I see Bugurl747 shared info.
I can add about PRTF use of them here in SD
We did not use isolation but kids were asked to go or sometimes escorted to a time out room. Ours were not allowed to have doors and staff had to remain in the just outside the doorway. We documented everything the resident did. In cases where the child chose to go to the time out room, staff also was just outside the doorway but the documentation was every 5 minutes. All our time out rooms had cameras too. When the client was calm enough to control their actions and behaviors, the processed the incident (or what upset them if they placed themself in timeout) and then they exited the time out room. Kids that placed themself into or went on their own when staff directed them to go into TO rejoined the group. The length of time the resident was in the time out room largely depended on them. They were released as soon as they calmed, processed, and were ready to follow rules and structure.
Those that were escorted there were typically put on a 24 hour Restricted level (which was the closet to isolation we got). R level required they sit away from peers, typically at the staff desk (at the front of the living area) ,complete a write up about what happened, write letters to their social worker and parents/guardians about what happened and being place on restriction, they may also have a relevant packet assigned. All of that was also processed with staff. They could talk to staff but not their peers without permission and even then communication with peers was very limited. They still participated in groups and required physical activity groups but had to be by staff. They could have incoming calls but lost the privilege to call out for 24 hours. They missed out on fun activities(TV, games, crafts) too. If they had a higher level prior to the incident they lost that too and started over at level 1 once they were off restriction. If they got all their paperwork done, we had a little tub of things they could use- like puzzles, clay, coloring sheets, word finds, etc. The 24 hours included sleep time and school time. Kids on run procedures was somewhat similar but a lot more involved
Restraints and Escorts could only be used when a resident is a danger to self or others..like a serious danger to self, not like them using their finger nail to self harm. Danger to others included assault type things, possibly pushing a peer if they continued to escalate. As I previously stated, we could not touch a child to prevent or stop them from running away.
Orders were required for every restraint but we could start a restraint/escort and then call if it was an emergency type situation. All restraints and escorts had a staff or the order writer monitoring. Only certain staff were trained and licensed to be an order writer..sorry I can't remember the specifics but I believe it was a 4 year degree that was related to social work or psychology.
All escorts and restraints were documented via an incident report and a documentation log.
Restraints and escorts were last resort type thing. All staff had a minimum number of our crisis mgmt training hours required per year and we did refreshers. Staff cannot place their hands on the residents until they were certified in crisis mgmt program. That training also included a ton of de-escalation techniques.
Prone restraints weren't illegal (not sure if they are now) but we rarely used them. There are very strict guidelines regarding who cam even be placed in a prone position. Weight, health conditions like asthma, former trauma, etc all play into that. If they could be used it was a 1 min limit before they had to be moved into another position.
We were not licensed for medical restraints, the use of restraint chairs, tie to hold clients. Our restraints were hands on only and we could use spit masks.
Upon admission, residential staff were given intake info that included which restraints could be used on that particular client and those that were not permitted. Like I mentioned health conditions, weight, age, size all impact that but so does the type of abuse a client suffered.
There were a variety of holds and we always tried the least restrictive hold. There were single person and multi person holds. There was a time limit for each specific hold. The staff monitoring the restraint made sure the holds were done correctly, that staff didn't need to be switched out, and they were the only one talking to the client. Less people talking is easier for the clients.
We always tried to avoid restraints and escorts but sometimes they were necessary for safety reasons. Not gonna lie, I hated them and got really good at my de-escalation skills so I could avoid them as much as possible!
Staff were trained in a variety of things to try and de-escalte the situation. We were also informed of things going on with the client that might cause issues so we could be proactive. The clinical team did a great job of giving us other interventions that might help too. We also gave the therapist ideas of things that could help.
Just a note: As I said I am more familiar with CHS Sioux Falls Children's Home than I am Black Hills Children's Home but they operate similar programs. I know they use timeouts and they have restraint training program too. I am not familiar with the program they use because my center used a different one. I know it was similar to ours though. They used some of the same holds but also used very different ones due to the younger ages of their clients. They also used some different de-escalation techniques for that same reason.