A health trust has been criticised for unnecessarily restraining an autistic child after it failed to properly monitor a school’s use of specialist seating.
The report, by the Northern Ireland Public Services Ombudsman, also said the Western Trust did not fully assess the child’s needs before approving the chairs, nor ask his parents for consent to use them.
It also criticised the trust for not giving the school instructions on how they should be used.
The ombudsman investigated after a complaint was made by the child’s mother.
Her son, who is non-verbal but can walk unaided, used a special chair at mealtimes.
The report said when the school claimed it was having difficulty moving him to the dining room it asked the trust to add a wheeled base to the chair.
His mother said this was unnecessary restraint, as he was able to walk but just needed time and encouragement to do so.
The report said that when the trust was told about the issues with the child’s mobility, the occupational therapy team should have carried out a multi-disciplinary assessment.
It concluded that in approving and fitting the wheeled base to the chair, the trust did not fully consider the child’s human rights.
The child’s mother also said the lap belt on the chair was too tight.
The report said when she raised this with the trust she was told the chair was also used by others in the school, and that her son could use another chair if she wished.
The ombudsman said this was a highly specialist chair for a child who has very limited mobility.
The report said it was more restrictive and had foot straps, a lap strap, and a wheeled base.
The investigation found that there was no assessment by the trust of the child’s needs prior to this change, and no assessment of whether he could engage in school activities with or without the chair.
The report concluded that the chair was an over prescription and caused him to be restrained unnecessarily.
Deputy Ombudsman Sean Martin said: “The failures in this case caused the child’s parents a huge amount of distress.
“Our investigation highlights the requirement for health professionals to involve patients, or in this case parents, and work closely with others, particularly schools before making decisions on appropriate equipment for use in a school setting.
“The trust should have given guidance to the school on how to use the specialist chairs so that the child was only restrained when it was absolutely necessary.
“The principle of using the least restraint possible should be an imperative for everyone, regardless of the setting.”
The report welcomed the learning and service improvements the trust has implemented in response to the complaint.
It said these include holding regular multidisciplinary meetings to discuss any issues with restrictive practices, and the removal of belts from certain chairs within educational settings.
A spokesperson for the Western Trust said: “The trust will be contacting the service user and their family to offer a sincere apology.
“We have accepted the findings and learning within the ombudsman’s report and an action plan has been developed to take the recommendations and learning forward.”