The following is an actual story and scenario which was reported to our training team in the sessions that we deliver for staff who look after vulnerable people in care. I believe that stories like this are generally representative of the kinds of conflict and violent incidents which occur with largely un-recognised frequency in learning disability services.
The staff member was working with a 16-year-old service user with complex needs and extreme challenging behaviour who was allocated workers on a 2:1 basis. They were in a room in the day centre. The staff member’s colleague (who was the #2 on the two-person team) needed to use the toilet and left the room to do so. The staff member who was still with the client was assisting him with drinking, using a straw in a cup.
Without warning, the client punched the staff member in the face, which resulted in a black eye.
The staff member had been told that “because he is only 16 years old, we can’t restrain him” and so she backed away from him but didn’t leave the room. She had been told that “you can not leave a client alone at any time” and so she decided not to leave the room, even though he threatened to punch her again.
This staff member had not received any conflict management, physical intervention or breakaway skills training at the time of the incident, even though she had been assigned to a client with a history of violent behaviour and who was on a 2:1 tariff.
The situation resolved when her colleague came back to the room, however the staff member suffered bruising to her eye from the client’s punch.
Two days later the staff member was working with the same service user again. He punched her in the face again and spat in her face. The advice from managers had not changed in this time and at the point she attended our training course on Personal Safety (some weeks later) she had still not had, nor had been scheduled for, any form of self-protection / physical interventions training.
What went wrong? Four critical failures
1. The use of reasonable force — legal principles
Where the use of force in a given set of circumstances is both necessary and proportionate — for the purposes of preventing or terminating a crime, or to stop unlawful physical force being used on any person — then it will be reasonable.
There are no age limits or restrictions for the use of force. Any suggestion otherwise is wildly inaccurate, regardless of how ethical, moral, or values-based it might be. Telling staff they “can’t restrain” a 16-year-old — regardless of the danger he poses — is legally incorrect and operationally dangerous.
⚠️ Warning: The idea that age restricts the lawful use of force is a persistent and dangerous myth in care settings. Reasonable force is assessed on necessity and proportionality — not the service user’s age.
2. Leaving and withdrawing from an unsafe situation
Where a staff member finds herself in a situation which is inherently dangerous, she must consider whether to leave and “proceed to a place of safety” if that danger is unavoidable. Section 8 of the Management of Health and Safety at Work Regulations 1999 requires employers to:
“Enable the persons concerned (if necessary by taking appropriate steps in the absence of guidance or instruction and in the light of their knowledge and the technical means at their disposal) to stop work and immediately proceed to a place of safety in the event of their being exposed to serious, imminent and unavoidable danger.”
The instruction “you can not leave a client alone at any time” — without any qualification for safety — directly contradicts this legal duty. Staff must be empowered to make safety-first decisions.
3. Duty of care and safe systems of work
It is surprising to see that two staff members are assigned to this service user due to his unpredictability and history of violence — yet the procedure when one staff member needs to use the toilet leaves the other completely vulnerable.
This raises serious questions about the service’s safe systems of work and whether management have properly risk-assessed the roles and work-tasks of this team. A 2:1 staffing ratio is meaningless if the system collapses the moment one person steps away.
4. Risk assessment and training
While one unforeseen event — a true emergency — is perhaps acceptable, it is completely bonkers that after the first incident where this carer was punched in the face, she was again placed in the same situation and again physically attacked by the service user.
Negligence? An unsafe working environment? It is quite likely that a court would find for the staff member and penalise the organisation for this kind of loose safety management.
It is clear that this worker needs more in-depth training for her role. Section 13 of the MHSWR 1999 states: “Every employer shall ensure that his employees are provided with adequate health and safety training.”
💡 Key takeaway: After a near miss, the failure to conduct a fresh risk assessment and provide immediate training is not just poor management — it may be unlawful. The same incident happening twice is not bad luck; it’s a predictable failure of the system.
Two days later the staff member was working with the same service user again. He punched her in the face again and spat in her face. The advice from managers had not changed.
Gerard O’Dea is a conflict management, personal safety and physical interventions training consultant. He is the training director for Dynamis, a specialist provider of personal safety and violence management programmes and the European Adviser for ‘Verbal Defense and Influence’, a global programme which addresses the spectrum of human conflict. www.dynamis.training