Governance systems, accountability and processes sustain and improve high-quality care.
- Having structured internal audit and reporting systems (see Leadership).
- Recording and reviewing all instances of restraint and seclusion as soon as possible, to prevent or minimise future restraint.
- Informing executive level staff about incidents immediately as they arise.
- Establishing and adhering to clear debriefing processes for staff (three-tier: immediate, delayed and senior review; post hoc debrief and incident debrief following restrictive intervention) and considering collaborative debriefs with the person with lived experience.
- Practising debriefing through simulation training.
- Ensuring there is cultural awareness and recognition of the effects of previous trauma on the experience of restrictive practices.
- Reporting on restraint and seclusion rates and improvement activities in public spaces.
- Modelling excellent behaviours when services and staff adopt guidelines and to share what worked well or didn’t across services.