Here’s to a Happy, Hopeful New Year – from our CALM family to yours!

“Through hope-centred relationships we can learn, grow and reach our goals – and enable those we support to do the same.”

By Helen Stevenson, CALM Director

 

My inner ‘responsible adult’ is pleased to say that the CALM server still contains every piece of information ever written and produced about CALM, on CALM, by CALM team members and others. Given CALM celebrated its 25th year of existence last year I’m sure you can imagine that this constitutes a pretty big back catalogue – the ‘ARCHIVE’ folder is extensive! I recently came across this passage – contained in a handout for a CALM theory course for staff in Adult Learning Disability services in 1997 (please excuse some of the archaic language, I have left it as written for historical authenticity):

“The CALM approach to aggression management is based on a “systems model”. It rests on specific principles, primarily that safe practice in any organisation is dependent on the development of a “whole organisation” approach to safety. In complex organisations different responsibilities are carried at different levels. Failure to effectively address these responsibilities invariably results in enhanced risk to those staff most exposed to potential aggression from service users. Although the development of skills in the prediction, avoidance and de-escalation of aggression will be a key objective of training, the promotion of a “safety culture” remains the overriding aim. This requires that training initiatives are:

  • “Owned” by managers
  • Supported by a clear training strategy
  • Part of a continuum of training
  • Located within a clear framework of policy
  • Supported by adequate resources
  • Located within an adequate framework of safe practice (i.e. Policies, risk assessment, individual care planning, staff support etc)”

This is cause for reflection indeed. How many organisations do we see, hear and read about that are still struggling to achieve this and grasp this nettle. Financial pressures and heavily cut training budgets often see senior organisational managers seek out quick fixes and commission reductionist training in de-escalation skills only that ‘ticks a box’ rather than offers education and learning that promotes real reflection and opportunities for growth, development and challenge.

Long ago a wise colleague told me that, “Good training changes something – it sparks a thought, inspires change, highlights alternatives and empowers people to try something new, speak out and ‘Do’ differently” (he was a bit of a disrupter ?). I have always believed that CALM training offers this kind of transformative opportunity; and that CALM’s ‘critical friend’ approach alongside solid relationships based upon mutual respect, a willingness to listen and to try, can achieve the type of safety culture described in the paragraph above written nearly 25 years ago. This belief and its actualisation in the many organisations we support is what keeps me and the team here at CALM going.

2022 saw yet another heart-breaking BBC Panorama Undercover Investigation into abuse, this time at the Edenfield Centre, Manchester. Another, in a long line of spy-on-the-wall documentaries where we saw harrowing images of assaults by staff, inappropriate restraints, verbal abuse and dehumanisation of those we should be most compassionately caring for. Unfortunately, we know it’s not an isolated case as the CQC’s review on restraint in 2020 and its progress report of 2021 highlights (1).

It comes nearly a quarter of a century after the now infamous MacIntyre Undercover BBC TV documentary of 2000 – which gave rise to significant public concern and created a regulatory scheme for training, and the first set of practice standards for training providers AND for organisations commissioning the training (the BILD Physical Intervention Accreditation Scheme).

We hope that in 2023, the ripples are still felt from this most recent Panorama expose and that real positive change is there to grasp. Things are certainly different now and some of the building blocks of better, safer, more compassionate practice are embedded in the cultures we see around us. Members of the CALM team come back weekly from organisations with stories of staff who are achieving so much with and for the people they support; and are continuing to do this despite challenging external pressures on services. Perhaps they can do this because they have a real empathy and love for the person they spend time with and because they are within an organisation that truly values them and equally treats them with understanding and compassion. This isn’t rocket science – it’s simple and it’s doing the right thing. Caring for staff as we should care for the person supported is the key stone to the arch of safe practice – an undeniable fundamental.

Our understanding from literature and research has also improved immensely. Kevin Ann Huckshorns’ great work – ‘6 Core Strategies to reduce seclusion and restraint use’ 2008 (2) – is a simple mantra and guide that embraces and publicises the ‘systems model’ and the ‘whole organisational approach’ espoused by CALM at the time of its inception. These 6 Core strategies are now widely known and used as the foundations of best practice, guidance and learning here in the UK and internationally too; successfully reducing restraint and seclusion is no longer a holy grail – the action plan is there for us to follow.

We also have many current national-level initiatives and restraint matters have quite rightly become front and centre as an issue. Many national groups such as the Restraint Reduction Network, Restraint Reduction Scotland, Scottish Physical Restraint Action Group (SPRAG), Reducing Restrictive Interventions Safeguarding Children Group (RRISC), Positive Action Behaviour Support Scotland Group (PABSS) – and many other groups have influenced thinking and are beginning to have an impact on changing culture and practice; and for the first time ever in Scotland, we are about to have dedicated guidance on restraint and seclusion for the school sector! (3). In CALM’s 25 years there has never been another time where these matters have been so high profile, topical, current and progressive – there is much dedication, hard work and activity currently and therefore much to be hopeful about.

And at last – the importance of Trauma Informed Approaches has been recognised, in the literature and embraced in practice and has become truly multi-sector. As we review and update much of our own Trauma training and teaching we find the importance of ‘Hope’ as a narrative and we find positivity in the present. Being Trauma Informed helps us all to recognise and celebrate our strengths and to support others to do the same. Through hope-centred relationships we can learn, grow and reach our goals – and enable those we support to do the same. It is this hope that empowers and motivates us to believe in the possibility of a brighter future – there is much for us all to embrace in 2023. We look forward to hearing about your achievements as well as telling you about ours as we move into a new year together.

All our best,

Helen and the CALM Team

 

REFERENCES

(1) https://www.cqc.org.uk/sites/default/files/20220325_rssreview-progress-march_print.pdf – Out of Sight Report – CQC’s Restraint, segregation and seclusion review (2020)

https://www.cqc.org.uk/publications/themes-care/restraint-segregation-seclusion-review-progress-report-december-2021 – progress Report Dec 2021

(2) https://www.nasmhpd.org/content/six-core-strategies-reduce-seclusion-and-restraint-use

(3) https://www.gov.scot/publications/included-engaged-involved-part-3-relationship-rights-based-approach-physical-intervention-scottish-schools/ – Physical Intervention in Schools DRAFT Guidance (Scotland) 2022

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