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Guidelines, policies and procedures will never cover every eventuality. Members of staff whatever their level of responsibility or role, must use their experience, skills and common sense when faced with aggressive service users.

Staff identified in the risk assessment must be provided with relevant training in personal safety, de-escalation and breakaway techniques.

Where physical violence is likely staff should:

  • The first choice remove themselves from the vicinity
  • Try to put some sizeable object like a table, between them and the potential assailant
  • Keep themselves between the service user and the door and/or escape route
  • Stay calm, speak firmly, quietly and more slowly since obvious anxiety or aggressiveness can provoke a violent reaction
  • Disperse any onlookers
  • Remove any potential weapons for example ashtrays and tools.
  • If threatened with a weapon the service user should be asked quietly but firmly to put it down
  • Avoid sudden moves
  • Maintain eye contact, but do not stare
  • Raise an alarm and call for assistance, where possible.

Physical restraint is the last option and should be used only by staff at risk as a defence against potential or escalating violence and in circumstances where there is a reasonable chance of success. For example, staff should not normally attempt physical restraint, if physically inferior, outnumbered or when the service user has ready access to weapons.

Where an incident escalates and the person cannot be controlled, staff members must be prepared to vacate the room, even if extensive damage results. Police assistance should be summoned immediately. Personal safety is of paramount importance.

You should have practices and procedures documented, where lone workers and staff are aware of how to report incidents and near misses.   Risk assessments must be reviewed after any incident or near miss.