Regulation of Physical and Chemical Restraint

Key points:

• The Commission’s focus continues to be on ensuring that risks to consumers’ safety, health and well-being through the use of restrictive practices are minimised, and consumers are treated with dignity and respect.

• Restrictive practices must only be used as a last resort and in the least restrictive form.

• The Principles require providers to satisfy a number of conditions before and during the use of any restrictive practice.

• From 1 July 2021, restrictive practices must only be used where the provider has documented changed behaviours (or behaviours of concern) for the consumer, where these changed behaviours have been assessed by an approved health practitioner who has day to day knowledge of the consumer, or a behaviour support specialist, alternative strategies have been used prior to the use of any restrictive practice, and consent to the use of any restrictive practice if required. This process builds on existing strategies a provider should already have in place under the Principles (as expired on 30 June 2021).

• The provider is required to document the alternatives to restrictive practices that have been considered and used, and why they have not been successful.

• The provider is required to have a clinical governance framework in place to minimise the use of restrictive practices. The Commission expects that where a restrictive practice is used, such a framework will ensure that informed consent for the restrictive practice has been obtained from the consumer or their restrictive practices substitute decision maker.

• • Where any restrictive practices are used, the consumer must be regularly monitored for signs of distress or harm, side effects and adverse events, changes in wellbeing, as well as independent functions or ability to undertake activities of daily living (ADLs).

• The use of the restrictive practice must be regularly reviewed by the provider with a view to removing it as soon as possible or practicable.

• • From 1 September 2021, providers are required under the Principles to have a Behaviour Support Plan in place for every consumer who exhibits behaviours of concern or changed behaviours, or who has restrictive practices considered, applied or used as part of their care. The Behaviour Support Plan forms part of the care and services plan, and does not replace it.

• The Commission may issue a Restrictive Practices Compliance Notice where a provider is not, or may not be, complying with its responsibilities on the use of restrictive practice. The Commission’s existing regulatory powers to respond to non-compliance also continue to apply and are detailed in the Commission’s Compliance and Enforcement Policy.

• • Providers should familiarise themselves with the amended requirements in the Aged Care Act and Principles.

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