What is restrictive practice? NDIS Restrictive Practice

Restrictive Practice

Restrictive Practice NDIS

A restrictive practice refers to any form of support or intervention that restricts the freedom of movement or rights of a person with a disability. This can include actions such as confining an individual to a room, administering excessive medication, or using coercion to make them comply with certain actions.

Restrictive practices are often used to prevent individuals from exhibiting challenging or concerning behaviors, such as self-harm, harming others, or property destruction.

To ensure the safety and well-being of people with disabilities, the use of restrictive practices is regulated by federal, state, and territory laws. These regulations outline the appropriate use of restrictive practices, the requirements for providers, and the actions that are not permitted. The regulations aim to prevent abuse and mistreatment of individuals with disabilities and ensure that their rights are protected.

Behavior support plans

Behavior support plans are developed to manage challenging behaviors in a positive manner and reduce the use of restrictive practices by providing alternative behaviour management strategies.

The plan is created through collaboration with the individual with a disability, their caregivers, family, and other support people. It is designed to be “evidence-informed” and “person-centred,” according to the National Quality and Safeguards Commission (NQSC).

The primary objective of a behavior support plan is to establish alternative positive behaviors and reduce or eliminate the need for restrictive practices. However, some circumstances may require the use of regulated restrictive practices.

The NDIS Restrictive Practices and Behavior Support Rules mandate that any restrictive practice must be a last resort response to a risk of harm to the individual or others. Additionally, it must be authorized according to state or territory legislation or policy requirements, proportionate to the risk of harm, and used for the shortest possible duration.

The NQSC recommends that any behavior support plan with a regulated restrictive practice be reviewed at least annually or more frequently if there are changes in the participant’s circumstances.

When can a restrictive practice be used?
The following legislative instruments outline the conditions under which regulated restrictive
practices can be used:
 National Disability Insurance Scheme (Restrictive Practices and Behavior Support) Rules 2018
 National Disability Insurance Scheme (Provider Registration and Practice Standards) Rules 2018
 National Disability Insurance Scheme (Incident Management and Reportable Incidents) Rules
2018.

The NDIS regulations specify that particular restrictive practices such as seclusion, chemical restraint, mechanical restraint, physical restraint, and environmental restraint are closely regulated. In line with this, NSW is committed to minimizing and ultimately eliminating the use of restrictive practices.

What are the 4 types of restrictive practice?

These are chemical restraint, mechanical restraint, physical restraint, environmental restraint and seclusion. 

Reducing and eliminating restrictive practices

To align with the positive behavior support framework and the NDIS Act 2013, regulated restrictive practices must be a last resort in response to risk of harm and used for the shortest possible time. Therefore, it is essential to have clear plans in place to gradually reduce and eliminate their use, substituting them with proactive and less restrictive alternatives that consider the individual’s needs and the underlying cause of their behavior.

Australia is dedicated to reducing and ultimately eliminating restrictive practices. The National Framework for Reducing and Eliminating the Use of Restrictive Practices in the Disability Service Sector highlights six key strategies to achieve this:

  1. A person-centred approach
  2. Organisational leadership promoting change
  3. The use of data to inform practice
  4. Workforce development
  5. The application of restraint and seclusion reduction tools, such as evidence-based assessment, prevention approaches, emergency management plans, environmental changes and integration of meaningful activities into the individual’s support plan
  6. Debriefing and practice review.

The primary objective of behavior support is to enhance quality of life, while reducing behaviors of concern is the secondary goal. The reduction and elimination of restrictive practices protects the rights of people with disability and plays a critical role in promoting their quality of life.

Resources

The NDIS Commission website provides an overview of behaviour support and restrictive practices for providers.

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