RATER (Risk Assessment To Estimate Ratio) is a tool used to inform training professionals of the safe ratio of trainer(s) to participants during the teaching of restrictive skills.

The Restraint Reduction Network (RRN) Training Standards (2019) requires training providers to ensure that each restrictive physical skill included within their curriculum is holistically risk assessed. The RATER Tool is not to be used in isolation, but used in addition to Biomechanical Risk Assessments, Environmental Risk Assessments, Training Needs Analyses, and Individual Risk Assessments.

Training providers may use their own tool as long as they have considered all relevant risks when planning training. NAPPI developed the RATER Tool, based on the RRN Tool, “Risk assessment tool to support training ratios”. RATER is used within the holistic risk management of NAPPI training, and forms part of the agreed training delivery plan.

The RRN Training Standards state that when teaching and assessing competence in a restrictive physical skill, the ratio of trainers to participants must not exceed 1:12 (in line with first aid training that also requires competency testing).  When one trainer is used, there must be evidence of low risk across all four risk domains Safety; Client risk factors; Trainability; and Effective. A second trainer is required where risks are identified as higher, for example, complexity of a technique, or use of simulation. A minimum of two trainers are required if the cohort size is above 12, with the total participant cohort not exceeding 18, irrespective of the number of trainers.

The RATER Tool is used by authorised NAPPI uk employees to analyse risks within a NAPPI training event. It is a requirement of the RRN that a Risk Assessment Tool is used, and BILD ACT have announced that they will robustly monitor use, as part of their Quality Assurance process. 

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For further information about NAPPI Restrictive Physical skills or Clinical Holding skills and how they link to the NAPPI PBS Model, please contact the team on:

   Call 01723 353353 to speak to NAPPI uk

   Click here to email NAPPI uk