Single-Person Restraint: An Accident Waiting to Happen?

When incidents escalate, staff often act instinctively.

A teacher intervenes to stop a fight.

A support worker attempts to prevent self-injury.

A healthcare professional tries to stop a patient from absconding.

The temptation is understandable:

“I’ll deal with this myself.”

Unfortunately, good intentions do not always produce good outcomes.

The Problem

Physical restraint carries risks.

These include:

• Musculoskeletal injuries to staff.
• Falls and impact injuries.
• Compression and positional asphyxia concerns.
• Escalation of aggression.
• Trauma and psychological harm.
• Increased legal scrutiny following injury.

Many injuries occurring during restraint are not caused by malicious intent, but by poor decision-making under pressure.

One recurring factor identified in numerous investigations is the lone staff member attempting to manage a violent or highly resistant person without adequate assistance.

Lord Laming’s Warning

As far back as 1997, Lord Laming advised against single-person restraint.

His recommendation recognised an important principle:

The greater the imbalance between the force required and the number of people involved, the greater the likelihood of injury.

Attempting to control a struggling individual alone often means:

• excessive force being unintentionally applied;
• awkward body positions;
• prolonged struggles;
• loss of balance;
• greater fatigue;
• poorer monitoring of distress or medical complications.

Reducing Restraint Does Not Mean Restraint Elimination

Modern practice emphasises:

1. Prevention.
2. Communication.
3. De-escalation.
4. Dynamic risk assessment.
5. Least restrictive options.

The aim should always be to avoid restraint whenever reasonably possible.

However, where restraint becomes necessary, the intervention should be:

• lawful;
• necessary;
• proportionate;
• reasonable;
• for the shortest duration possible;
• and subject to continuous assessment.

The Human Factors Problem

During a physical incident, one person is:

• communicate,
• assess risk,
• maintain balance,
• monitor breathing,
• observe distress,
• summon help,
• and physically control resistance,

attempting to perform several complex tasks simultaneously.

Human factors research tells us that performance deteriorates under stress.

Additional staff provide:

• support;
• observation;
• communication;
• safer positioning;
• opportunities for de-escalation;
• and the ability to terminate the intervention sooner.

What Does Current Guidance Say?

Department for Education (England)

The new 2026 guidance on restrictive interventions places greater emphasis upon:

• prevention;
• minimising restrictive practices;
• staff confidence;
• safeguarding;
• recording and reporting;
• reducing the likelihood of injury.

The guidance also stresses avoiding interventions that may compromise breathing or circulation and highlights the importance of training and competent practice.

NHS England

NHS England promotes the principle of:

“Least restrictive practice.”

Restrictions should only be used when necessary and should minimise trauma and harm.

The NFPS Family Network

The NFPS standards and associated practice frameworks continue to encourage:

• restraint reduction;
• person-centred approaches;
• trauma-informed care;
• and ensuring that any intervention used represents the least restrictive alternative.

The Legal Test Has Not Changed

Courts do not judge techniques.

They judge behaviour.

The central questions remain:

Was there a lawful objective?

Preventing:

• injury,
• serious damage,
• crime,
• or disorder.

Was intervention necessary?

Could the incident reasonably have been managed differently?

Was the response proportionate?

Was the force used proportionate to the perceived threat?

Was the intervention reasonable in the circumstances?

These principles arise from:

• Common Law
• Section 3 Criminal Law Act 1967
• Health and Safety at Work etc. Act 1974
• Human Rights Act 1998
• Education and Inspections Act 2006
• Mental Capacity Act 2005 (where applicable)
• Mental Health Units (Use of Force) Act 2018

Foreseeability and Duty of Care

From a negligence perspective, an important question following any injury may be:

Was it foreseeable that one person attempting restraint alone could increase the risk of harm?

If assistance was available, but not used, investigators and courts may ask:

• Why was help not summoned?
• Why was the intervention not delayed?
• Were staff adequately trained?
• Were safer alternatives available?
• Was the risk assessment suitable and sufficient?

There Will Be Emergencies

There are occasions when a lone worker or single member of staff has no option.

For example:

• a teacher separating two pupils
• a support worker preventing a child from running into traffic
• a nurse stopping immediate self-harm
• a community worker acting before assistance arrives

In such situations, immediate action may be entirely justified.

The issue is not whether single-person restraint can ever be lawful.

It clearly can.

The question is:

Should it become normal practice when safer options exist?

A Better Question

Rather than asking:

“Can one person restrain somebody?”

Perhaps organisations should ask:

“Why are we putting one person in a position where they have to?”

Final Thoughts

Reducing restraint is not about removing options.

It is about improving decision-making.

Because when injuries occur, investigations rarely ask:

“What technique was used?”

They ask:

• Why did the staff act?
• What alternatives existed?
• Was assistance available?
• Was the response proportionate?
• Could the harm have been avoided?

Sometimes the safest intervention is no intervention.

Sometimes it is disengagement.

And sometimes, when restraint is unavoidable, having another trained person available may be the difference between a professionally managed incident and an accident waiting to happen.