health; one of which, Least Restrictive Care, includes seclusion monitoring and training. SPSPMH promotes implementation and spread of the interventions in the safety principles through the sharing of best practice, identifying opportunities for improvement through appropriate measurement and responsive improvement support. SPSP-MH aims to extend and build on existing good practice, providing an improved model of person-centred care that can be applied in any healthcare setting. SPSP-MH advocate that the use of seclusion should be a proportionate response, should respect the individual’s human rights, and only be employed by highly-trained staff as a last resort to avoid a greater harm occurring to the individual or others. Registered care providers The Care Inspectorate (CI) expect seclusion in any form or coercion to be used only as a last resort where there is no viable alternative and that the appropriate legal processes would be in place. Where people need support as their behaviour is assessed as challenging to the service or as they can experience stress or distress the CI expect to see this in a person centred personal plan that details: • • • What brings about the behaviour (triggers); What helps to calm a person; What should staff never do as this will make the situation worse. If the person’s behaviour puts themselves or others at risk the plan should also contain: • • • • • What is the action service takes; If seclusion or control where does this take place; Observation: how do staff stay in regular contact and observe person; Who authorises the action taken; Recording of the incident including authorisation, monitoring carried out. The person using the service where possible should be involved in agreeing the person centred plan and be involved in the planning of the intervention and has agreed the intervention. If the person cannot be involved the CI expect to see involvement of family or carers and of people who hold legal powers for example Welfare Power of Attorney or Guardianship. In line with the Care Inspectorate Notification Policy the service must notify the CI of any incidents of seclusion or control. The Care Inspectorate would expect any seclusion or control to be the last course of action after other interventions have failed and expect to see how the intervention was agreed and the aims of the intervention clearly stated. The aims of the intervention should support selfmanagement rather than focus on compliance and be supported by clearly stated strategies to achieve this. Special situations For people with learning disability/autistic spectrum disorders and significantly stressed or distressed behaviour there may be circumstances where their care plan requires that they be managed in isolation from their peers for lengthy periods. 18