Eliminating Restrictive Practices Policy

1. PURPOSE

This Policy outlines how DCIRS Community Care (“DCIRS”) will manage the identification and elimination of restrictive practices in its workplaces. DCIRS supports the rights and freedoms of participants and is committed to operating its business in accordance with NDIS Practice Standards.

This Policy will commence from 9 October 2024. It replaces all other eliminating restrictive practices policies of DCIRS (whether written or not).

This Policy supports DCIRS to apply the National Standards for Disability Services, in particular Standard 1: Rights.

The requirements surrounding restrictive practices are outlined in two modules of the NDIS Practice Standards:

• Practice Standard Module 2: Specialist Behaviour Support; and

• Practice Standard Module 2A: Implementing Behaviour Support Plans.

2. APPLICATION

This Policy applies to all employees, contractors (including temporary contractors), volunteers and business partners of DCIRS, collectively referred to in this Policy as ‘worker.’ Specifically, the Policy applies to everyone who works with participants and clients and/or makes decisions that affect them. This Policy does not form part of any worker’s contract of employment or service.

3. DEFINITIONS

Restrictive practices are those identified and regulated by the NDIS and designed to protect persons with disability from harm, including trauma. The five regulated restrictive practices are:

• Chemical restraint (e.g. medication).

• Environmental restraint (e.g. locking something to prevent access or only being allowed out if supervised).

• Mechanical restraint (e.g. non-therapeutic measures such as helmets and straps).

• Physical restraint (e.g. taking a person’s hand and pulling them in a direction they don’t want to go or holding down a body part for medical reasons such as blood test.)

• Seclusion (a last resort strategy such as leaving someone in a room to calm down where they can’t, or believe they can’t, leave).

Section 9 of the NDIS Act 2013 defines a restrictive practice as ‘any practice or intervention that has the effect of restricting the rights or freedom of movement of a person with disability.’

The NDIS Quality and Safeguards Commission provides the framework for restrictive practice.

The following definitions should be considered in conjunction with restrictive practice:

Choice and control derives from the presumption that people with disability have the capacity to make decisions and to exercise choice and control in life and service outcomes, with appropriate support where needed. See Choice and Control Policy.

Dignity of risk is autonomy and self-determination used by a person when making decisions, including the choice to take some risks in life.

Informed consent is voluntary agreement and willing acceptance of a proposition and following action where the person making the decision has appropriate information and capacity to make the decision free or fear or influence.

4. POLICY

DCIRS only supports participants who do not require authorised restrictive practices, and is committed to ensuring restrictive practices are not used in its workplaces.

Restrictive practice conditions

The conditions for the use of restrictive practices are regulated under the NDIS. Each decision is made considering the safety of the person with the disability and others.

A regulated restrictive practice must be:

• Clearly detailed in the behaviour support plan, informed by a functional behaviour assessment.

• Authorised within the confines of any existing State or Territory authorisation process.

• Only used as a last resort in response to risk of harm to the person with disability or to others, and after a provider has explored and applied other strategies with an evidence-based, person-centred approach.

• The least restrictive practice for the circumstance.

• In proportion to the potential negative consequence or risk of harm. • Used for the shortest possible time.

Non-registered providers cannot provide support that uses restrictive practices.

Understanding how restrictive practice decisions are made

Registered providers must ensure that restrictive practice measures and decisions are only undertaken through a framework of:

• Communication

  • The intention to use a restrictive practice will be communicated with the person with disability and their family in a form they can engage with and understand. This may involve the assistance of an allied health professional (e.g. speech pathologist).

• Collaboration

  • The provider will collaborate with behaviour support practitioners and the individual with disability to develop and understand the necessary behaviour support strategies.

    • Where required, the provider will collaborate with health and allied health professionals to best serve the interests of the participant when considering the use of a restrictive practice.

• Consideration

  • The provider will ensure that the individual’s personal beliefs, culture, language, gender, environment, expressions of self, and other relevant considerations, and that of their family, are taken into account when considering or implementing restrictive practice. This is informed by the values and principles in the Positive Behaviour Support Capability Framework.

  
  

Understanding and responding to restrictive practice

Workers and supports must be aware of the impact of restrictive practices on the individual. This includes being trauma informed, recognising the increased likelihood of traumatic experiences for a person with disability.

Each restrictive practice should be understood in terms of potential trauma to the individual. Each type of restrictive practice has its own inherent risks associated with its use, including how it affects people with particular types of disability.

DCIRS will ensure its workers are trained to know what a restrictive practice is, emphasising the rights of the person with disability to respectful, dignified, and safe practices that are proactive, supportive, and non-restrictive.

If there is any uncertainty of whether a practice is a restrictive practice, you must seek advice from your manager or the Managing Director. If necessary, further advice will be obtained externally by DCIRS’s senior management.

It is important that no-one uses a restrictive practice on any occasion.

DCIRS will upskill and develop its workforce in matters under this Policy. For more information, see DCIRS’s Training and Development Policy.

Monitoring the workplace for restrictive practices

DCIRS will monitor its care plans and participant and client practices to identify restrictive practices.

Workers must be able to identify what constitutes a restrictive practice to avoid using any restrictive strategies.

Responsibility

Workers must work to individual care plans and avoid restrictive practices at all times.

Workers must adhere to all reasonable directions from their manager and DCIRS relating to restrictive practices under this Policy. This may include participating in a risk assessment to determine proactive and non-restrictive strategies.

Managers will support their direct reports to have sufficient skills, knowledge, and ability to uphold and implement this Policy. This includes training in restrictive practices.

Reporting

If DCIRS discovers that restrictive practices were not disclosed at the time of commencing services, it will discontinue services and report the matter to the relevant State / Territory reporting body. The same applies for unapproved use of restrictive practices.

Review and evaluation

DCIRS will monitor and review its organisational care plans in accordance with this Policy and the regulated requirements for restrictive practices. Any inconsistencies with this Policy or regulations will be recorded and promptly reported.

Senior management will consider internal sources of data when monitoring for restrictive practices, including feedback and complaints.

Key contact

Questions about how to implement this Policy and its Procedure should be directed to Emily Mills, Managing Director, by emailing emily.mills@dcirs.com.au.

Breaches of Eliminating Restrictive Practices policy

Workers must comply with the terms and conditions contained in this Policy. Any breach of DCIRS’s policy may result in disciplinary action. Under no circumstances are workers to use restrictive practices when working with participants and clients.

In the case of employees of DCIRS who are found to have breached this Policy, they may be subjected to disciplinary action. The type and severity of the disciplinary action will depend upon the circumstances of the case and the seriousness of the breach. Disciplinary action may include termination of employment.

Contractors or agents of DCIRS who are found to have breached this Policy may have their contracts with DCIRS terminated or not renewed.

5. ASSOCIATED DOCUMENTS

• Incident and Risk Reporting Policy

• Incident Report Form

• Feedback and Complaints Policy

• Feedback and Complaints Form

• Complaints Register

• Continuous Improvement Policy

• Code of Conduct Policy

• Choice and Control Policy

• Safeguarding Policy

DCIRS upholds the laws of Australia and the states and territories in which it operates, including all laws relating to the protection and rights of the parties covered by this Policy.

6. VERSION AND REVIEW INFORMATION

DCIRS reserves the right to amend and vary this policy from time to time.

Version 1.0: 9 October 2024 Review Date: 9 October 2027

Version 1.5: 28 March 2025 Review Date: 9 October 2027