any of the previously described holds represent an unacceptable risk to the trainee or staff then the hold should be released.

Communication between the staff is important to affect a simultaneous release of the holds.

On the command ‘leaveleave it’ both members of staff will release their holds and back off away from the trainee in a protective stance.

From a distance of at least a reactionary gap staff will continue their dialogue with the trainee, should it be necessary staff will re-engage the trainee using Two From the Front technique previously described. The reactionary gap will be between 1½ and 2 arms length distance away from the young person. Thereby allowing the member of staff sufficient time to react to any further action instigated by the young person.

STUDENTS TO PRACTICE IN GROUPS OF THREE

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1.81.81.8 DEDEDE-DE ---ESCALATIONESCALATION

At all times the objective for staff is to de-escalate the situation, this can be done in a number of ways and staff should use all of their interpersonal skills to achieve this.

If this proves successful then staff should look to release any holds and resolve the situation without the use of force.

If at any time a member of the Healthcare deems that the continued use of holds presents a medical risk then all holds will be released immediately.

If the situation initially requires any phase above Phase One, then staff should look to de-escalate down to a lower phase, this will be dependent on the level of resistance offered by the trainee and with the full agreement of the staff involved.

THESE TECHNIQUES WILL BE PRACTICED AS PART OF PHASE ONE, TO BE TAUGHT LATER IN THE SYLLABUS.

1.8.1. DESCALATION

OPTION 1

When a trainee has been removed in the Double Embrace and is safely relocated into their room, staff then have two options as to the de-escalation method to be used.

If the situation requires the staff to be present elsewhere within the establishment then once inside the room the trainee will be placed in a position facing the far wall.

On command ‘Release’ both staff will release their holds and withdraw from the room in a protective stance back to back facing the trainee.

Staff will secure the door and return to the trainee at the earliest opportunity.

STUDENTS TO PRACTICE IN GROUPS OF THREE.

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OPTION 2

If there is adequate time and resources to allow the staff to fully de-escalate the situation then once they are in a suitable position the Double Embrace will be converted into 2 figure 4 arm holds. The trainee will be sat down onto either a chair or their bed. As the trainee is sat down their legs will be eased forward by the member of staff’s inside leg, the trainee will be kept upright throughout.

As the situation calms down then the hold can be further de-escalated to one member of staff. This will depend on who is nearest the exit. The non-door side staff will exit first, prior to leaving the door side staff will change their outside hand from an underhand to overhand grip and move their inside arm from the upper forearm to the trainees shoulder.

At this point the non-door side staff will release their hold and move around the trainee in a protective stance and position themselves at the door as a safeguard should the situation deteriorate and holds need to be re-applied.

Maintaining the dialogue the remaining member of staff releases their hold and continues dialogue until it is suitable to exit the room.

STUDENTS TO PRACTICE IN GROUPS OF THREE

INSTRUCTORS NOTE: IF USING CHAIRS DO NOT PUT THEM ON THE MAT, POSITION THEM AROUND THE OUTSIDE TO AVOID DAMAGE.

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SECTION 2:2:2: PHASE IIIIIIIII

Phase 3 requires the introduction of a third member of staff; any phase 2 hold can be increased into a phase 3 hold. This will only be required if the young person is so violent that a phase 2 hold is deemed to be inadequate. If this is the case a third person will be used to control and protect the young person’s head until de-escalation becomes possible.

2.12.12.1 RESPONSIBILITIES OF THE PERSON PROTECTING THE HEAD

a) In charge of the team.

b) Responsible for the control and protection of the young person’s head, and for observing the head and neck.

c) To monitor the condition of the young person, to ensure that it is safe to continue with the restraint.

d) To monitor the condition of the staff.

e) Maintain dialogue with the young person throughout, explaining what is happening and trying to calm the young person down.

f) To instigate any movement of the young person by the team during the hold phase.

ROLE OF THE HEAD SUPPORT OFFICER

Approaching in a protective stance being aware of the young person’s legs. The leading hand is placed on the rear of the young person’s neck, pulling the young person’s head forward and downwards no furtherfurther that the young person’s waist height. (Consideration must be given to the potential breathing problems related to the position as outlines in the Medical Advice section of this manual)manual). This will have the effect of restricting the young person’s ability to kick forward.

The trailing hand will remain in a protective position until the danger from the young person’s head has passed. The trailing hand will then adopt a head

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The index finger, second finger and thumb will cup the chin. Care should be taken that the remaining fingers do not come into contact with or apply pressure to the throat area. The forearm should be extended down the side of the young person’s nose.

To control and protect the young person’s head it should be kept in close proximity to the body of the head officer.

N.B. THE YOUNG PERSON’S HEAD SHOULD REMAIN IN AS NATURAL A PLANE AS POSSIBLE. IT MUST NOT BE TWISTED OR TURNED.

THE USE OF THE HEAD SUPPORT SHOULD BE CAREFULLY MONITORED. IT IS THE RESPONSIBILITY OF THE PERSON CONTROLLING THE HEAD TO ENSURE THAT THE SPISPINALNAL COLUMN IS MAINTAINED IN A STRAIGHT LINE AND THAT BREATHING IS NOT IMPAIRED. THE TRAINEE SHOULD BE OBSERVED CONSTANTLY BY HEALTH CARE STAFF AND RISK ASSESSED EVERY 30 SECONDS TO ENSURE THAT IT IS MADICALLY SAFEW FOR THE RESTRANT TO CONTINUR. IF BREATHINBREATHINGG IS COMPROMISED THE SITUATION CEASES TO BE A RESTRAINT AND BECOMES A MEDICAL EMARGENCY.

IN CERTAIN CIRCUMSTANCES THE NUMBER ONE MAY HAVE TO TAKE CONTROL OF THE TRAINEE’S HEAD PRIOR TO THE TWO STAFF CONTROLING THE ARMS. THIS IS ONLY WHEN THE POTENTIAL FFOROR ASSAULT IS SUCH THAT CONTROLING THE TRAINEE’S HEAD IS THE SAFETEST OPTION

2.22.22.2 MOVEMENT

The young person should be moved in the double embrace with the third officer taking control of the head. If the young person becomes so refractory or excessively violent, the officer in control of the head can consider the use of a nose distraction.

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Guidelines on the use of Distractions:

Distractions are only used when a trainee is extremely violent and the safety of the staff and the trainee is at risk, and itit’s’s uses fully justified. The distraction must be necessary and proportionate to the circumstances.

You must give the trainee a command or order first, before using a distraction

Do not hold the distraction on for any length of time.

Short, Sharp, BurstsBursts....

Only distractions approved in the PCC Manual to be used.

No more than 2 distractions are to be used in a removal.

APPLICATION OF NOSE DISTRACTION

The number one of the team will move the hand on the trainee’s chin to a position to just underneath the nose and above the top lip. The fingers stay taut with the index finger making contact with the trainee’s face. The opposite hand acts as a counter pressure on the back of the head. The number one will direct pressure at an angle of 45 degrees toward the back of the trainee’s head. Once used the hand moves back onto the trainee’s chin in the head support position.

NB ONLY A MAXIMUM OF TWO NOSE DISTRACTIONS ARE PERMITTED DURING AN INTERVENTION.

2.32.32.3 TRAINEE ON THE GROUND

Prone position

If during the restraint a trainee deliberately takes themselves to the ground, the staff will maintain the holds and the number1 will protect the head. If they are already on the ground and restraint is necessary then the following techniques will be used.

Once on the ground staff must be aware of the heightened risk of positional asphyxia and avoid placing any weight on the trainee’s head, neck or torso.

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(Refer to Medical Advice section).

UNDER NO CIRCUMSTANCES WILL STAFF INITIATE THE TAKING OF A TRAINEE TO THE FLOOR

2.3.1 ROLE OF THE NUMBER 1

Trainee Taken To The Ground

The role of the Number 1 during this movement is to control and protect the trainee’s head. This will be achieved by maintaining the head support position, ensuring that the Number 1’s forearm makes contact with the ground first, protecting the trainee’s face. Once the Number 1’s forearm has made contact with the ground, the trainee’s head will be turned to one side. To control and protect the trainee’s head on the ground, the Number 1 will position their knees, one to the rear of the head and one alongside the forehead. A pregnant trainee must not be held face down on the floor

THE KNEE THAT IS POSITIONED ALONGSIDE THE FOREHEAD MUST NOT PROTRUDE PAST THE FOREHEAD SO AS NOT TO INTERFERE WITH THE TRAINEE ’S BREATHING.

The Number 1’s hands, without undue pressure, should assist in securing and protecting the head against injury.

Care should be taken to ensure that the Number 1’s hands do not interfere with the trainee’s hearing.

STUDENTS WILL PRPRACTISEACTISE THIS TECHNIQUE ONE ON ONE

2.3.2 THE ROLE OF THE NUMBER 2 & 3

The 2 arm officers will when on the ground convert from the D/E to a figure 4 arm hold. The inside knee will block against the back of the elbow in order to secure the arm. If no holds are applied and control sought then staff will go straight to figure 4 arm holds.

This is achieved by placing the trainees arm at a right angle (approx. 90 0), the outside hand takes an underhand grip of the trainee’s lower forearm, the inside hand is passed under the trainee’s shoulder and across the trainee’s forearm into a figure 4 arm hold.

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STUDENTS TO PRACTISE ONE ON ONE

STUDENTS TO PRACTISE AS PART OF A 3 OFFICER TEAM

Once control is gained the numbers 2 & 3 will inform the number 1 that they have control of their respective arm. At this point the number 1 will

• Check the condition of the trainee • Check the condition of the staff

If any staff received any injuries or are showing signs of fatigue they can be replaced at this stage. If the trainee shows any sign of injury or restraint related distress then the holds are to be released and medical assistance sought.

2.3.3 TRAINEE TO STANDING

The trainee should not be held in the rest position for any longer than is strictly necessary and within 3 minutes. The trainee will be brought to their feet under the direction of the Number 1 of the team.

When both the Number 2 and 3 are in a figure 4 arm hold, the Number 1 will turn the trainee’s head and place the trainee’s forehead supported by the Number 1’s hand onto the floor. The Number 1’s free hand will control the back of the trainee’s head. The trainee will then be instructed to draw their knees up to their chest. The trainee will then be instructed to kneel up. After ascertaining that the Number 2 and 3 are well balanced, the trainee and team will rise to a standing position. The Number 2 and 3 will assist by supporting the trainee with their forearms under the trainee’s armpits.

STUDENTS WILL PRACTISE AS PART OF A THREE OFFICER TEAM WITWITHH THE NUMBER 1 IN CONTROL

IF THE TRAINEE REFUSES TO BRING THEIR KNEES UP, THE NUMBER 1 WILL INSTRUCT THAT THE TRAINEE IS MOVED REARWARD. THE NUMBER 1 MAY INSTRUCT A SUPPORT MEMBER OF STAFF TO BLOCK THE TRAINEE’S FEET. NUMBERS 2 AND 3 WILL DROP THEIR WEIGHWEIGHTT REARWARD AS THE NUMBER 1 MAINTAINS CONTROL OF THE TRAINEE’S HEAD. THE TRAINEE IS BROUGHT TO A KNEELING POSITION AND STOOD UP AS PREVIOUSLY TAUGHT.

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Supine position

If a trainee is on the floor and restraint is required to prevent self-harm, damage to property or threats to others then the following holds can be used.

2.4.1 ROLE OF THE NUMBER 1

The number 1 will position their knees either side of the trainee’s head above the ears. The number1’s hands, without undue pressure will assist in securing the head. Care must be taken to ensure that the number ones hands and knees do not interfere with the trainee’s hearing.

STUDENTS TO PRACTISE ONE ON ONE

2.4.2 ROLE OF THE NUMBER 2 & 3

Initially the staff will block and secure the trainee’s arms using their own body weight.

TRANSFER TO FIGURE 4 ARM HOLDOLD OPTION

Under the direction of the number 1 the numbers 2 and 3 will carry out the following movement. The Officer will keep the Trainee’s arm flat on the floor, maintaining control by placing body weight over the Juvenile’s arm.

The Officer will then take hold of the Trainee’s lower forearm with their outside hand, thumb pointing towards the Trainee’s head. Whilst keeping the arm pinned to the floor the Officer will come to their knees ensuring their body weight is supported on the Juvenile’s upper arm. The Officers inside knee will block the Trainee’s elbow. The officer will then pivot on their knee, they will now be in a position looking down the Trainee’s body towards the Trainee’s feet. With the lower forearm held by the Officers hand the Officer’s hand moves down to the Trainee’s upper arm. The Trainee’s hands, fingers pointing down will be lowered towards the foot. The Officers hand will be passed under the Trainee’s shoulder, palm down and the Figure 4 arm hold applied. The Officer will then bring that outside leg up, foot planted firmly on the ground.

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STUDENTS TO PRACTISE ONE ON ONE

STUDENTS TO PRACTISE AS PART OF A 3 OFFICER TEAM

2.4.3 TRAINEE TO SEATED

The number 1 will control and support the Trainee’s head. The numbers 2 and 3 will maintain their respective holds, and assist the Trainee into the seated position by supporting under the Trainee’s armpits with their inside forearm. The Trainee’s legs will remain flat on the floor throughout this phase. The number 1 will move to a standing position ensuring that they maintain control of the trainee’s head without undue pressure being applied.

STUDENTS TO PRACTISE ONE ON ONE

2.4.4 TRAINEE TO STANDING

The number 2 and 3 will ensure their inside shoulder is placed behind the Trainee to prevent any backward movement. The number 1 will then instruct the Trainee to draw their knees towards their chest, feet planted on thee floor as near to their backside as possible. The number 1, keeping on hand on the top of the Trainee’s head for control purposes will move around and, to prevent the Trainee kicking will place one of their feet alongside the Trainee’s feet. Under the direction of the number1 the numbers 2 and 3 will assist the Trainee to a standing position by rolling the Trainee’s body weight forward and lifting on their inside forearms under the Trainee’s armpits. Throughout this move the number 1 will maintain control of the Trainee’s head, one hand on the back of the head and the other hand protecting the number 1’s face, taking no active part in the lifting process. When the Trainee is in the standing position the number 1 will adopt the head support position.

STUDENTS TO PRACTISE AS PART OF A 3 OFFICER TEAM

NB --- EXEXEXTREMELY EX TREMELY HEAVY TRAINEE --- AN EXTRA MEMBER OF STAFF CVAN BE EMPLYED TO ASSIST GETTING THE TRAINEE TO A STANDING POSTION.

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2.52.52.5 DOORWAY NEGOTIATION

Whilst moving the Trainee, it may be necessary to negotiate doorways/gates. On reaching the doorway the member of staff controlling the head will maintain the head support position and instruct the two members of staff applying the double embrace to proceed through the doorway first. Selection of who goes first will depend upon the direction to be taken once through the doorway, e.g. if the member of staff controlling the left arm places their left shoulder into the doorjamb, and initiates the spin out then the team having passed through the doorway will be facing to the left. The member of staff controlling the head will be the last person to pass through the doorway.

STUDENTS TO PRACTISE ONE ON ONE

STUDENTS TO PRACTISE AS PART OF A 3 OFFICER TEAM

Whilst a Trainee can be moved using the phase three---method-method dede----escalationescalation would make movement far easier.

2.62.62.6 STAISTAIRWAY RWAY NEGOTIATION MOVING DOWN STAIRS:

Whilst on the landing at the top of the stairway, the team will turn sideways so that the members of staff applying the double embrace have their backs to the wall. A fourth member of staff will take up a position at the side of the member of staff nearest to the stairs acting as an anchor for the team by gripping the handrail. The member of staff controlling the head will dictate the rate at which the stairs are descended.

STUDENTS TO PRACTISE AS PART OF A 3 OFFIOFFICERCER TEAM

MOVING UP STAIRS:

Whilst on the landing at the bottom of the stairs the team will turn sideways so that the members of staff applying the double embrace have their backs to the wall. The extra member of staff will take up a position directly behind the team acting as an anchor by gripping the handrail. The member of staff controlling the head will dictate the rate at which the stairs are ascended.

If at any time a member of staff feels that their hold is insecure the command “DOWN” is given. staff will sink down into a kneeling position and adjust their holds, before standing back up and continuing their movement.

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STUDENTS TO PRACTISE ONE ON ONE

STUDENTS TO PRACTISE AS PART OF A 3 OFFICER TEAM

2.6.1 HOLD RELEASE OPTION

Should the situation deteriorate to such an extent that the continued application of holds represents an unacceptable risk to the Trainee and/or themselves, staff should release the holds.

Staff should move away from the Trainee and where appropriate continue their dialogue with the Trainee from a safe distance. Communication between members of staff is very important to ensure that the holds are released simultaneously.

Staff must be prepared to re-engage the Trainee physically if necessary to ensure the safety of the Trainee or others.

STUDENTS TO PRACTISE AS PART OF A 3 OFFICER TEAM

DEDEDE-DE ---ESCALATIONESCALATION

Whilst the trainee is being held by the staff, the dialogue with the Trainee should continue. One member of staff should adopt the role of team leader to co-ordinate the de-escalation of the holds.

The person controlling the head will be the first person to step away allowing the head to come up.

2.72.72.7 RELOCATION PROCEDURES:

How the trainee is relocated will depend on

• The level of compliance • The availability of staff • Other activity within the centre

The supervisor must follow the guidelines for reception previously described.

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If the Trainee is showing signs of becoming compliant then staff will endeavour to de-escalate the situation and relocate as per de-escalation of Phase 2 holds.

2.7.2 OPTION 2

If de-escalation is not effective or the level of violence offered is too great then a full relocation will take place. In preparation of this the trainee’s room will be checked prior to relocation and all unauthorised items removed as per local policy.

The staff maintains the Phase Three Holds and move through the doorway as previously described. They then move into the room clear of the door. The young person is knelt down with their back to the door. Once in position the member of staff supporting the head places a hand on top of the young person’s head and moves to the rear of the young person. They then place their hands on the young person’s shoulders giving a command to the two members of staff applying the double embrace to release their holds and step rearwards towards the door. At this point the member of staff holding the young person’s shoulders will bring the young person’s back onto the side of their thigh pushing through the shoulders and stepping rearwards towards the door.

The dialogue will continue with the young person from the doorway with the door closed if necessary.

STUDENTS TO PRACTISE AS PART OF A 3 OFFICER TEAM

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SECTION 3: SPONTANEOUS INCIDENTS

Many of the incidents that occur within the centre are spontaneous, they can happen without any indication or prior warning.

The types of incidents encountered are: -

• Fights • Assaults on other trainees • Assaults on staff • Trainees refusing to move • Attempted escapes • Trainees damaging property or the fabric of the establishment

Before dealing with the incident staff must assess the situation and not put themselves in a position of danger, if possible they must wait until sufficient staff arrives to safely resolve the situation.

However, there are times when staff will be required to intervene as a duty of care to both trainees and fellow members of staff. In these situations staff may have to use whatever force is necessary provided it is reasonable and proportionate in the circumstances as they see it.

The following techniques are to assist staff to either separate or distract trainees before applying the previously taught techniques.

3.13.13.1 PHASE 1

Phase1 holds are only used during a spontaneous incident where it is necessary to intervene in order to

• Prevent a serious injury • Prevent an escape • Prevent a situation escalating • Prevent damage to property

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Phase 1 holds are not to be used on a planned removal, although Phase 2 holds can be de-escalated to a phase 1

Phase one requires only one member of staff to be able to apply a hold. They are low-key holds and should only be used if the member of staff has assessed the situation and is happy to control a young person on their own. They must consider the level of risk to themselves and the young person if they consider the risk to be too high assistance should be summoned and a Phase Two hold applied.

3.1.1 SINGLE EMBRACE HOLD

The member of staff approaches from the side and adopts a protective stance as proximity to the young person is made. The member of staff’s lead hand is passed around the young person’s back and takes hold of the young person’s upper forearm. The member of staff’s trailing hand is placed on top of the young person’s lower near arm. The young person’s near arm is folded and placed between the young person and the member of staff’s body with the palm facing down. The member of staff remains in a side on stance with their hip in and head out of the way

TURNING

To turn the young person the member of staff’s outer leg is moved rearwards, maintaining hip contact the young person is turned towards the member of staff’s outer leg.

MOVING

Maintain hip and body contact, move forward purposefully.

DEDEDE-DE ---ESCALATIONESCALATION

The member of staff should continue to talk to the young person throughout the use of the embrace hold. As the young person regains self-control the member of staff should seek to release the hold when in their assessment the situation is safe to do so.

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HOLD RELEASE

Should the situation deteriorate to such an extent that the continued application of the hold represents an unacceptable risk to the member of staff or the young person the hold should be released. The member of staff should move away to a safe distance summon assistance and attempt to continue their dialogue with the young person.

3.1.2 SIDE HUG HOLD

The member of staff approaches from the side of the young person and adopts a protective stance as proximity to the young person is made.

The member of staff’s leading hand is passed across the front of the young person’s abdomen taking hold of the young person’s lower far forearm.

The member of staff’s trailing hand is passed across the young person’s back to take hold of the young person’s upper arm.

BODY POSITION

The member of staff’s body is sideways on to the rear nearside of the young person. The member of staff maintains hip contact, and their head is placed on the young person’s back. The member of staff’s rear foot is moved backwards to create and maintain a strong stance.

TURNING

It is possible to maintain the hold should the young person move around. The member of staff continually adjusts the placement of their rear foot to retain the ‘T’ shape formation of the hold.

MOVING

As the situation improves it is possible for the member of staff to change the Side Hug Hold into an Embrace Hold and so make it possible to move the young person away.

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DEDEDE-DE ---ESCALATIONESCALATION

If appropriate, convert the Side Hug Hold to Single Embrace. Step forward so that the member of staff is to the far side of the trainee. The hand on the trainee’s shoulder moves down to the lower forearm. The hand on the trainee’s forearm moves across to the shoulder.

HOLD RELEASE

Should the situation deteriorate to such an extent that the continued application of the Side Hug Hold represents an unacceptable risk to the young person and/or the member of staff, the Side Hug Hold should be released. The member of staff should move away to a safe distance and continue their dialogue with the young person if appropriate.

3.1.3.1.3333 SIDE HUG HOLD TO SINGLE BASKET

This technique and subsequent basket holds are not to be applied to young people who are pregnant or overly obese.

It may be possible for the young person held in the side hug hold to get the arm held down by their side free. In these circumstances the member of staff holding the young person may attempt to block and trap the arm as it comes across the young person’s body. Once held the member of staff simply places the arm below the elbow of the arm already held, thus having both the young person’s arms crossed across their midriff area.

The member of staff then steps from behind the young person and stands to the same side as the arm that they have just blocked and held. The member of staff is then holding the young person in a single basket hold.

HOLD RELEASE OPTION

If at any stage the member of staff deems the situation to be too dangerous they simply release their hold and step away to a safe distance.

DEDEDE-DE ---ESCALATIONESCALATION

As the young person calms down and regains self control the single basket hold can be phased down to a single embrace hold and the young person led away.

RESTRICTED - PHYSICAL CONTROL IN CARE - RESTRICTED 3.1.4 SIDE HUG HOLD TO SINGLE BASKET WITH ASSIST

If another member of staff is available they may be able to assist if the arm comes free from the side hug hold. The second member of staff adopts a protective stance and moves towards the young person’s free arm blocking it with their forearms. They then take hold of the arm below the elbow and above the wrist with both hands. Once secure the arm can be passed to the member of staff holding the young person and a single basket hold applied as previously described.

3.1.5 SIDE HUG HOLD TO DOUBLE BASKET

Once the member of staff has secured the free arm of the young person it may be deemed that the situation is too dangerous to apply a Phase One Hold. In this situation the second member of staff can assist to phase the hold up to a Double Basket thus making it a Phase Two Hold.

To phase the hold up the second member of staff steps to the side of the young person. The young person will now have both arms crossed across their body with a member of staff stood at either side.

The members of staff then adjust their holds so that their hand on the outside takes hold of the young person’s nearest forearm. The members of staff then pass their inside hands across the back of the young person and take hold of the young person’s forearm below their colleague’s but above the young person’s wrist.

The members of staff will now be situated either side of the young person and maintain hip contact. The officer will be facing slightly outwards with their inner shoulders against the rear of the young person’s shoulders.

RESTRICTED - PHYSICAL CONTROL IN CARE - RESTRICTED 3.1.6 SINGLE BASKET TO DOUBLE BASKET

When a member of staff is holding a young person in a single basket the situation may deteriorate to such an extent that a Phase Two Hold needs to be applied. In this case with the young person already in a single basket the double basket is the easiest option.

To apply the double basket from the single basket the member of staff steps to the opposite side of the young person to that of their colleague. The hand on the outside takes hold of the young person’s nearest forearm above the hand of their colleague. The inside arm is then passed across the back of the young person taking hold of the young person’s forearm below their colleague’s but above the young person’s wrist.

3.1.7 DOUBLE BASKET TO DOUBLE EMBRACE

As the double embrace is the preferred option for moving young people when they are being held in a phase two hold. The double basket must be converted to a double embrace before a young person can be moved.

The members of staff communicate with each other and agree when they are going to change their holds to that of the double embrace.

To convert the members of staff slide their outside hand onto the forearm of the young person and start to bring it towards their side, at the same time placing the hand that is across the young person’s back onto the forearm above the hand of their colleague.

The holds are then adjusted so that the double embrace is applied as previously described.

3.1.8 TANTRUM HOLD

The Tantrum Hold should only be used in extreme circumstances to prevent a young person from self-harm when all other methods have been tried.

APPROACH

The member of staff approaches the young person on the floor and kneels down facing the upper body/head of the young person.

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HANDS/ARMS

The member of staff’s lead hand pushes the young person’s near arm across the young person’s body. The member of staff’s lead hand continues its move across the young person’s body and travels between the young person’s arms to cradle the far side of the young person’s head.

The member of staff’s near hand maintains the position of the young person’s near arm across the body and assists with rolling the young person onto their side. The young person is now facing away from the member of staff. Having rolled the young person onto their side the member of staff’s trailing hand cradles the near rear side of the young person’s head.

BODY POSITION

The member of staff facing away from the young person adopts a seated position making contact with their near hip and lower back with the young person’s rear upper back/shoulder area.

The members of staff’s legs are bent in a forward running position.

The member of staff’s head is lowered onto the young person’s near shoulder and upper arm to complete the hold.

MOVING

If the young person moves around on the floor the member of staff retains the hold and moves systematically with the young person and continuously checks medical signs and symptoms of the young person.

DEDEDE-DE ---ESCALATEESCALATE

As the young person regains self-control and the member of staff assesses that it is appropriate the hold can be released and the young person can be sat up and then moved away.

HOLD RELEASE

Should the situation deteriorate to such an extent that the continued application of the Tantrum Hold represents an unacceptable risk to the young person and/ or the member of staff, the Tantrum Hold should be released. The member of staff should roll away to a safe position but be prepared to re- engage the young person physically if necessary.

RESTRICTED - PHYSICAL CONTROL IN CARE - RESTRICTED 3.1.8.1 ESCALATION

Where a Tantrum Hold has been applied and the young person has adversely responded to the member of staff, and where assistance from trained staff is readily available another member of staff can secure the young person’s legs to further protect the young person from injury.

When staff assess it is safe to do so the situation can be de-escalated by initially removing the Leg Hold.

Should the Leg Hold and the Tantrum Hold fail to resolve the incident, staff must always be prepared to use the Hold Release Option if in their assessment with the continued application of the holds injury to the young person or themselves is a foreseeable outcome. Staff should release the holds and move away to a safe distance from the young person. If necessary they should re-engage the young person physically.

3.23.23.2 SEPARATION TURN

This technique is to be used when two trainees are involved in a dispute but have not laid hands on each other but the dispute needs to be resolved quickly to prevent further escalation.

The two members of staff need to position themselves to the rear of each trainee. Both must be in left leg lead protective stance and will move toward the trainees at the same time.

As they approach the lead hand is placed onto the trainee’s hip the trail hand is placed on the trainee’s shoulder.

From this position the lead hand pushes on the hip and the trail hand pulls on the shoulder ensuring that they avoid grasping the clothing.

As the push/pull movement is effected the trainees will be turned to the right. This allows staff to create a substantial gap between the trainees and position themselves between the trainees.

Once separated the staff can apply the Single Embrace Hold by sliding the trail hand from the shoulder to the lower forearm and moving the lead hand from the hip to the upper arm. From here the trainees can be moved away

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STAFF PRACTICE ONE TO ONE.

WHEN FULLY COMPETENT TO PRACTICE IN GROUPS OF FOUR EMPHASISING THE INITIAL POSITIONING AND COMMUNICATION PRIOR TO THE SEPARATION.

3.2.1 NOSE DISTRACTION

In incidents where the trainee has physically grabbed hold of either another trainee or a member of staff then the following techniques can be applied to gain initial control before application of approve P.C.C. holds.

If two trainees are involved then ideally two members of staff will work simultaneously to separate the trainees.

USE OF NOSE DISTRACTDISTRACTIONION

The guidelines previously described must be adhered to when using the nose distraction. Once separation has been achieved then the necessary hold will need to be applied, this will depend on the level of violence offered and the staff available.

Approach the trainee from the rear in a protective stance. The lead hand will pass either over the trainee’s head or if there is a disparity in size around the side.

Keeping the finger taut with the index finger making contact underneath the nose, the hand will be at an angle of approximately 45º and ensure that the fingers are well clear of the mouth. Pressure will be applied through the base of the nose towards the crown of the trainee’s head.

The trail hand will be placed on the back of the trainee’s neck with the palm facing toward the member of staff. This acts as counter pressure to the force.

Once the force has been applied and separation achieved, then turn the trainee away and apply the necessary hold.

STUDENTS PRACTICE ONE TO ONE.

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PRACTICE IN GROUPS OF FOUR EMPHASISING COMMUNICATION AND TIMING ON THE APPROACH.

REMEMBER TO GIVE CLEAR VOCAL COMMANDS PRIOR TO APPLYING THE NOSE DISTRACTION.

ONLY USE PAIN IN SHORT SHARP, BURSTS ANANDD ONLY WHEN NECESSARY TO ACHIEVE COMPLIANCE.

NO MORE THAN 2 NOSE DISTRACTIONS ARE TO BE USED DURING AN INTERVENTION

3.2.2 RIB DISTRACTION

There may be occasions when trying to separate a trainee that the Nose distraction is not possible. This may be the case if the trainees are grappling or if they have a member of staff or trainee trapped against a wall and their head is positioned in such a way that staff cannot safely apply the Nose Distraction, in such circumstances the Rib Distraction can be used.

Approaching the trainee in a protective stance from the rear take hold of the trainee’s clothing around the rib cage area with both hands.

With an inverted middle finger drive sharply inward and upward to distract the trainee and effect a separation by turning the trainee away from the incident.

THE PREVIOUSLY DESCRIBED INCIDENT GUIDELINES ON DISTRACTION TECHNIQUES MUST BE FOLLOWED.

Once separation has been achieved the appropriate hold will be applied depending on the level of violence offered and the staff available.

STUDENTS MUST PRACTICE ONE TO ONE.

REMEMBER GIVE CLEAR VOCAL COMMANDS PRIOR TO APPLYING THE RIB DISTRACTION

ONLY USE PAIN IN SHORT, SHARP BURSTS AND ONLY WHEN NECESSARY TO ACHIEVE COMPLIANCE.

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ONE MEMBER OF STAFF

If a member of staff is faced with two trainees on the floor fighting or a trainee on top of another trainee or member of staff and they have no option but to intervene the following techniques should be utilised.

Prior to any intervention the staff must assess the situation and use any other means to resolve the incident i.e. verbal commands and wait for assistance.

Before attempting to intervene, assess whether or not it will be possible to safely separate the trainee, bearing in mind the member of staff needs to be aware of their own self-protection. If they are to intervene then they must utilise correct lifting skills.

3.3.1 OPTION ONE

Approach the trainee from the side in a protective stance and take hold of the trainee’s shoulders with both hands, taking care to avoid taking hold of the skin.

Bending the knees and keeping the arms straight step rearwards pulling the trainee off the other person and continue to drag them away until there is sufficient distance between them. Release the grip and position themselves in between both parties, so as to deter any further incident and begin to de- escalate the situation.

STUDENTS TO PRACTICE ONE TO ONE.

INSTRUCTOR’S NOTES:

ENSURE STUDENTS PRACTICE ON SOMEONE OF SIMILAR WEIGHT AND CHECK FOR ANY EXISTING INJURIES BEFORE PRACTICE.

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It may be possible to avoid pulling the trainee away by using a pushing technique. This can only be used if there is sufficient space to the side and there is minimal risk of injury to the trainee.

Approach in a protective stance from the side, when in position push the trainee off the other person and position themselves between both parties to deter any further incident and begin to de-escalate the situation.

STUDENTS TO PRACTICE ONE TO ONE.

3.4. FIGHT ON THE FLOOR

TWO MEMBERS OF STAFF

If two members of staff are available to separate either two trainees or a trainee with a member of staff pinned to the floor then the following technique can be used: -

When practicing this technique stafstafff must use correctcorrect lifting skills.

Instructors to check for injuries prior to practice.

Ensure staff practice on students of a similar weight.

Approach the trainee from the rear and either side in a protective stance. The staff should be back to back i.e. the staff on the trainee’s right side in a left leg lead and the staff on the left with a right leg lead.

Both members of staff will apply a Figure of Four Arm Hold to affect a release and to gain initial control of the trainee.

Once the arms are secure the trainee can be removed by using a Scoop Lift.

STUDENTS PRACTICE IN GROUPS OF THREE.

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From the Figure Four Arm Hold the member of staff removes their lead arm from their trail hand forearm and takes hold of the trainee’s forearm, thumb to thumb.

The trainee’s arm is driven upwards towards their shoulder.

Release the outside hand and turn to face the opposite direction to the trainee. Drive the outside hand under the armpit and onto the trainee’s shoulder. Use the other hand to push down on the elbow thereby trapping the trainee’s arm between their body and the member of staff’s.

THIS MUST BE PERFORMED SIMULTANEOUSLY.

When both members of staff are in position they will step forward on their inside leg at a 45º angle. By stepping in this direction the trainee will be moving backwards and be off balance.

The staff will continue to move the trainee until they are clear of the other person. The trainee will then ideally be placed in a seated position and the staff will then reverse the previous conversion back into a Figure of Four Arm Hold and then into a Double Embrace.

If this is not possible then the trainee will be placed onto the floor and all holds released.

Staff must then position themselves between both parties and attempt to resolve the incident.

STUDENTS WILL PRACTICE IN GROUPS OF THREE.

If a third member of staff is available then they can control the other trainee on the floor by applying the Tantrum Hold if needed, or by moving them away from the scene in a Phase One Hold.

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If the Figure of Four Arm Holds cannot release the trainee’s arms then the staff can use a Thumb Distraction to effect release.

As with all distraction techniques the Thumb Distraction is an extreme measure and can only be used if justified. If it is used then the previously described procedures must be followed.

PRINCIPLES OF THE THUMB DISTRACTION

• Block the base of the thumb • ‘Cock’ the thumb • Apply pressure between the base and tip of the thumb • To be use only when necessary • Report reasons for use • Use in short sharp bursts • Use in conjunction with verbal commands

STUDENTS TO PRACTICE ONE TO ONE.

From the Figure of Four Arm Hold place the inside hand onto the trainee’s thumb and apply the Thumb Distraction. Be aware that the trainee’s arm may react quickly to the technique and staff to exercise care from flaying arms.

STUDENTS TO PRACTICE IN GROUPS OF THREE.

Once the arms are released staff perform the Scoop Lift as previously described.

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4.14.14.1 DEFENCE AGAINST IMPROVISED WEAPONS

An Officer, when faced with a trainee armed with an improvised weapon should aim to get out of the situation as quickly as possible. If it is not judged possible to escape quickly then the member of staff must consider whether the trainee is trying to take them hostage or whether they are actually going to strike them with the weapon.

LINES OF ATTACK

Research shows that the most common type of attacks are:

• Downward diagonal strikes • Downward vertical strikes • Lateral strikes • Straight thrusts (high / low)

MANAGING IMPROVISED WEAPON ATTACKS

As previously mentioned defence against weapons can best be achieved by not engaging the trainee, but looking to avoid / escape the situation.

Unplanned attacks often make this impossible. At the point when a trainee is within a meter of you with an improvised weapon, you must make a judgement as to whether attack is the only form of defence in those particular circumstances.

COMMUNIATION / LONG RANGRANGEEEE

It is vital to use correct communication to defuse the situation in order to prevent the situation from escalating to a physical encounter.

Communication and the creation of distance / obstacles between the trainee and ourselves may buy time to evade the situation. Distance will give time to

RESTRICTED - PHYSICAL CONTROL IN CARE - RESTRICTED assess and prepare for a personal attack on ourselves i.e. adopt a protective stance.

INTERMEDIATE RANGE

This range can be measured from between 6 – 10ft. At this range we should be recognising the warning signs of aggression. We can use this long range as a reactionary gap as we should not be taken by surprise if / when the trainee attacks. The adoption of a protective stance, use of loud verbal commands should give us a psychological edge over the trainee. This in turn will hopefully lead to the prisoner changing their mind, becoming compliant or disengaging.

CLOSE RANGE

A confrontation can often happen at close range (6 – 2ft), as an aggressor may perceive that this will suit their objective, officers should be aware that the aggressor might not necessarily intend to use physical violence. (A good example of this is where sports players try to influence a referee’s decision).

EDGED WEAPONS

NOTES

Penetration of only a few millimetres can sever major arteries causing unconsciousness in seconds and death in minutes. A blade of less than 4 centimetres can penetrate vital organs including the heart.

Where possible Officers should:

• Withdraw • Create distance or • Attempt to diffuse the situation

The use of barriers in this instance (the placing of objects between yourself and the trainee) can also be affective. Try to maintain a reactionary gap of 10ft plus the length of the weapon to increase your reaction time.

In facing a knife attack the Officer must be psychologically prepared to receive some type of edged weapon wound, even a small cut can have a massive psychological and debilitating effect on some people. If they can understand this then the ability to defend against an edged weapon becomes more viable.

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EDGEEDGEDD WEAPON GRIP

To effectively deal with an edged weapon attack Officers must have an understanding of the way they are used. Generally they are held in one of two grips:

Straight Grip

The edged weapon is held on the strong hand with the point of the weapon pointing forward. The cutting edge is usually down and the most common attacks from this grip are:

• Slashes and Straight Thrusts

Inverted Grip

The edged weapon is held in the strong hand with the point of the blade pointing back or down. This grip offers less options of attack for the unskilled, however it allows the trainee to conceal it. The most common attacks are:

• Downwards, vertical or Diagonal Thrusts

Hypodermic Needles

Another concern for Officers working in a Training Centre environment is the use of a hypodermic needle as an edged weapon, given that AIDS and other infectious diseases can be transmitted by contaminated needles.

In reality, the risk of infection with HIV or Hepatitis B after a needle stick is quite low.

Staff who suspect that they may have been in contact with a contaminated needle should seek medical advice immediately as prompt action can reduce risk.

All Officers are encouraged to receive Hepatitis B and Tetanus immunisation as a precautionary procedure

THE REALITY OF FACING ANY WEAPON ATTACK WITHIN A METRE OF THE TRAINEE IS THAT CONTRIVED PROTECTIVE STANCES AND ANY LEARNED DEFENSIVE SYSTEMS WILL BE BYPASSED. THE “FLINCH” RESONSE WILL TAKE OVER WITH

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THE HANDS, FOREARMS, ELBOWS COMING UP TO PROTECT THE FACE AND HEAD, THE SHOULDERS RISE AND THE HEAD RETRACTS. THIS IS THE STARTING POSITION AND WE MUST BLOCK / DEFLECT THE WEAPON ARM AND DELIVER A DEFENSIVE STRIKE.

TRAINING SHOULD REFLECT THIS WITH ATTACKS COMING IN FROM VARYING ANGLES WITHIN THE OFFICER’S PERIPHERAL VISION. ALL TECHNIQUES WILL BE PRACTISED IN ISOLATION AND WILL BE PROGRESSIVE.

4.1.1 WEAPON ATTACK NONNON----DOORDOOR SIDE

Where an armed young person is threatening a member of staff whose exit is blocked by the young person, the member of staff should use articles of furniture to keep the attacker away. The member of staff should attempt to manoeuvre into a position so that they can exit the room safely closing the door if possible.

Negotiation can then take place.

4.1.2 RESCUE

Staff are only to act to save a third party if the situation becomes life threatening. This may include using a chair to pin the trainee allowing the intended victim an opportunity to exit or to assist in arresting the trainee. When two more staff arrive then the following techniques can be used.

Having pinned the weapon arm against the wall the two remaining staff step forwards from behind the leading member of staff and take control of the young person’s arms.

To remove the weapon the following methods may be used:

The member of staff fixes the young person’s arm to the wall using their inner hand/arm. The outer hand is placed on the young person’s hand holding the weapon.

The clenched hand is rolled along the wall away from the member of staff. This will cause the hand to open allowing the weapon to fall to the floor.

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The member of staff fixes the young person’s arm to the wall using their inner hand/arm.

The outer hand grasps the thumb and compresses it towards the little finger side of the hand.

This will cause the young person to drop the weapon onto the floor.

If the trainee has an impact weapon i.e. chair leg / broom handle etc. then the member of staff will take hold of the end of the weapon and rotate it against the weak point of the grip, the thumb and fingers. Once the weapon is released the staff will move into a double embrace and the number 1 places the chair away and takes control of the trainee’s head.

4.1.3 RESOLUTION AND ESCORT

If following a serious incident negotiation takes place and proves to be successful staff maybe confident enough to lead the young person awaawayy without having to use any force. If this is the case the following method should be used to ensure staff safety:

Three staff are positioned near to but out of the young person’s line of vision.

The sincerity of the young person is tested by the negotiator asking them to place the weapon on the ground.

The negotiator will then ask the young person to face the wall with their back to the door.

The door will then be opened and the young person asked to step backwards towards the door.

Once outside the room the young person will be asked to take a step to the side and place their hands on the wall in front of them.

At every stage compliance must be agreed and tested before moving to the next.

The three members of staff waiting outside the room will conduct an

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Two members of staff will take up a position behind the young person with a reactionary gap between themselves and the young person.

The third member of staff will take up a position in front of the young person with a similar reactionary gap between themselves and the young person.

The member of staff at the front of the team should give clear instructions to the young person.

The members of staff should always be in a position to react if the young person becomes violent again.

The young person will then be led away to an agreed destination.

The Supervisor will consider the use of video recording the incident.

4.1.4 PLANNED INTERVENTION

Guidelines will be covered from the Role of the Supervisor, previously described in this manual. Outside intervention may be required as per local contingency plans.

RELOCATION PROCEDURE

There may be circumstances where staff sees a need to relocate a violent young person in a room following an incident quickly and safely. The methods previously described in phase three should be used.

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SECTION 5: HANDCUFFIHANDCUFFINGNGNGNG

INTRODUCTION

The use of handcuffs on a trainee must only be in exceptional circumstances.

• Long or difficult route to escort the trainee • Staff unlikely to maintain P.C.C. holds • Exceptionally strong / violent trainees • To aid de-escalation

Only the approved model is to be used: HIATT HANDCUFF MODEL 2015

Prior to using handcuffs staff will attempt to de-escalate the situation with interpersonal skills and / or approved P.C.C. techniques. If handcuffs are deemed necessary then their use will only be as a temporary measure, and they are to be removed as soon as the threat has receded.

THE USE OF HANDCUFFS MUST BE AUTHORISED BY THE DIRECTOR

The medical staff at the centre will examine any trainee who has been subjected to the use of handcuffs. They will record details of any injuries consistent with the use of handcuffs. The Use Of Force report must state the reasons for applying handcuffs and the director’s authority

5.15.15.1 APPLICATION OF HANDCUFFS

When the authority for handcuffs has been authorised they will be applied in the following manner

From a phase 3 hold the number 1 will instruct the trainee to adopt a kneeling position, the members of staff will at this time be in a double embrace. When the trainee is taken to their knees the 2 staff will kneel down with their inside leg at right angle. The number1 will instruct the two staff to convert into figure of four arm holds. The supervisor will instruct a support member of staff to support the trainee’s head from the rear.

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The support staff will approach the trainee in a protective stance and place the side of the lead leg alongside the trainee’s back. They will take control of the head by placing their trail hand across the nape f the trainee’s neck. Their lead hand will cup the trainee’s chin as previously described in the head support position. The number 1 will then apply the handcuffs to the front of the trainee. When the cuffs have been applied the number1 will take control of the trainee’s head and the support member of staff will move away.

From the kneeling position the 2 staff will assist the trainee to their feet by passing their inside arm underneath the trainee’s armpit and helping them to their feet. Once in a standing position the number 1 in consultation with the supervisor will decide as to whether or not restraint holds are necessary.

Students ttoo practise

5.25.25.2 MOVING A TRAINEE IN RATCHETT HANDCUFFS

Compliant If the trainee responds to staff instruction and it has been decided to maintain the use of handcuffs they will be moved in the following manner for safety reasons. The 2 staff will place their outside hand on the trainee’s shoulder. Their inside hand will be placed on the trainee’s forearm. The number1 will be positioned to the front and slightly to the side of the trainee, at a distance of approximately 6-8 feet.

Students to practise

5.5.5.2.15. 2.12.12.1 NON COMPLIANT

Should the trainee be non-compliant throughout the escorting procedure the number 1 will maintain the hand support position. The 2 staff will maintain the figure four arm hold. Staff to be aware that it is possible to cause discomfort to the trainee if the arms are pulled apart, therefore the holds will be sympathetic to the degree of movement in the arms.

Students to practise

RESTRICTED - PHYSICAL CONTROL IN CARE - RESTRICTED 5.2.2 MOVING A TRAINEE AGAINST THEIR WILL If the only option available to staff is to carry the trainee then an assessment is required prior to attempting the lift (as described in double embrace lift). From the figure of four arm holds the inside arm will extend through between the trainee’s arm and torso, the outside hand will be placed behind the trainee’s knee. On the command ‘lift’ both staff will lift the trainee using correct lifting skills, once lifted the staff will clasp their hands together.

Students to practise

5.35.35.3 REMOVAL OF HANDCUFFS

When the decision has been taken to remove the handcuff. The trainee will be placed onto their knees and the procedure will be a reversal of the section on ‘Application of Handcuffs’.

5.45.45.4 HANDCUFFING FOR ESCORT

If a trainee needs to be escorted outside of the centre then the following procedure will be used. The trainee will be handcuffed as previously described, once this is complete then the member of staff that is to be cuffed will have the handcuff applied by either the person in charge of the dispatching officer. When the cuffs need to be removed the reverse process will take place.

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SECTION 6: PERSONAL PROTECTION

INTRODUCTION

It is important that each member of staff is able to defend him/her self from attack. This part of the course deals with one on one techniques, whereby the individual, faced with more common methods of assault is able to:

• Defend themselves effectively using only the amount of force necessary. • Avoid the possibility of becoming a hostage. • Prevent threats to security as a result of loss of keys, radio etc: • Avoid an incident escalating into a larger one through the involvement of other young people.

All techniques are therefore concerned with breakaways in which the individual’s prime objective is to disengage quickly and seek assistance.

Some of the techniques are concerned with situations in which the member of staff is at grave risk and where the individual may need to use exceptional methods to save themselves. Such techniques may be used only where a member of staff is in grave danger and no other option is available.

In training the greatest care must be exercised when practising such techniques in order to avoid injuries to students. The instructors must realise that whilst these techniques have the potential to inflict pain and injury to the aggressor, it is therefore strictly necessary for instructors to control the training environment and ensure that unnecessary pain or injury is not inflicted on the students.

ALL OF THE FOLLOWING TECHNIQUES WILL BE PRACTICED ONE TO ONE.

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BREAKAWAY FROM THE FRONT

6.16.16.1 LOWELOWER R ARM / WRIST RELEASE ––– DIAGONAL/PARALLEL/ONE ONTO ONE

The student adopts a protective stance as the trainee grasps their lower arms(s). The student clenches the fist of the held arm(s) and shortens the arm by bending it at the elbow as far as the trainee permits.

With this shortened lever, the student pulls upwards against the trainee’s thumb to affect a release.

The student exits.

6.1.1 LOWER ARM / WRIST RELEASE ––– TWO HANDS ONTO ONE ––– DIAGONAL / PARALLEL

The student adopts a protective stance as the trainee grasps their lower arm with two hands. The student clenches the fist of the held arm and shortens this arm by bending it at the elbow as far as the trainee permits.

The student reaches forward with their free hand and grasps the clenched fist of the held arm.

The student pulls the held arm against the trainee’s thumb to affect a release.

The student exits

RESTRICTED - PHYSICAL CONTROL IN CARE - RESTRICTED 6.1.2 LOWER ARM / WRIST RELEASE ––– DIAGONAL PARALLEL/ONE ONTO ONE /HIGH

The student adopts a protective stance as the trainee grasps their lower arm above the head. The student identifies where the trainee’s thumb is and performs a small rotation against the trainee’s thumb to affect a release.

The student exits.

6.26.26.2 UPPER ARM

The trainee grasps the student’s arm(s). The student adopts a protective stance. The student swings one arm over the trainee’s arm trapping the trainee’s hand.

The student’s other arm reaches under the trainee’s arm and grasps their other arm. Applying pressure to the trainee’s trapped hand the student steps backwards and breaks the grip.

The student exits.

6.36.36.3 HAIR GRAB

The student adopts a protective stance. The student bends the knees slightly and allows their neck to go rigid. The student maintains eye contact with the trainee and places both hands, one on top of the other (palm on top of knuckles, thumb to thumb) on top of the trainee’s hand and applies downward pressure the student will step backwards wiping the trainee’s hand from their head.

The student exits.

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6.46.46.4 COLLAR GRAB

SINGLE/ TTWOWO HANDS

The student adopts a protective stance as the trainee takes hold of their collar. The students leading arm is raised above their head and using a windmill action drive the arm downward and rearward whilst simultaneously turning toward the trail leg. Continue to rotate until the student is facing the trainee within a reactionary gap.

The student exits

STRANGLES

6.56.56.5 OPEN SPACE ––– PRIOR TO CONTACT

The student adopts a protective stance immediately. Whilst simultaneously pushing backwards off the front foot the student strikes the trainee’s arms, using the inside of their forearms with their fists clenched, knocking the trainee’s arms in towards each other.

The student exits.

6.5.1 OPEN SPACE ––– ON CONTACT

This technique is as per Collar grab.

6.5.2 AGAINST A WALL

The student quickly adopts a protective stance. The student will raise their lead shoulder and pass their lead arm over the trainee’s arm. The student will strike the trainee in the face with their elbow.

The student exits.

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6.5.3 TO THE SIDE

The student reaches across the trainee’s arms with one arm and places the hand of that arm around the elbow joint of the trainee’s far arm. The student’s other hand is placed on top of the student’s hand grasping the trainee’s elbow joint. The student straightens the leg on the side which the trainee is to be rolled away, the student’s other leg is bent, foot flat on the floor.

The student pulls the trainee’s held arm across to the student’s straight leg side, whilst at the same time vigorously pushing the hips upwards to break the trainee’s balance. As the trainee is rolled away the student will get to their feet and exit.

6.5.4 OVER THE HEAD

The student bends both of their legs so that their knees are bent and their feet are flat on the floor. The student will grab the clothing at either side of the trainee with both hands, just below the trainee’s rib cage area, ensuring that they have inverted the knuckle of the middle finger of each hand.

There is now a simultaneous action by the student of thrusting their hips upwards and driving the inverted knuckles of either hand under the trainee’s rib cage driving the trainee over the head of the student.

The student will get to their feet as quickly as possible and exit.ex it.it.it.

BEAR HUG

6.66.66.6 OVER ARM

The student’s head is turned to the side for protection and they immediately drop their body weight as the hold is applied by the trainee.

The student’s shoe is raked down the trainee’s shin and driven down onto the instep of the trainee.

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Should the hold be maintained by the trainee, the student may escalate the attempt to escape from the hold by turning their body and placing both hands onto the trainee’s hips and with a sharp thrust push the trainee away. If still unsuccessful then use an inverted knuckle into the trainee’s sternum and drive inward and upward.

6.6.1. UNDER ARM

The student’s head is turned to the side for protection as they immediately drop their body weight as the trainee applies the hold.

The student’s shoe is raked down the trainee’s shin and driven down onto the instep of the trainee’s foot.

Should the trainee maintain the hold, the student then can use inverted knuckles on both of their hands to drive into both sides of the trainee’s rib cage area. If the hold is still maintained the student’s hands can apply pressure upwards and forwards to the trainee’s nose. The trainee is pushed away and the student exits.

KICKS

6.76.76.7 STANDING

The student adopts a protective stance and uses the sole of their foot to block kicks from the trainee. By turning the foot inwards, the blocking area presented to the trainee presents a broader surface to counter the kick giving the student a greater chance of success in achieving the block.

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ON THE GROUND

6.76.76.7.16.7 .1.1.1

If possible, the student adopts a sitting position and faces the trainee. The student’s legs are used to block kicks from the trainee and keep the trainee at bay. At the earliest opportunity, the student should regain a standing position and exit or adopt a protective stance.

6.7.2

The student, having been taken to the ground as a result of the trainee’s assault and being unable to sit up to face the attack, uses the following technique to resolve the situation.

The student, lying sideways to the trainee, curls up, (i.e. foetal position). The student holding the arms in a relaxed flexed position across the face uses the inner forearms to block the kicks.

As the opportunity presents itself, the student takes hold of the trainee’s legs and uses a rolling action towards the trainee taking them off balance and onto the floor.

At the earliest opportunity, the student should regain a standing position and exit or adopt a protective stance.

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HAIR GRAB

7.17.17.1 INWARD TURN

The member of staff will bend their knees slightly and allow some rigidity of their neck. Simultaneously they will make a platform with their hands, one on top of the other (palm to knuckles, thumb to thumb). They will drive this platform onto the grip of the young person’s hand and apply downward pressure. The member of staff will then turn in towards the young person and as they do so place their thumbs around the young person’s wrist to keep the hand fixed to the member of staff’s head. As the member of staff turns, they should keep themselves as upright as possible and keep the young person’s elbow high. The member of staff will then straighten up and push the young person away.

The member of staff exits.

7.27.27.2 OUTWARD TURN

The member of staff will bend their knees slightly and allow some rigidity of their neck. Simultaneously they will make a platform with their hands, one on top of the other (palm to knuckle, thumb to thumb). They will drive this platform onto the grip of the young person’s hand and apply downward pressure. The member of staff will then turn outwards away from the young person and as they do so place their thumbs around the young person’s wrist to enable them to maintain contact with the young person.

The member of staff will then push the young person away and exit.

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7.27.27.2 NAPE/COLLAR GRAB.

One handed/Two handed

The member of staff will turn outwards away from the young person with their arms held up in a position to protect themselves. The member of staff’s leading arm will make contact with the young person’s lower arm. The member of staff will carry on the rotation and their trailing arm will make contact with the young person’s arm. The member of staff will still maintain their rotation resulting in breaking the young person’s grip.

The member of staff exits.

7.37.37.3 STRANGLE

The member of staff drives straight fingers into the young person’s face, and then quickly drives the straightened fingers of the same hand downwards into the young person’s groin area. The member of staff’s other arm will extend fully, with their palm uppermost, and their elbow will be driven back whilst moving their hips laterally into the young person’s rib cage. The member of staff will continue to carry alternate elbow strikes to the young person’s ribs until a release is achieved.

The member of staff exits.

7.47.47.4 SIDE HEAD CHANCERY (LEGS TOGETHER)

The member of staff will place their inside arm around the young person’s waist. Simultaneously the member of staff’s outside arm is placed in a position to protect their face. The member of staff’s inside leg is extended to a position behind both of the young person’s legs. The member of staff’s outside hand will then move to the young person’s waist area. The member of staff initiates movement by sitting and rotating so that the member of staff

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The member of staff exits.

7.4.1 SIDE HEAD CHACHANCERYNCERY (LEGS APART)

The member of staff will place their inside arm inside the young person’s thigh taking a strong grip. Simultaneously the outside hand is brought up to protect the face then onto the elbow of the young person forcing the elbow up and over the head.

The member of staff exits.

BEAR HUGS

7.57.57.5 OVER ARM

The member of staff should immediately relax their body weight to make the young person’s task of holding them more difficult. The member of staff will rake their shoes down the young person’s shins and drive their foot into the young person’s instep. The member of staff will move their hips forward allowing them to strike with extended fingers into the young person’s groin area. The member of staff buttocks are then driven rearwards into the young person’s groin whilst simultaneously driving forward with both of their arms to achieve a release.

The member of staff exits.

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The member of staff should immediately relax their body weight. The member of staff will rake their shoes down the young person’s shins and drive their foot onto the young person’s instep. Should the young person persist then the member of staff can drive with extended knuckles of both hands into the young person’s rib cage area. The member of staff can also break the young person’s grip by pressing an inverted knuckle into the base of the young person’s thumb and applying of downward pressure.

The member of staff will continue these options until a release is achieved.

The member of staff eexits.xits.

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INDEX

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Physical Control in Care Syllabus

FOREWORD

PRINCIPLES OF P.C.C.

SECTION 1: PHASE II

1.1. Protective Stance 1.2. Double Embrace 1.3. Figure of Four Arm Hold 1.4. Wrap Around Arm Hold 1.4.1. Transfer to Double Embrace 1.5. Double Wrap Around Arm Hold 1.5.1 Transfer to Double Embrace 1.6 Double Embrace Lift 1.6.1. Double Embrace Lift Escalation 1.7 Hold Release Option 1.8. De-escalation 1.8.1 De-escalation Option 1 1.8.2 De-escalation Option 2

SECTION 2: PHASE IIIIIIII

INTRODINTRODUCTIONUCTION

2.1. Head Support Position 2.2. Movement 2.3. Trainee Prone 2.3.1. Role of the Number 1 2.3.2. Role of the Number 2 & 3 2.3.3. Trainee to Standing 2.4. Trainee to Supine 2.4.1 Role of the Number 1 2.4.2. Role of the Number 2 & 3 2.4.3. Trainee to Seated 2.4.4. Trainee to Standing 2.5. Doorway Negotiation

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2.6. Stairway Negotiation 2.7. Relocation 2.7.1. Relocation Option 1 2.7.2. Relocation Option 2

SECTION 3: SPONTANESPONTANEOUSOUS INCIDENTS

INTRODUCTION

3.1. Phase 1 3.1.1. Single Embrace 3.1.2. Side Hug Hold 3.1.3. Side Hug Hold To Single Basket 3.1.4 Side Hug Hold To Single Basket with Assistance 3.1.5. Side Hug Hold To Double Basket 3.1.6. Single Basket To Double Basket 3.1.7. Double Basket to Double Embrace 3.1.8. Tantrum Hold 3.1.8.1 Tantrum Hold Escalation 3.2. Separation Turn 3.2.1. Nose Distraction 3.2.2. Rib Distraction 3.3. Fight On Floor 1 Staff 3.3.1 Fight On Floor Option 1 3.3.2 Fight On Floor Option 2 3.4. Fight On Floor 2 Staff 3.4.1 Scoop Lift 3.4.2. Thumb Distraction

SECTION 4: MANAGING WEAPON ATTACKS

INTRODUCTION

4.1. Defence Against Improvised Weapons 4.1.1. Weapon Attack Non – Door Side 4.1.2. Rescue 4.1.3. Resolution and Escort 4.1.4. Planned Intervention

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SECTION 5: HANDCUFFHANDCUFFSSSS

INTRODUCTION

5.1. Application of Handcuffs 5.2 Moving A Trainee in Ratchet Handcuffs 5.2.1. Non Compliant 5.2.2. Moving A Trainee Against Their Will 5.3. Removal of Handcuffs 5.4. Handcuffing For Escort

SECTION 6: PERSONAL PROTECTION BREAKAWAYS FROM THE FRONT

INTRINTRODUCTIONODUCTION

6.1. Lower Arm / Wrist Releases – 1 Arm 6.1.1. Lower Arm / Wrist Releases – 2 Arm 6.1.2. Lower Arm / Wrist Releases – 1 Arm High 6.2. Upper Arm 6.3. Hair Grab 6.4. Collar Grab 6.5. Strangle Open Space – Prior To Contact 6.5.1. Strangle Open Space – On Contact 6.5.2. Strangle Against the Wall 6.5.3 Strangle on Ground – To The Side 6.5.4 Strangle on Ground – Over The Top 6.6. Bear Hug Over Arm 6.6.1. Bear Hug Under Arm 6.7. Kicks Standing 6.7.1 Kicks on the Floor – Option 1 6.7.2. Kicks on the Floor – Option 2

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INTRODUCTION

7.1 Hair Grab Inward Turn 7.1.2 Hair Grab Outward Turn 7.2. Collar Grab – 1 / 2 Hand 7.3. Strangle 7.4. Side Head Chancery – Legs Together 7.4.1. Side Head Chancery – Legs Apart 7.5. Bear Hug Over arm 7.5.1 Bear Hug Underarm