After years of pondering how Restrictive Practices would be monitored in the new world of NDIS we now have our answer. Well some of it. The new NDIS Restrictive Practices and Behaviour Support Rules 2018. Just in case you haven’t had chance yet to wade through the pages of legislation I have provided a brief outline as I see it for you here.

Function of NDIS Quality and Safeguard Commission
No surprise here, the Commissioner will take a pivotal role in protecting and preventing harm to people with a disability – through the monitoring of how services are provided to people with a disability – especially those registered providers of NDIS. In addition, the Commissioner will be involved in establishing the direction and leading organising to reduce the use of restrictive practices, basically upholding the UN rights of the person with a disability around these issues.

Who can provide behaviour support

The legislation tells us anyone the Commissioner considers suitable to do behaviour support assessments. So not too much help really. We do know from information that has gone out to collect the qualifications and experience of those registered and providing this support that there is an expectation of experience is this area to be able to be registered. Certainly, under the old system third party verification required supervision of all behaviour support Practitioners by a Practitioner with more than 5 years’ experience providing behaviour intervention and support. Other than this information we really don’t have clear guidelines from the Commission as yet.

What are Regulated Restrictive Practices?

Not too many changes here if you are familiar with the old Restrictive Practices Policy from ADHC (NSW). The notable changes are the removal of Exclusionary Time Out – this has been included into the definition of Seclusion (good move it was bit confusing!).
Mechanical restraint has been separated from Physical Restraint – again another good move in my opinion. Mechanical restraint being the use of a device to restrict behaviours (but not when it is a therapeutic device for non behavioural purposes, (big question does not this mean seatbelt buckles are no longer considered restrictive??)).

Restricted Access is no referred to Environment Restraint. But the real big one is the return to use of regular medication that is prescribed to manage behaviour returning as a Regulated Restrictive Practice. Whether a medication prescribed for anxiety or bi polar will be considered for behavioural purposes remains to be seen. There was much disagreement in ADHC about this. But what it does mean is those participants prescribed a daily does of Seroquel because of persistent agitation – will be considered to have a Regulated Restrictive Practice in place and hence will need to be abide by the rules. This is likely to mean lots of new behaviour support plans for people who may not have them currently – and may not have funding for them currently!

What do providers need to do?

Well lots of preparation time of course, no these rules come into effect on the 1st July. But don’t panic there is a transition period that gives some breathing room. However all new behaviour support plan dated after 1 July will need to comply and report Regulated Restrictive Practices to the Commissioner in the form determined by the Commission – yet to see this form but there is still 2 weeks!

I would suggest firstly if you can get to one of the FACs training sessions advertised on Eventbrite get there. Unfortunately, we haven’t been given much notice but it may be the kind of thing someone in your organisation needs to drop everything they had scheduled for that day to get to this presentation. Hopefully we will get more practical information about the implementation of the rules for providers.

The rules in a nutshell
All regulated Restrictive Practices must only be used where there is a behaviour support plan in place and if there are any local authorisation processes these must be adhered to. I’m guessing but these would include anything that comes under the Guardianship Act and possibly the panels that have been used under ADHC funding in the past (the FACS workshops should give us definitive answer on this).
The provider must advise the Commissioner of any regulated restrictive practice and its authorisation. So, you will need and administrative system to ensure this is done quickly and effectively as your registration as a provider can depend upon it.
If there is no behaviour support plan currently in place – you must do what you can get an interim plan in place – Behaviour Support Practitioners have 1 month to do this document from when they accept a referral. Then you have 6 months to develop a comprehensive behaviour support for the person.

Reporting:
All individual uses of Regulated Restrictive Practices must be reported to the Commissioner monthly via report from a provider – so if you don’t already have one you will need an administrative system to do this. But what the Commission wants this in his approved form – we don’t know what that is yet.
There is a long list of the information you must keep on regards to each Regulated Restrictive Practice – names and details of witnesses, impact of the practice on the person, actions taken in response, what less restrictive options were considered etc etc.
As mentioned above there is a transition arrangement in place that see providers having 6 months to start the process to seek comprehensive behaviour support plans and register all regulated restrictive practices with the Commissioner.

Summary
Overall the philosophy and reasoning behind these rules is obvious and commendable. People with disabilities should not have restrictions placed upon them that are not necessary and their needs to be a regulator and monitor of these practices. The downsize of this is the administrative burden it will place on providers – but more so the administrative burden that you are expected to largely comply with in 3 weeks time. Sleep is overrated anyway!
So good luck, I know we are madly scrambling now to ensure the administrative systems are in place to continue to support the hundreds of participants we have under Behaviour Support. But no problems after all we did get 3 weeks!!

Find the legislation HERE