A restrictive practice is anything that restricts a person's rights or freedom of movement. In disability support, these practices are sometimes used to keep a person or others safe. Because they affect a person's rights, the NDIS sets strict rules about when and how they can be used, and positive behaviour support aims to reduce them and, where possible, stop them altogether.
The five regulated restrictive practices
The NDIS recognises five types of regulated restrictive practice:
- Seclusion: keeping a person alone in a room or space they cannot leave, or believe they cannot leave.
- Chemical restraint: using medication mainly to influence a person's behaviour, rather than to treat a diagnosed condition.
- Mechanical restraint: using a device to prevent, restrict or subdue a person's movement for the purpose of influencing their behaviour.
- Physical restraint: using physical force to prevent, restrict or subdue a person's movement for the purpose of influencing their behaviour.
- Environmental restraint: restricting a person's free access to parts of their environment, such as locking a pantry or a door.
Some of these may be easy to recognise. Others, such as a locked fridge or medication given when a person becomes upset, can become part of a daily routine without anyone thinking of them as restrictive.
What the rules require
When an NDIS provider uses a regulated restrictive practice with a participant, it must be included in a behaviour support plan developed by an NDIS behaviour support practitioner. Depending on the state, it may also need authorisation before it is used. In Queensland and New South Wales, state authorisation arrangements apply.
The provider using the practice must report its use to the NDIS Quality and Safeguards Commission. Any use that is not in line with the plan and authorisation must be reported as an incident.
How a behaviour support plan reduces them
Restrictive practices usually respond to a behaviour after it has started. Positive behaviour support works earlier, by understanding why the behaviour happens and changing what leads up to it. A good plan:
- identifies what each restrictive practice is being used to manage
- puts in place changes to the environment, routines and support that make the behaviour less likely
- teaches the person skills that meet the same need in a safer way
- sets out clear, gradual steps for reducing each practice, and how progress will be measured
- makes sure everyone supporting the person understands and follows the plan
Reducing a restrictive practice is done carefully and in stages. Removing one suddenly, without anything in its place, can put the person and others at risk.
Questions to ask about a restrictive practice
- Is it in the person's behaviour support plan?
- Has it been authorised, where authorisation is required?
- What is it being used to manage, and is there a less restrictive option?
- What is the plan to reduce it, and how will we know it is working?
The NDIS Quality and Safeguards Commission also has information on understanding behaviour support and restrictive practices.
This article is general information only and is not advice about a particular person's circumstances.
