Disability/Nursing Home Services: Can Residents Be Detained And Restrained?

Author:Ms Joanelle O'Cleirigh and Grace-Ann Meghen
Profession:Arthur Cox
 
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Can a healthcare professional restrain a resident where there is a concern that his or her behaviour poses a risk to themselves or others?

Yes, but only if - and this is crucial - the resident consents to the restraint or the restraint is otherwise permitted by law.

This is relevant to nursing home providers and centres that care for people with disabilities.

RESIDENTS' RIGHTS

Residents have a fundamental right to their liberty. This right is enshrined in the Constitution. A person's liberty cannot be restricted or detained in some way unless they either consent to it or permitted by law.

Any restriction or detention of a person's liberty must be a last resort and must be subject to appropriate safeguards. Any restrictive measure should be proportionate and the least intrusive measure in the circumstances. It should also be kept under regular review.

A resident's liberty should never be restricted for disciplinary reasons or for the convenience of staff .

POTENTIALLY UNLAWFUL RESTRAINTS

Chemical restraints - Giving sedatives to a resident to control their behaviour and make them more "manageable". Environmental restraints - Locking doors to stop a resident from wandering at night. Physical restraints - Physically holding a resident down, using limb restraints, using clothing to restrict their movement or removing their mobility aids. It may be necessary to restrict a resident's liberty in certain circumstances for a brief period of time, e.g. where there is an urgent and signifi cant risk to their safety or the safety of others. It is important to have a policy in place to deal with these circumstances. and to report and address the circumstances immediately aft erwards.

CONSENT

If the legal basis for a restriction of liberty is the resident's consent, the consent must be fully informed. For example, you should ensure the resident understands how the restraint will be used, how it will assist him/her, the potential negative outcomes, and possible alternatives to restraint use.

If there are any doubt as to a resident's capacity to consent, appropriate legal and medical advice should be sought.

OTHER LEGAL BASIS

If the resident does not have capacity to consent, it may be necessary to apply to the High Court for an order authorising the detention and/or restraint, together with any ancillary orders that may be necessary. This might include an order permitting managerial staff to restrain a resident from leaving the facility.

A court order...

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