Table 3.

Strategies for Managing Risk

Term	Frequency of Mention	Example
Dementia specific control and restraint; Forced care	6	Dementia specific control and restraint. [P21] Dementia specific PMVA* training and forced care. [P21]
Training and supervision	6	Identify regular triggers, ensure people/staff are mindful of these. Identify what works in order to calm the situation before further escalation and offer training in identifying need and life history. [P13] Counselling/clinical supervision for staff built into regular work. [P3]
Organisational response	5	Integrated care systems, including use of more psychiatry and psychology support. [P22] Work with CQC and safeguarding how behaviours that challenge can be managed safely; Develop some risk management eg infection risk, or not allow alcohol; Learning should be shared more widely, more systematically across settings, especially domiciliary care staff; CQC be on board early about risks and managing agitation so de-escalation can be conducted without care home worrying. [P25]
Creating safe environments	5	Remove self or person from the environment (exit strategy, call for help). [P21] Rapid intervention techs when behaviour begins to escalate - change environment (very environment specific) [P29]
Prevention and Management of Violence and Aggression (PMVA)	3	Safe PMVA holds. [P12]
Medication, including PRN (“when required”)	3	PRN medication [P15] Medication [P21]
Clear plans of action regarding. Risk	2	Clear plan of action around risk for the individual. [P10] Molthorpe and Moriaty’s risk guidance. [P25]
Specialist input	2	Access to specialist clinicians, eg via specialist teams. [P22]

Abbreviations: *CQC, Care Quality Commission; PMVA, prevention and management of violence and aggression; PRN, as need (pro re nata).