What are Restrictive Practices?
According to the NDIS, a restrictive practice is any method or action that limits the rights or freedom of movement of a person with a disability1. There are five types of restrictive practices2:
· Chemical: “‘the use of medication or chemical substance for the primary purpose of influencing a person’s behaviour.”
· Environmental: “Restricts a person’s free access to all parts of their environment, including items or activities.” Examples include:
o Locked doors
o Locked cupboards
o Locked fridge
o Not allowed to smoke cigarettes
o Cannot watch certain TV shows
· Physical: “The use or action of physical force to prevent, restrict or subdue movement of a person’s body, or part of their body, for the primary purpose of influencing their behaviour.” Examples include:
o Holding a person’s hand to stop them from hurting themselves
o Holding a person down to stop them from being aggressive
o Pulling someone in a direction they do not want to go
· Mechanical: “The use of a device to prevent, restrict, or subdue a person’s movement for the primary purpose of influencing a person’s behaviour,” Examples include:
o Helmet for head banging.
o Restrictive clothing (body suits)
§ There has been some confusion over seat belt buckle guards and child locks in cars. The advice we have received, as of Feb 2024 is that a report does not need to be made to the NDIS if these practices are used, but authorisation is still required from FACS. Please confirm with the NDIS regarding your personal circumstances.
· Seclusion: “sole confinement of a person with disability in a room or a physical space at any hour of the day or night where voluntary exit is prevented, or not facilitated, or it is implied that voluntary exit is not permitted,” Examples include:
o Leaving a person alone in a room and not letting them leave
o Telling someone to go to their room and they believe they cannot leave without permission.
Any NDIS supports using these types of restrictive practices need to have the practice authorised first. Only registered providers can use a restrictive practice.
How to get authorisation for restrictive practices
Our goal should always be to reduce restrictive practices were possible. The following steps are used to get authorisation for restrictive practices:
1. A behaviour support practitioner completes an interim or comprehensive behaviour support plan.
a. An interim behaviour support plan needs to be developed within 4 weeks of the practitioner discovering a new restrictive practice.
b. A comprehensive behaviour support plan needs to be developed within 6 months of an existing restrictive practice.
2. The behaviour support plan is submitted to the NDIS commission.
3. The NDIS provider submits the restrictive practice.
4. A restrictive practice panel is organised, and the restrictive practise is either approved or rejected. If it is rejected the practice needs to stop immediately. If approved then the practice can continue.
5. Ongoing behaviour support training is provided, and data is regularly collected and reviewed. This can also occur prior to authorisation.
6. The restrictive practice is reviewed by the restrictive practice panel every 12 months, or sooner.
Do I need to get authorisation if the restrictive practice is in the family home?
Maybe. It depends on who is implementing the restrictive practice. For example, if the family locks the fridge at night, then authorisation is not required. If a NDIS support worker locks the fridge while in the family home, then authorisation is needed. We should always be focused on using strategies that minimise the use of restrictive practices.
Do I need to get authorisation if the restrictive practice is to keep someone safe?
Yes. Any restrictive practice that is used by a NDIS service needs authorisation.
How can I check if something is a restrictive practice?
If you are unsure if something is a restrictive practice you can contact the NDIS on behavioursupport@ndiscommission.gov.au. Response times can vary when contacting the NDIS.
While you wait for a response our behaviour support practitioners can help guide you through the process. If you find yourself in need of immediate assistance contact us at Info@intertwinedhealth.com.au for prompt and effective solutions tailored to your unique situation.
What do I need to do if the restrictive practice is unauthorised?
The registered provider will need to inform the NDIS each time the restrictive practice is used. For example, if a locked door is in use, then reporting will need to be submitted daily. If it is a seat belt buckle guard, then each time the buckle guard is used, a report will need to be made. The provider will need to request a behaviour support plan to be developed, in order to start the authorisation process.
How do you reduce restrictive practices?
Restrictive practices can be reduced with the assistance of a behaviour support practitioner, refer to these two blogs for further information on positive behaviour support and strategies.
What is Positive Behaviour Support and How Can It Help?
What Strategies Can I Use While Waiting for a Behaviour Support Practitioner?
Resources
1. NDIS Commission
2. NDIS Commission Restrictive Practice Types https://www.ndiscommission.gov.au/sites/default/files/2022-02/regulated-restrictive-practice-guide-rrp-20200_0.pdf