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21st January 2014 Use of Restraint Orders Doubles in Care Homes

The Care Quality Commission has reported a massive rise in the number of elderly people being tied to chairs, locked in their rooms or restrained in other ways by carers and nurses. Other examples include removing walking sticks or frames, using beds with high railings and strapping patients in chairs with lap belts. In the past three years the use of these measures has doubled for certain age groups.
There are times where these measures, known as deprivation of liberty safeguards (DoLS) which were introduced in 2009 may be necessary and in such cases hospital staff should apply to their NHS trust whilst social workers must make an application to their council in order to use them. Approximately half of the applications are for dementia sufferers and approval is normally given in less than 24 hours.
It has been reported that there were 157 restraint orders granted per 100,000 people aged 75 – 84 and 265 orders per 100,000 last year. This compares to 71 per 100,000 and 129 per 100,000 respectively three years ago. However, this figure is likely to be much higher as two-thirds of care homes and hospitals do not report incidents to the CQC.
On the face of it these figures seem alarming and certainly merit further investigation as it is not known how many times restraints have being carried out without seeking permission. There have certainly been some well documented cases recently where such restraints have been used inappropriately and in some cases criminally.
However, there may be other more benign reasons why the figures have risen so sharply such as the rising population of people in those age groups. Also as counter intuitive as it may seem, the rise may actually reflect improvements in the system, such as increased compliance and more accurate reporting.
What is not in doubt is that restraints of any kind should only be a matter of last resort. Unfortunately for staff who have not been properly trained it all too often becomes the option of first resort.