The member of staff who is in attendance must be aware of the particular needs of the individual, the immediate care plan and the antecedents to the seclusion. The legality of using CCTV in a community setting must be considered and where the person cannot consent will require powers to be granted under the AWI Act. Maintaining a relationship While being sensitive to the situation, and to the individual’s mental state, staff should maintain communication and discussion with the person being secluded, where indicated. The person secluded must be informed, as far as is possible, of the reason for the seclusion and the conditions for its ending. Efforts must be made to dispel any perception by the person that they are being punished. Seclusion is an isolating procedure and can become lonely and frightening for the individual concerned. The seclusion may have immediately followed an incident resulting in restraint by staff. The person concerned may want to talk about what has happened. It is vital to maintain contact to ensure that the need for seclusion is continually assessed. Involvement of an independent advocate should be considered. Seclusion must not go on for any longer than is absolutely necessary and keeping communication open can help towards an early resolution. Record keeping For level 1 seclusion Staff in attendance must keep the person under constant observation either directly or via CCTV and make regular written reports on the individual’s observed mental and physical state. A written record should be made at least every 15 minutes. Review discussions by care staff and decisions made must be recorded. These records are part of the individual’s record of care. Managers must maintain and hold a record of the use of seclusion in any particular health or social care setting. An audit procedure should also regularly monitor the reason, frequency and duration of all episodes of seclusion. This will allow the effectiveness of such measures to be properly reviewed. Independent health or social care providers registered by the Care Inspectorate or HIS have a statutory requirement to record any incident of restraint or control, the reason why it was necessary and the name of the person authorising it. The arrangements for continuous assessment and review The local manager and other staff in attendance must continuously review the need for seclusion. For level 1 seclusion, a senior member of staff should formally review the need for seclusion on a regular basis (at least every four hours). Over and above this, the RMO or senior manager must complete a multi-professional review if the seclusion continues for longer than the period of time specified in local policies. We believe that this should certainly take place within a 12 hour period. Seclusion must be for the minimum necessary period of time required and be in accord with the principles of least restriction and benefit in the 2000 and 2003 Acts. 15