contributed to staff leaving the service. Due to his behaviour, he is unable to participate in many activities. Care plans indicate triggers and reactive strategy and these are evaluated and reviewed on a regular basis. There is a plan for use of seclusion and at these times he occupies a selfcontained area at one end of the ward with bedroom, sitting room and toilet designed with most internal objects removed as risk factors in self-harm. Mr AF is on a constant 3:1 level of observation when not in seclusion. His presentation is unpredictable and he is often violent. Several members of staff are currently on long term sick leave following injury. His behaviour has resulted in extensive environmental damage to the area he lives in and to the exterior of the building when in the garden area. This has become so problematic that he is being referred to a more secure service to try to manage the increased levels of violence and aggression. His family believe that it is the environmental setting which triggers the behaviour and that he should be in accommodation which properly meets his autistic needs. We agreed the use of seclusion in this case was appropriate and the service developed a policy and protocol for its use. We advised that the accommodation was inappropriate and supported the view that alternative community accommodation which fully met his needs be sought. Mr RS Mr RS has a moderate learning disability and frequently displays behaviour likely to cause harm to others. He lives in a community placement with support and is subject to a welfare guardianship order. On occasions he is restrained by staff and regularly secluded in his flat for his and others’ safety. There was a concern that alternatives to seclusion were not being considered by regular review and there should be some move towards trying to manage without seclusion. Staff have come to recognise trigger signs to Mr RS's behaviour and attempt de-escalation techniques. During seclusion they record their observations every five minutes and keep a dialogue going. They seek direction from senior staff every 15 minutes and there is a comprehensive plan to detail this and record events. Mr RS has a weekly programme of activities much of which takes place out with the flat with 2:1 support. He has a full programme including getting out most days. This includes outings in the car, bowling, exercise, baking, drawing, coffee and cake, shopping, and every night he goes for a walk. Mr RS says he enjoys his programme. He also enjoys the fire drill which he helps to organise each week. There are care plans for daily support, self-care, menu plan, and monitoring weight. Staff have found that constipation can lead to aggressive behaviour so they monitor bowel movements. He takes part in household chores and enjoys visiting neighbours. He also receives visits from his cousins. We thought that the management of this individual’s behaviour met the definition of seclusion. However there were no guardianship powers to authorise use of restraint or seclusion and, being subject to an indefinite order, no opportunity for the court to review. We advised that additional powers to authorise restraint and seclusion be sought from the sheriff. 24