High-intensity supports
A Guide to Restrictive Practices
A Restrictive Practice is any practice or intervention that restricts the freedom and/or rights of a person with disability.
Sometimes behaviours of concern can pose a safety risk to the person or those around them. When this happens, restrictive practices may need to be used to ensure their safety and wellbeing.
Restrictive Practice is a last-resort measure to ensure a person's immediate safety after less restrictive responses are exhausted. They must be approved and authorised by both State and National bodies.
This article will explore what restrictive practices are, provide examples, explain how the National Disability Insurance Scheme (NDIS) defines them and outline who can provide them.
What are Restrictive Practices?
Restrictive Practices are interventions used in disability support to manage behaviours of concern or prevent harm to the individual or others.
Under the NDIS, Restrictive Practices must be:
- a last resort
- proportionate to the risk
- monitored and reviewed regularly
- consistent with human rights principles.
What are some examples of regulated Restrictive Practices?
- Seclusion: the confinement of a person with disability to a room or space where the person is not able to leave voluntarily. This also includes "time outs" where it is implied the person is unable to leave voluntarily, even when there are no locks preventing the person's exit.
Chemical restraint: is the use of a chemical substance or medication prescribed to influence or manage a person’s behaviour. This does not include medications prescribed for diagnosed mental health conditions. - Mechanical restraint: when a device is used to prevent, restrict, or subdue a person’s movement to influence their behaviour. This does not include devices used for therapeutic or non-behavioural purposes.
- Physical restraint: when physical force is used to prevent, restrict or subdue movement of a person’s body, or part of their body, to influence their behaviour. This does not include hands-on techniques to guide or redirect a person away from potential harm or injury, which could reasonably be considered as the exercise of care towards a person.
- Environmental restraints: means to restrict a person’s free access to all parts of their environment, including items and activities.
Luka’s behaviour support is a ‘learning adventure’ for mum, Amy
Amy has been self-managing Luka’s support for many years. But as Luka’s condition progressed into requiring behaviour support and elements of restrictive practice, she needed to find a disability support provider.
Does the NDIS provide funding for Restrictive Practices?
The NDIS encourages Positive Behavior Supports, which prioritise skill development to reduce the need for Restrictive Practices. Behaviour Supports are funded under the “Improved Relationships” category of Capacity Building budgets.
The NDIS recognises the need for Restrictive Practices but tightly regulates their use to protect an individual's rights.
What is the NDIS Quality and Safeguards Commission?
It’s the NDIS Quality and Safeguards Commission (QSC)'s responsibility to monitor the use, effectiveness and reduction of Restrictive Practices.
The QSC is an independent agency set up to improve the quality and safety of NDIS supports and services.
As a registered provider, Hireup is mandated to work within the guidelines set by the NDIS, NDIA and the QSC.
The QSC responds to concerns, complaints and reportable incidents. Reportable incidents include where there's hospital admission of a client, a prohibitive practice, unauthorised restrictive practice, an allegation of abuse by a support worker, or the death of a client.
Who can provide Restrictive Practices?
Only NDIS registered providers using trained staff and authorised professionals should provide Restrictive Practices in disability support. These may include:
- Qualified health professionals: medical practitioners, psychiatrists, psychologists, and behaviour specialists.
- Behaviour Support practitioners: who develop behaviour support plans with positive reinforcement as a priority
- Accredited support workers: who carry specific training in Restrictive Practices, under the direct supervision of qualified professionals.
The use of Restrictive Practices in disability support requires thoughtful consideration and regulation. Although necessary for safety, they should always be used minimally, reported and closely monitored.
The NDIS plays a vital role in overseeing these practices, emphasising Positive Behaviour Support and individual rights.
Hireup's approach to Positive Behaviour Support and Restrictive Practices
Hireup’s experienced team of Behaviour Support Relationship Managers are focused on creating supportive environments where people can learn new skills and adopt positive behaviours, while avoiding situations that could increase behaviours of concern.
There’s no one-size-fits-all approach to this type of support, learn more about how it works with Hireup.
