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The Priory Group has been using the Safety Pods in a medium secure service for women. Patients included those with a personality disorder diagnosis.

The feedback stated that ‘yes’ the introduction of Safety Pods had reduced injuries to both staff and patients in restraint situations, with the additional comments:

“There has been a reduction in staff and patient injury during physical intervention.” Another staff member said: “I’ve worked here several years and the use of the Safety Pods has reduced staff injury. They have also reduced the aches and pains during and after restraint.”

This unit has seen a 100% reduction in floor restraints to 0 in six months of 2019 and since the introduction of the Safety Pod. This was despite 77 situations where an individual required the use of restrictive practise for theirs and others’ safety.

It reported that in the same six month period of 2017, it had 70 episodes of restraint, in which 9 (12.9%) had resulted in floor restraint. Additionally, in the same six-month period in 2018, it had 12 episodes where restraint was required, of which 3 (25%) had ended in floor restraint.

The Priory Group said ‘yes’ it would recommend Safety Pods for use in other similar organisations or units. It also rated UK Pods Ltd’s customer service as “excellent”

Patients were using the Safety Pods at their own leisure for example, to listen to music and other activities such as mindfulness colouring, watching television, or simply relaxing.

Safety Pods are now incorporated in to positive behavioural support plans on the unit, and patients themselves have highlighted that they would prefer the use of a Safety Pod if they require physical intervention.

Patient Quote

“I really enjoyed the training, especially the use of the Pods”

Priory Calverton Hill provides acute adult mental health services, delivered in partnership with Nottinghamshire Healthcare Trust, at its purpose built facility in Arnold.

After two years of successfully providing services for females, it opened a second service in May on behalf of the Trust, for male patients. It also has Medium Secure Services on site for patients with a learning disability and is looking to develop other service types in the future.

The feedback stated that ‘yes’ using the Safety Pod at the facility had reduced the number of injuries to both staff and patients, with the additional comment: “Since the introduction of Safety Pods incident numbers have reduced and injuries to patients and staff have been dramatically reduced through implementation and use of [the Safety Pod] during an episode of restraint.”

The feedback also stated that using the Safety Pod minimised the need for using higher level physical interventions such as prone (face down on the floor) and supine (face up on the floor) restraint.

The additional comment that “prone has virtually been eradicated within our local sites” was also included.

The feedback stated that ‘yes’ Calverton Hill would recommend the use of Safety Pods to other similar services. The site also rated the overall service of UK Pods Ltd as “very good”.

Jason Timmons, patient safety, security and PMVA lead at Calverton Hill, added that patient care and safety with this resource has made a general difference to managing challenging behaviour.

He added it had also “improved de-escalation and confidence amongst staff” and had led to “respect from the patient group on how they are being managed”.

At the Deacon Unit, a 10-bed inpatient facility for people with learning disabilities in crisis, the Trust was able to completely eliminate the use of supine restraints, following the introduction of the Safety Pod. It also significantly reduced other types of restraint.

The number of staff needed for each restraint was also reduced in many cases. In the case of one 21-year-old male who displayed high levels of aggression towards staff and other patients, the number of staff involved in his restraint was reduced from four to two with the use of the Safety Pod. The need to restrain him in the supine position, on his back on the floor, was also eliminated, as he could be supported safely on the Safety Pod where de-escalation of the situation arising could take place.

For another 20-year-old male with a history of self harm, regular supine restraint involving five staff was also eliminated and now, just two staff can support the patient on the Safety Pod – which the patient chooses to use himself as part of an advanced directive/request. On occasion, a third member of staff is required to use the XL Cushion to support legs.

Staff feedback showed 100% agreed the Safety Pod was easy and safe to use compared to only 9% saying supine restraint was easy and safe to execute.

Qualitative staff feedback included the following:

A manager said: “I have never seen a new practice enhancement be taken up so quickly with as much consistency as the Safety Pod. It is easy to use and has made a positive impact to both patients and staff.”

A patient who was supported with a Safety Pod said: “Safety Pod is good, it feels comfortable and is very relaxing.”

Staff Nurse Soji Fasanya stated: “The Safety Pod encourages better communication and more positive interactions when a patient is being restrained. It enables you to have good eye contact at the same level as the person rather than looking down at them.”

The Safety Pod has increased the safety for both the patient and staff during restraints and seems much more dignified than supine restraints.

Whilst restraint is used as a last resort, patients have chosen to utilise the Safety Pod during sensory sessions as it provides deep pressure feedback. Using the Safety Pod in positive ways ensure it does not get seen negatively by patients.

“More dignified than supine restraints”
Owen Kaseke
Senior Care Support worker

• Reduction in staff injuries due to kicking
• Reduction in patient bruising due to restraint
• Reduction in floor and mattress restraints
• Easier to assist with feeding and medication
• Reduced patient’s challenging behaviour
• More comfortable for both patient and staff

A patient with very complex needs presented over a lengthy period of time with very challenging behaviours, including kicking staff. As a result, the patient was being subjected to very long periods of manual physical restraint with, at times, up to five staff.

The Safety Pod was introduced and the client reported Palkesh and the team at UK Pods Ltd could not have been more helpful and were very understanding of the complexities it was facing.

Staff were trained in the use of the Safety Pod on the ward and from the outset, the Safety Pod and leg pad had a positive effect on both the patient and the staff.

Staff found the equipment easy to transport and clean and over time, staff reported a reduction in the patient’s challenging behaviour. Injuries to both staff and patients were also reduced.

The client stated the Safety Pod helped to minimise the risks associated with the more restrictive physical interventions they had to carry out prior to the Safety Pod being introduced.

They also regarded the team as highly professional and understanding.

The primary purpose of the XL Cushion is to reduce the inherent risk of injury to a persons legs during manual support including the risk of injury to the supporting professional team members.

Following research, reports clearly demonstrate that the vast majority of restraint injuries are a direct result of physically supporting a persons legs. This is largely due to the degree of power legs can produce as well as the level of force often applied in order to manually support them; bruises, grazes, friction burns, dislocations, fractures, brakes are all common injuries.

Historically, safer alternatives for physically supporting a persons legs are limited, particularly when they involve more resistive, flexible and stronger legs. Methods involving more than one team member are common, with upwards of 2 – 4 people used in extreme cases.

With regular use of multiple people required on legs we then find that considerations for more restrictive mechanical methods such as leg straps and wraps are common ground and in some cases an ideal solution.

The XL Cushions have been developed alongside multiple physical intervention teams and healthcare sectors across the UK with the primary aim to achieve a safer, dignified control of a persons legs without increasing the restriction applied, therefore reducing the potential force that often leads to injury.

The size of the cushion and construction has been selected based entirely on the common procedural dynamics of a typical leg restraint, making it ideal for staff that are either supporting legs in a seated position or on the ground.

The high density memory foam particles within the cushion allow for constant breathable movement from a persons legs, but in a controlled space. This space does not grow over time as the foam compresses and expands with the movement as and when it occurs.

• Reassurance and safety for a girl who used to hit out at parents and damage property
• Regular calls to police eliminated
• Need for restraint eliminated
• Safety Pod used in positive behavioural support to watch a film, or have a foot massage
• Portable Safety Pod used in different rooms in the home
• Enables parents to sit beside and comfort daughter

When Olivia Turner became overwhelmed and distressed, the 15-year-old, who has autism, ADHD and a learning disability would sometimes resort to hitting out at her parents and trashing property in the family home.

But since coming out of an inpatient facility after a 12 week stay from April this year – and using a Safety Pod to help her calm down at home – her parents Dawn and Jonathan have not had to resort to calling the Police, something which was a weekly occurrence before.

Dawn says: “We have been on a journey – some might say a nightmare. It has been quite horrific, both for Olivia and for us as parents.”

“Our daughter spent time in an inpatient facility from April this year. We were having quite a lot of escalations in her behaviour. She was getting very overwhelmed at home and getting very angry causing damage to property – and damage to my husband and I.”

“My husband was having to restrain her which, I felt was very wrong as a parent, having to do that for her own safety and the safety of the house. She is a 15-year-old girl and was doing quite a lot of damage to the home and trying to get out of the house. When she got angry, she got angry with both of us and we needed a third person to come in to de-escalate the situation. That’s why we were having to call the Police on a weekly basis – and they remain part of our crisis support plan.”

The family were recommended to use a Safety Pod by a healthcare professional who was looking into Olivia’s needs and helping to create a safe environment for when she returned home following her 12-week inpatient stay. He had been implementing the use of Safety Pods for a local NHS service.

Dawn said: “We got the Pod not long after she was discharged.”

“It’s in her bedroom and we will be making a safe room in the house that will become a sensory room and we will have a Pod in there.

“Just having the Pod in her room is helpful and now one of her “calm down” cards that she uses to communicate her feelings has a picture of the bean-bag like Pod on it, so she can use it to tell us she wants the Pod.”

Now, rather than growing increasingly angry, Olivia will sit on the Pod and have a foot massage, or snuggle under a blanket on it whilst watching a film or having a sleep.

“We haven’t had to restrain her once since she’s come back from her inpatient stay,” said Dawn.

“We use the Pod as a tool to help her calm down and we’ve never got to the point where we have had to restrain her while we’ve had the Pod.”

Occasionally, the family bring the Pod downstairs and it has even been used in the kitchen to help calm Olivia.

“Just the fact that it is there, and her knowing it is there if she needs it is a massive help,” said Dawn.

“It’s also reassuring for me and my husband to know it’s there as part of our crisis plan.

“Since having the Pod, we have never got to that level of having to restrain her, instead, we’ve both sat beside her on the Pod to comfort her.”

Dawn admits she will even sit on it herself sometimes and says it makes her feel calm.

*Names have been changed to protect the identity of the client.

“For us it’s reassurance that we have it in the house should we need to use it to support her to stay safe”

The effective use of Safety Pods during de-escalation and restraint is a feature in the December issue of the Quality Network for Forensic Mental Health Services’ (QNFMHS) newsletter.

Safety Pods™ were introduced at Kemple View as part of the facility’s ongoing commitment to reducing restrictive interventions, with the aim to enhance safety and reduce injury for both staff and patients.

And since their introduction by Kemple View’s Prevention and Management of Violence and Aggression (PMVA) team at the beginning of 2018, the facility has seen a marked reduction in prone position, ground and prolonged restraint.

There was an 81% reduction in all ground restraints in 2018 compared to 2017 – and by October 2019, this had risen further to 88%.

Prone restraints, in which patients are restrained in a face down position on the floor, reduced by 82% in 2018 – and up until October in 2019 there had been no prone restraints – a 100% reduction.

Restraints lasting 10 minutes or more reduced by 12% in 2018 compared to 2017 but this has risen dramatically in 2019 so far, to 76%.

Importantly, injuries to staff have reduced by 75% in 2018 and up to October 2019, while injuries to patients reduced by 66% in 2018 – with no injuries to patients at all so far in 2019. So it is little wonder that patients have reported “better satisfaction” following the introduction of the Safety Pods.™

Writing in the December edition of the Quality Network for Forensic Mental Health Services’ newsletter, Rob Holcroft, Quality Improvement Lead at Kemple View Hospital, highlighted how the Safety Pods are easy to transport, so staff can manoeuvre the pod to the patient, minimising the higher risk movement of patients during restraint.

This reduces the likelihood of injury to both staff and patients and minimises moving and handling issues related to health and safety.

The use of Safety Pods at Kemple View was raised in the CQC report’s discussion of the use of feedback from patients to inform positive behaviour support plans and improve practice. The report states how Kemple View had invested in Safety Pods™, describing them as “specially designed bean bags that maintained the body angle at 135 degrees, which optimised chest expansion and lung function, and minimised head trauma during restraint”.

You can view the full report or you can email info@ukpodsltd.co.uk for a copy.

Kemple View, part of The Priory Group received an Outstanding rating from the Care Quality Commission (CQC). The watchdog’s report highlighted the use of Safety Pods as a factor in promoting positive behavioural support.

The statistics above show staggering results, not only in terms of the reduction in restraints since Safety Pods were introduced in 2018, but also in terms of injuries to both staff and patients and a reduction in staff time spent restraining individuals.

There was an 81% reduction in all ground restraints in 2018 compared to 2017 – and at the time of writing in October 2019 this has risen further to 88%.

Prone restraints, in which patients are restrained in a face down position on the floor, reduced by 82% in 2018 – and so far in 2019 there have been no prone restraints – a 100% reduction.

Restraints lasting 10 minutes or more reduced by 12% in 2018 compared to 2017 but this has risen dramatically in 2019 so far, to 76%.

Importantly, injuries to staff have reduced by 75% in 2018 and 2019 so far, while injuries to patients reduced by 66% in 2018 – with no injuries to patients at all so far in 2019. So it is little wonder that patients have reported “better satisfaction” following the introduction of the Safety Pods™.

Kemple View is an independent hospital in Langho, near Blackburn, Lancashire. The hospital provides services for 90 men with mental health needs. Care and treatment is provided in four low secure wards and two rehabilitation wards.

The use of Safety Pods  at Kemple View was raised in the CQC report’s discussion of the use of feedback from patients to inform positive behaviour support plans and improve practice. The report states how Kemple View had invested in Safety Pods, describing them as “specially designed bean bags that maintained the body angle at 135 degrees, which optimised chest expansion and lung function, and minimised head trauma during restraint”.

Staff at Kemple View had been trained to use Safety Pods as part of prevention and management of violence and aggression training. Trainers had been trained in their use and the safety rationale, and had annual trainer refresher courses, plus access to video sessions to refresh their learning.

The report stated that “the bean bags were easy to move so staff could manoeuvre the bean bag to the patient rather than having to move the patient”. It was stated that this “reduced the likelihood of injury to both staff and patients and reduced moving and handling issues”.

The introduction of Safety Pods at Kemple View had resulted in reductions in the use of prone restraint. There was just one incident in 2018 and there were no incidents of prone restraint recorded in 2019. Patients reported better satisfaction following the introduction of the Safety Pods™.

Kemple View staff told CQC inspectors how using the Safety Pod had been effective in the second of two incidences of seclusion involving the same patient, reducing the time of restraint and the use of prone restraint.

The report states: “In the first incident, prolonged restraint and attempts to leave the seclusion room lasted for almost two hours, with prone restraint being required along with rapid tranquilisation. In the second incident, when the Safety Pod was used, staff were able to exit immediately and no prone restraint or rapid tranquilisation was needed. The multi-disciplinary team seclusion review stated that the patient appeared much calmer and reported no injuries or physical distress.”

This demonstrates the potential of the Safety Pod to improve safety and dignity for both staff and patients on wards like these at Kemple View.