Case Study: Learning Disability Home Care

An 11-year-old boy with a brain injury was grabbing staff by the hair and throat and assaulting school escorts. Training followed 2002 Department of Health guidance and used holds designed not to cause pain.

An 11-year-old boy with a brain injury and learning disabilities was presenting challenging behaviours that his home care team needed to manage safely and confidently. The Case-Manager who administrates and supervises the care package reached out to Dynamis for specialist guidance.

The Challenge

The young man was presenting infrequent but severe combative behaviour that put his support team at risk:

  • Grabbing staff by the hair or by the throat
  • Occasional inappropriate sexual behaviour in public
  • Assaulting school escorts in the taxi to and from school

Our Approach

Our advice and training for this project would be driven by the Department of Health guidance (2002) on restrictive physical interventions with children and young people with Autistic Spectrum Disorder and Learning Disabilities. This guidance formed the core of every recommendation we made, helping the team make the best possible decisions about the young man’s care.

The training was delivered in a workshop format, gathering information directly from the care team as we examined the guidance together. The most serious and most frequent behaviours attracted the most focus in the initial stages — offering staff and service user greater safety and security from the outset.

Techniques were drawn from the Dynamis system of physical interventions, specifically the Non-Harmful Methods of Control: secure holding techniques designed not to cause pain to the client.

Why, when, and how it may be necessary to use physical interventions — and when it may instead be abusive.

Training Delivery

Gerard O’Dea, Dynamis Principal Trainer, began by gathering information from the Learning Disability Home Care team about the behaviours they found most challenging, as well as the methods the carers were already using to manage agitation, frustration, and combativeness.

A discussion of core principles followed, derived from the Department of Health guidance. Much of the conversation focused on robust decision-making about the use of force with vulnerable people.

The later sessions were devoted to practising physical intervention and holding skills specific to the behaviours staff were seeing day to day — including simple separation techniques from the various grabbing behaviours the client presented.

Outcomes

✅ Outcome: Staff and family were very happy with the training programme, reporting that they now had better approaches they could feel confident in when dealing with their client.

Learn More

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Picture of Gerard O'Dea

Gerard O'Dea

Gerard O'Dea is the founder of Dynamis, creator of the SCENA approach, and a holder of the ICM Physical Skills Tutor Award. He designs conflict management and physical intervention programmes for NHS and emergency services teams.

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