Inappropriate use of restrictive practices

Was a restrictive practice used or applied to a consumer (or was this alleged or suspected)?

Restrictive practices are defined as ‘any practice or intervention that has the effect of restricting the rights or freedom of movement of a residential care recipient’, including:

  • Chemical restraint
  • Environmental restraint
  • Mechanical restraint
  • Physical restraint, and 
  • Seclusion. 

For more information about each type of restrictive practice, refer to the ‘Regulation of restrictive practices’ Regulatory Bulletin.
Did the use of the restrictive practice comply with:
  • the requirements (if any) of the law of the state or territory in which it was used?
  • the Aged Care Quality Standards?
  • the Charter of Aged Care Rights?
Was the restrictive practice necessary to use in an emergency situation to prevent harm to the consumer or others?
Was the restrictive practice used in response to the consumer’s documented behaviour changes or behaviours of concern?
Was a behaviour support plan in place?
Did an approved health practitioner, who has day-to-day knowledge of the consumer assess and document that there is a risk of harm to the consumer or another person, and that the use of a restrictive practice was necessary?
For chemical restraint the assessment and prescription must be made by a medical practitioner or nurse practitioner with day to day knowledge of the consumer.
Were all alternative best practice strategies exhausted prior to the use of restrictive practice, and were these strategies documented (including the reasons why the strategies were not successful)?
Was there documentation in the consumer’s care plan about:
  • The consumer’s behaviours that were relevant to the need for the use of the restrictive practice
  • The alternative strategies that were used (if any) before the use of the restrictive practice
  • The reasons the restrictive practice was necessary
  • The assessment conducted by the approved health practitioner
Was the restrictive practice used in the least restrictive form, and for the shortest time necessary, to prevent harm to the care recipient or other persons?
Did you obtain informed consent from the consumer or their substitute decision maker before the restrictive practice was used?
Was the likely impact of the restrictive practice on the consumer considered before the restrictive practice was used?
Was the use of the restrictive practice proportionate to the emergency situation?
Was the consumer’s restrictive practices substitute decision maker informed about the restrictive practice as soon as practical after the restrictive practice was applied in the emergency situation, and was this documented?
Did you revert to usual policies and practices regarding restrictive practices use as soon as the emergency was over, including:
  • removing or reducing the restrictive practice,
  • assessment,
  • consideration of alternative strategies, and
  • updating the consumer’s behaviour support plan and care and services plan?
While the restrictive practice was being used, was the consumer regularly monitored for:
  • signs of distress or harm,
  • side effects and adverse events,
  • changes in wellbeing,
  • independent functions, and
  • ability to undertake activities of daily living?
While the restrictive practice was being used was it regularly reviewed with a view to removing it as soon as possible?
Did the incident cause (or could it reasonably have been expected to have caused) a consumer physical or psychological injury or discomfort that requires medical treatment to resolve?
Did the incident cause (or could it reasonably have been expected to have caused) a consumer physical or psychological injury or discomfort that requires psychological treatment to resolve?
Are there reasonable grounds to report the incident to the police?

The phrase ‘reasonable grounds’ may include scenarios where you are aware of facts or circumstances (alleged or known) that lead to a belief that an incident is likely to be of a criminal nature and therefore should be reported to police (e.g. if you as the approved provider suspects the incident involves an indecent assault, or if there is an ongoing danger). If you become aware of reasonable grounds at a later time, you must notify the police within 24 hours of becoming aware of those grounds.

If you are in any doubt about whether an incident is of a criminal nature, make a report to the police. Police are the appropriate authorities to investigate and identify whether an incident may involve criminal conduct.

Not reportable

Based on the information you have provided it appears that your incident is not a reportable incident under the SIRS.

However this incident, like all incidents, should be managed using your service’s Incident Management System, or IMS.

It is important that your IMS is able to record incidents in a way that allows you to identify patterns of incidents that may reflect an ongoing risk or systemic issue.

For more information, please refer to the Effective incident management systems: Best practice Guidance.

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Priority 1 reportable incident

Based on the information you have provided it appears that this incident is an Inappropriate use of restrictive practices – Priority 1 reportable incident.

Priority 1 incidents must be reported to the Aged Care Quality and Safety Commission within 24 hours of you becoming aware of the incident.

What do I do next?

You must take immediate and any ongoing action to ensure appropriate support is provided to the consumer and their family and make a Priority 1 notification to the Commission within 24 hours.

You must report the incident through the My Aged Care Provider Portal.


Go to My Aged Care Provider Portal

 

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Priority 2 reportable incident

Based on the information you have provided it appears that this incident is an Inappropriate use of restrictive practices – Priority 2 reportable incident.

Priority 2 incidents must be reported to the Aged Care Quality and Safety Commission within 30 days of you becoming aware of the incident.

Note:

It is your responsibility to initiate a timely response to every serious incident regardless of whether the incident is categorised as Priority 1 or 2. The timeframe for reporting a serious incident to the Commission is separate from and in no way modifies your obligation to respond speedily to all serious incidents.

You must report the incident through the My Aged Care Provider Portal.

Go to My Aged Care Provider Portal

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Acknowledgement of Country

In the spirit of reconciliation, the Aged Care Quality and Safety Commission acknowledges the Traditional Custodians of Country throughout Australia and their connections to land, water and community. We pay our respect to their Elders, past, present and emerging and extend that respect to all Aboriginal and Torres Strait Islander peoples.