Recommendations - Thames Valley Police, December 2024
We identified organisational learning following an IOPC investigation where a man was arrested and taken to hospital after swallowing a large quantity of tablets. After being discharged from hospital, he was physically restrained by police officers in the prone position, handcuffed and placed in limb restraints. The man’s condition deteriorated over the following days and the man sadly died.
Recommendations
2 totalThe IOPC recommends that Thames Valley Police (TVP) review its training material on handcuffing from prone (subject lying on their front) and the use of ground pin. The review should consider whether training is sufficiently clear regarding: This follows an IOPC investigation where a man was arrested and taken to hospital after swallowing a large quantity of tablets. After being discharged from hospital, he was physically restrained by police officers in the prone position, handcuffed and placed in limb restraints. During the course of the restraint, the man’s arms, following the application of handcuffs, were pulled at and beyond a 90-degree angle for a prolonged period of time. This resulted in significant injuries to the man’s shoulders. The man appeared distressed but did not verbally communicate with the officers. However, following his death it was established that he sustained a serious injury to his shoulders. While the TVP training material on the ground pin is clear that elevating a subject’s arms should be done to gain compliance and be removed once this has been achieved, the training material on handcuffing from prone is not as clear. It appears that the matter of how a subject’s arms should be restrained after the application of handcuffs is not currently covered in the training material on handcuffing from prone. The training material reviewed during our investigation is not clear on when it might be proportionate to use this tactic. Currently, the training only talks about lowering the arms once compliance has been achieved.
Accepted Thames Valley Police (TVP) use a series of resources to guide Public and Personal Safety Training (PPST) instructors through training content. A timetable provides guidance regarding the order of training days for a particular course, a session plan provides the content to be delivered on any training day, and trainer notes provide the detail of how a technique is to be taught / the method of demonstration. Trainer notes cover key points to support any depiction in the College of Policing’s Personal Safety Manual of Guidance. Scenario based training allows for officers to utilise appropriate skills to control varying behaviours in an operational context. Competence is addressed and developed when necessary. This delivery style is in line with the College of Policing’s mandated programme for PPST. TVP have reviewed the training material associated with handcuffing from a prone position (subject lying on their front). TVP accepts that training may be clarified further and are taking the following actions to ensure necessary change: How a subject’s arms ought to be restrained during and after the application of handcuffs. Following review, TVP have made changes to their Handcuffing from Prone Trainer Notes (Strong Side and Support Side) and their Ground Pin Trainer Notes. This provides further clarity on how a subject’s arms are to be restrained during and after the application of handcuffs. When it might be necessary and proportionate to elevate a subject’s arms during restraint to the ‘natural point of resistance’ to gain compliance, including when a subject’s arms should be lowered. Following review, TVP have made changes to their Handcuffing from Prone Trainer Notes (Strong Side and Support Side) and their Ground Pin Trainer Notes. This provides further clarity on how a subject’s arms are to be restrained during and after the application of handcuffs. This includes the method in which the arms are elevated prior to the application of handcuffs, how each arm is managed during application, and what position they are placed in after the handcuffs have been applied. TVP’s trainer notes do not reference elevating arms to gain compliance. This is done to gain (mechanical) control (this is without the use of handcuffs). This material review is centred on handcuffing from prone. TVP do not teach the elevation or lowering of arms whilst handcuffed to achieve compliance or control. The difficulties in determining another person’s ‘natural point of resistance’. For example, if a subject is in distress, is non-verbal, or intoxicated, then they may not be able to properly communicate, display resistance, or show indicators of pain. Following review, TVP have made changes to their Handcuffing from Prone Trainer Notes (Strong Side and Support Side) and their Ground Pin Trainer Notes. This provides further clarity on the difficulty in determining another person’s natural point of resistance / tension. Specifically, the following teaching point has been added: ‘It may be difficult to determine another person’s natural point of tension, for example if they are in distress, non-verbal or intoxicated. These subjects may not be able to properly communicate, display resistance or show indicators of pain’. TVP’s trainer notes provide more detail than the College of Policing Personal Safety Manual of Guidance. This is to support instructors’ understanding of techniques and how they should be taught. Minimal requirement would be to refer to the illustrations and brief descriptions in the personal safety manual. TVP go ‘over and above’ national requirement to ensure diligence and support to their training team.
The IOPC recommends that Thames Valley Police (TVP) ensure that its training and guidance on restraint and positional asphyxia clearly states the role and responsibilities of the safety officer. This includes when a safety officer should be used, the safety officer identifying themselves to those present, monitoring the subject’s signs of life and any deterioration, and verbally encouraging those present to raise any concerns they may have about the subject’s welfare as early as possible. This follows an IOPC investigation where a man was arrested and taken to hospital after swallowing a large quantity of tablets. After being discharged from hospital, he was physically restrained by police officers in the prone position (lying on his front) for a prolonged period of time. During the course of the restraint, there were five police officers present. The man’s breathing and airway were not closely observed. The signs and symptoms of positional asphyxia and cardiac arrest were present. The man later became unresponsive, and he was re-admitted to hospital where he subsequently died.
The TVP training material reviewed during our investigation does not appear to cover the role and responsibilities of a safety officer.Accepted TVP have introduced a PowerPoint presentation on positional asphyxia into their Foundation Delivery for student officers. This presentation covers the definition of positional asphyxia, its likelihood and the positions it may occur in, including the increased risk around prone restraint, signs and symptoms and officer response. Officer response is centred on situational awareness, communication and decision making. These areas promote the use of a safety officer where numbers permit. Referenced in the presentation itself but supported by trainer notes, instructors are to educate student officers in the essential use of a safety officer where viable. When a safety officer should be used The positional asphyxia PowerPoint states: ‘In any circumstances where a subject is restrained by multiple officers, consideration should be made towards the nomination of a safety officer.’ Monitoring the subject’s signs of life and any deterioration Verbally encouraging those present to raise any concerns they may have about the subject’s welfare as early as possible. The positional asphyxia PowerPoint states: ‘The responsibility of this nominated person should be focused on the subject’s wellbeing, signs of life and any deterioration of the subject whilst supporting colleagues’ actions.’ ‘If one or more members of a group are fixated on their own method of control, it may be helpful for a safety officer to direct the scenario. They may inform the team collectively and individually of their responsibilities, or identify when they are doing something which may be improved. The safety officer will also prioritise the wellbeing of the subject throughout’. An extensive amount of trainer notes focus on the requirement for communication as a collective group, officers involved, and safety officer. This includes maintaining communication to formulate a plan, communicating as a team, communicating with the subject to convey professionalism and provide a duty of care, challenging colleagues actions and providing regular updates. The safety officer identifying themselves to those present The positional asphyxia PowerPoint states: ‘If any additional officers arrive to assist, the safety officer should make themselves known and brief and direct the officers’. In addition to the positional asphyxia PowerPoint, TVP also deliver the College of Policing mandated PowerPoint presentation on Acute Behavioural Disturbance. This contains information specifically related to positional asphyxia and the increased risk of cases of actual bodily harm. Areas covered are response options, restraint concerns (including long periods of restraint), restraint considerations (including nomination of a safety officer, avoiding certain positions and aftercare positioning), monitoring detainees under restraint, duty of care and aftercare. TVP’s trainer notes provide more detail than the College of Policing Personal Safety Manual of Guidance. This is to support instructors’ understanding of techniques and how they should be taught. Minimal requirement would be to refer to the illustrations and brief descriptions in the Personal Safety Manual. TVP go ‘over and above’ the national requirement to ensure diligence and support to their training team. In addition to the support provided by the College of Policing, TVP have created trainer notes to assist instructors in the delivery of the Acute Behavioural Disturbance PowerPoint. These trainer notes include the following: Nominating a safety officer means that one officer can orchestrate proceedings whilst others are concerned with the restraint or containment of the subject. The safety officer will take responsibility for a number of things: In addition to Foundation Learning, a number of changes have been implemented by TVP to assist officers during annual re-certification training and whilst working operationally Future schemes of work