Dr Brodie Paterson writes on physical intervention training.
The challenges in securing good practice in physical intervention training.
The new level 2 qualifications in physical intervention training soon to be available represent a further step change in the management of aggression and violence for the security sector. When de-escalation or conflict resolution won’t work and withdrawal is not an option staff for the first time are now going to have be formally trained in how to protect themselves and how to accomplish physical restraint in ways that maximise customer as well as their own, safety. This is a good news story for the security industry representing evidence of the professionalisation of the sector extending to areas of practice that have historically been controversial and a source of expensive litigation.
It might appear that any initiative that has the potential to make both punters and staff safer and by doing so potentially lower insurance premiums, cannot have a down side. However, the initiative as planned will result in a number of challenges for the sector that regulators, training providers and organisations employing staff trained in accordance with the new standards will need to be mindful of.
Lack of standardisation
As in other sectors market forces means there will be no standardisation of the actual physical procedures taught. Accordingly these will vary between approved training provider. Hence someone trained by company A is unlikely to be able to work effectively and thus safely with somebody trained by company B particularly when they are attempting to restrain as a two or three person team. This will restrict the mobility of the workforce as the worker trained in system A will require at least partial retraining in system B before that attempt to use the physical interventions contained within that programme. There should be no need to repeat the training in legislation and in areas such as restraint related risk but the different physical skills will need taught.
Significant variation in operational safety between models
As noted all physical intervention procedures are not the same, differing radically in the approach they bring both philosophically and technically to the tasks of enabling staff to block assaults, enable their escape and restrain where required. Such differences are clearly significant in their consequences for safety evident in the published research comparing the safety of different models both during training and in practice with resistant and assaultive ‘customers’. Reported injuries to course participants during training in some models where high levels of resistance during training are encouraged have exceeded 25pc. The variation in reported injuries during attempted restraint can be marked. The rate per incident varies from zero to 15 per cent .
Potential providers of training should therefore always be asked for their injury rates during training and in practice. Trainers mindful of their legal obligations under UK and European product liability legislation that covers training as a service should be able to provide such figures as a matter of course. The SIA might however going forward want to mandate the inclusion of such information in any application to provide a master training programme.
Lack of mandatory practice / updating
Irrespective of the training provider selected or the model taught there is currently no requirement in the guidance for the door supervisor once trained, to be enabled to practice and formally retrained annually in order to maintain their SIA licence. The best training providers are likely to issues their own time limited certificates as the research is very clear in concluding that staff skills in physical interventions can decay rapidly over a short period of time leading to an increased risk of unsafe practice. Trainer assessed certificates, albeit to SIA standards’, will though place the onus on employers to check the physical intervention skills of SIA licensed staff they employ are up to date resulting in an additional administrative burden. The time commitment involved in annually re-training staff may not be huge eg three to four hours, but this will involve additional costs for either the member of staff or the employer.
Auditing compliance with training / guidance
Employers need to be aware that in this area as in others they cannot simply ‘train and pray’ but are under a legal obligation to monitor compliance with the arrangements they have put in place to reduce any risk including that associated with aggression and violence. The need for monitoring in this area is illustrated by the findings from a series of deaths associated with restraint in other settings. These suggest a common factor in such incidents was often that staff deviated from what they had originally been taught. In some scenarios such deviations come to effectively replace the procedures originally taught, which had been bio-mechanically assessed and endorsed for use by the organisation. Unfortunately what might seem even minor modifications to some physical intervention procedures can hugely increase the risk of fatality. Employers must therefore have in place robust quality systems that monitor not only incidents and injuries but routinely sample the procedures actually used such that they can rapidly detect any deviation from the approved practice and correct it before rather than after, a tragedy.
Assaults with weapons
The police long have long since abandoned any pretence that an individual with a knife or broken bottle could be safely disarmed by an officer even if they were wearing protective clothing. Their incremental adoption of side handled / extending batons then gas sprays and increasingly Tazers represent an acknowledgement that the ‘open hand’ skills taught in physical intervention programmes can never adequately protect an individual in the presence of weapon and a determined assailant. There will therefore remain even post training a significant risk to security staff that may require further investment in primary prevention such as a switch to poly-carbonate rather than glass tumblers and plastic rather than glass bottles.
Sector specific challenges
Physical restraint is intrinsically an area of high risk for all participants but some settings may pose particular challenges. In the health sector security staff are increasingly used to replace or complement clinical or ancillary staff should restraint be deemed necessary. Unfortunately though, the underlying cause of the violence presented by the patient may be clinical such as the 60-year-old woman with early onset dementia desperate to leave hospital in search of her infant son now long since grown up, who she has failed to recognise. The confused, violently aggressive and seemingly drunk young man in accident and emergency may also have a head injury the significance of which is proving difficult to establish due to his agitation. In such circumstances security staff can and do find themselves asked to restrain in order to facilitate treatment. However, this is an area they may require specialist training in order that they understand the relevant legal issues involved including capacity and consent to treatment and the potential physiological implications of restraint in such circumstances.
Problems don’t however only happen in specialist settings. In an era of community care security staff in a supermarket may find themselves dealing with violence presented by an individual with severe autism who was being supported by care staff to do his weekly shop. The cause of his violence may have been the combination of a sudden change in the music being played, a reorganisation of the shelves in aisle 2 and something as apparently minor as the temporary unavailability of ready cooked roast chicken. Recognising the presence of special needs should therefore perhaps be part of any revised future training specification.
Conclusion
Such challenges as described require customers of training providers in physical interventions to be more informed consumers of what they are purchasing. Training is this area is not an homogenous product. Customers need to be aware of what such training can and can’t do in consciously managing the use of such interventions as the evidence suggests these are themselves not without risk, as part of their overall risk management strategy.
About Dr Brodie Paterson: He is the author of more than 70 papers on violence prevention, de-escalation and physical restraint including a recent literature review on workplace violence prevention done on behalf of the Scottish Government. He is regularly instructed by the HSE as an expert witness and chairs the European Network of Trainers in the Management of Aggression. As a director of CALM Training, he is working with training company SAFE on physical intervention techniques for the security industry. For further information – contact Raymond Clarke at SAFE – 01952 585387.
