Report - Disability Rights Texas

# Provision Assessment of Status Compliance
Prone Restraint
Based on Facility policy review, prone restraint is prohibited. Based on review of
restraint records, restraint reduction committee minutes, staff interviews, and minutes of
the Incident Management Review Team (IMRT), no use of prone restraint was identified
or the subject of any discussion in meeting minutes. The Facility self‐assessment included
a review of video evidence of 14 of the 21 restraint episodes. This review did not detect
any restraint use that could be construed as prone restraint.
Other Restraint Requirements
Based on document review, the Facility policy states that restraints may only be used: if
the individual poses an immediate and serious risk of harm to him/herself or others;
after a graduated range of less restrictive measures has been exhausted or considered in
a clinically justifiable manner; for reasons other than as punishment, for convenience of
staff, or in the absence of or as an alternative to treatment.
Additionally, this Provision requires that restraint use occur in accordance with
applicable, written policies, procedures, and plans governing restraint use.
Restraint records were reviewed for Sample C.1 that included the restraint checklists,
face‐to‐face assessment forms, debriefing forms, Individual Support Plan Addendums
(ISPAs). IMRT minutes, and any other documents the Facility chose to provide to
demonstrate compliance with the SA. The following are the results of this review:
In all eight restraint records reviewed (100%), there was documentation showing that
the individual posed an immediate and serious threat to self or others. This information
was provided on the Restraint Checklist in the section labeled “Describe Events Leading
to Behavior That Resulted in Restraint” and on the Face‐to‐Face Assessment/Debriefing
form in section 3, “Determine if restraint was necessary.”
The Facility, through its restraint review process, identified in its self‐assessment one
instance of use of restraint where the Individual’s behavior did not appear to represent
imminent and serious risk of harm to self or others. The Facility self‐assessment also
concluded that it did not appear less restrictive behavior management techniques were
attempted without success prior to use of restraint. This was a six minute horizontal
restraint of Individual #77 on 7/3/12. This restraint episode was not the subject of
review by the Monitoring Team as it was not included in the Sample C.1.
The Monitoring Team met with 10 Direct Support Professionals (DSPs). All ten worked in
an area where restraint use occurs. Five were from the morning shift and five from the
afternoon shift. All were asked to respond to the question “From the training you’ve
Rio Grande State Center, November 19, 2012
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