Restrictive Practice Reduction Through Reviewing Access to Personal Belongings in PBS

Positive Behaviour Support requires providers to review how access to personal belongings is managed, especially where staff control items for safety, routine or risk reasons. The Positive Behaviour Support knowledge hub supports services to connect behaviour, proactive support, rights and restrictive practice reduction.

In specialist services, restrictive practice reduction and review should include everyday item controls such as staff-held keys, chargers, money, clothing, toiletries, food, devices or preferred objects. These restrictions may feel small, but they can have a significant impact on dignity and trust.

This reflects PBS principles and values, because people should have ordinary control over their own possessions wherever possible. Strong providers do not allow staff-held belongings to become routine without evidence, review and a reduction plan.

Concept Explained Clearly

Restricted access to personal belongings happens when staff control when, how or whether a person can use items that belong to them. Sometimes this is introduced after risk, damage, loss, excessive use or distress linked to the item.

The restriction may be necessary for a short period, but PBS requires services to ask what the item means to the person, what risk is actually present and whether support can be redesigned. A phone, wallet, coat, snack box or key is not just an object; it may represent independence, reassurance, identity or control.

Why It Matters in Real Services

Item restrictions can become normalised because they are easy to manage. Staff may say “we keep that in the office” or “they ask for it when they need it” without recognising the loss of autonomy involved.

This can create repeated tension. The person may ask frequently, become distressed, distrust staff or try to access items secretly. Commissioners and CQC will expect providers to evidence that restrictions on belongings are proportionate, individualised, reviewed and reduced where possible.

What Good Looks Like

Strong services maintain clear records of any staff-controlled belongings. Plans explain why access is restricted, what alternatives are being developed, how the person is involved and what evidence would support increased access.

Good PBS practice uses graded access, environmental changes, communication support, agreed routines and risk-specific safeguards. Providers should be able to evidence how increased control over belongings improves dignity, trust and quality of life.

Operational Example 1: Reviewing Staff-Held House Keys

Step 1 – Context: A person in supported living did not hold their own house key because of a historic concern about leaving late at night and becoming distressed in the community.

Step 2 – Support approach: Review showed the person now used a visual evening routine and had not attempted to leave at night for several months. The key restriction had not been updated.

Step 3 – Day-to-day delivery detail: Staff introduced daytime key practice, a familiar local route plan and an agreed check-in routine when leaving the house.

Step 4 – Reduction action: The person began holding their key during daytime periods, with overnight arrangements reviewed separately and transparently.

Step 5 – How effectiveness was evidenced: The person used the key appropriately, confidence increased and repeated requests to staff reduced. The provider evidenced that key access could be increased safely through staged review.

Deepening the Understanding: Belongings Often Carry Emotional Meaning

Personal belongings can provide reassurance, identity, routine and connection. Restricting them can feel more significant than staff realise. A charger may represent connection with family. A wallet may represent adulthood. A coat may represent readiness to leave when chosen.

Behaviour records help services understand whether item-related distress is about risk, uncertainty, ownership, communication or loss of control. The article on using ABC data in Positive Behaviour Support explains how services can identify patterns before deciding whether continued restriction is justified.

Operational Example 2: Reducing Staff Control of a Mobile Phone Charger

Step 1 – Context: Staff held a person’s phone charger because the person had previously stayed awake late using their phone and missed morning activities.

Step 2 – Support approach: Review found the person became more anxious when staff controlled the charger and repeatedly asked for it throughout the evening.

Step 3 – Day-to-day delivery detail: The provider introduced an agreed charging station in the person’s room, a night-time phone plan and a visual routine showing when the phone would be charged.

Step 4 – Reduction action: The charger returned to the person, with support focused on routine, sleep and expectation rather than staff-held control.

Step 5 – How effectiveness was evidenced: Repeated requests reduced, sleep did not worsen and the person showed greater trust in the evening routine. The provider evidenced that structured support reduced the need for item restriction.

Systems, Workforce and Consistency

Access to belongings must not depend on which staff member is on shift. Strong services record item restrictions clearly and brief staff on agreed access, support steps and reduction actions.

Supervision should test whether item controls are still needed or whether they continue because staff feel more comfortable holding the item. Handovers should include successful access trials, not only warnings about past incidents.

Operational Example 3: Restoring Access to Personal Toiletries

Step 1 – Context: A residential service kept one person’s toiletries in a locked cupboard because they had previously used excessive amounts and blocked the sink.

Step 2 – Support approach: Review identified that the person enjoyed the sensory routine of choosing products but did not understand quantity or sequencing.

Step 3 – Day-to-day delivery detail: Staff introduced a toiletry basket with smaller containers, a visual care sequence and a clear “finished” point for the routine.

Step 4 – Reduction action: The person regained access to their own toiletry basket, while bulk replacement products remained stored separately.

Step 5 – Evidence reviewed: Personal care became calmer, sink-blocking stopped and the person showed pride in managing their own items. The provider evidenced that adapting access was less restrictive than locked storage.

Governance and Evidence

Governance should show how restrictions on belongings are identified, recorded and reviewed. Providers should be able to evidence restriction register entries, PBS plan updates, risk assessments, item access plans, incident trends, supervision notes, person-centred feedback and quality-of-life outcomes.

Strong governance creates a clear line of sight from item-related risk to restriction, from restriction to support adaptation, from adaptation to increased access, and from increased access to improved outcome. Evidence should show how dignity and autonomy are restored alongside safety.

Commissioner and CQC Expectations

Commissioners expect providers to manage risk without unnecessarily controlling personal property. They need assurance that item restrictions are not used as simple staff convenience or long-term risk avoidance.

CQC will expect care to be respectful, person-centred and least restrictive. Inspectors may review whether people can access their own belongings, whether restrictions are justified and whether staff understand rights-based support. Strong services demonstrate that belongings are treated as part of autonomy, not just risk management.

Common Pitfalls

• Keeping personal items in staff offices without recording this as a restriction.
• Holding belongings because of historical incidents without current review.
• Using staff control instead of communication or environmental support.
• Failing to consider the emotional meaning of items.
• Returning items without a planned support route or evidence review.
• Measuring success only by reduced incidents, not increased trust and autonomy.

Conclusion

Restrictive practice reduction through reviewing access to personal belongings helps PBS services recognise quiet restrictions that can strongly affect dignity and trust. Personal property should not be controlled by default.

Strong providers evidence why item controls exist, how alternatives are tested and how access is restored safely. This gives commissioners and CQC confidence that PBS protects everyday rights as well as managing risk.