Key recommendations for the Ministry of Health and the DHBs • More effort needs to be directed at finding and agreeing a standardised measurement and national recording of seclusion events across the different health and disability services. • Physical conditions in all seclusion rooms must adhere to minimum standards regarding room size, ventilation, lighting and temperature. • Service users should have ongoing direct access to drinking water, toilet facilities, and sufficient clothing and bedding, without need for staff intervention. • Secluded service users should have access to fresh air and the opportunity to exercise. • All uses of locked seclusion rooms and areas which the service user cannot freely exit must be recorded as seclusion events. • Seclusion rooms must not be used as regular bedrooms. • Record keeping and data analysis must be improved nationally. • More work needs to be done to understand some of the barriers to achieving a sustained reduction in seclusion events. In particular, it may be worth exploring the views and concerns of different staff groups about seclusion reduction policies. • More work needs to be done to understand the divergence in use of restraints across DHBs and their use with Mäori and Pacific Peoples in particular. 47