Behaviour Support and Restrictive Practices Policy

Introduction

Purpose

The purpose of this Policy is to commit Disability and Mental Health Care Pty Ltd to positive behaviour support, to define regulated restrictive practices, and to make plain that no Worker may ever use a restrictive practice that is not authorised and included in a participant's behaviour support plan. It gives effect to the NDIS (Restrictive Practices and Behaviour Support) Rules 2018 and the NDIS Practice Standards.

Scope

This document applies to all Workers affiliated with Disability and Mental Health Care Pty Ltd. It is the responsibility of every individual, regardless of their employment status, to fully comprehend and comply with the commitments outlined here. All Workers must acknowledge that they have read, understood and will comply with its contents.

Policy Statement

Disability and Mental Health Care Pty Ltd does not use restrictive practices as part of standard service delivery. We understand behaviour as communication. Where a participant's behaviour places themselves or others at risk, our response is positive behaviour support: understanding the reasons for the behaviour, changing what we do and the environments we support in, and building the participant's skills. We never punish, and we never restrict a person's freedom except where lawfully authorised, planned, and as a last resort.

Relevant legislation

All legislation relevant to this document is outlined in the Legislation Register.

Related documents

• Incident Management Policy
• Violence, Abuse, Neglect, Exploitation and Discrimination Policy
• Participant Risk Assessment Form
• Training and Development Register
• Assessment and Provision of Supports Policy

Responsibilities and Roles

• Supriya Thapa is responsible for the development and review of this document and for ensuring it remains compliant with all applicable laws, regulations and standards.
• Key Management Personnel are responsible for its effective implementation, for assisting Workers to understand and comply with it, and for complying with it themselves.
• Workers are responsible for understanding this document and complying with all procedures applicable to them.

Definitions

Disability and Mental Health Care Pty Ltd means Disability and Mental Health Care Pty Ltd ABN 19 658 578 575, a registered NDIS provider (4-LO5XNY0).

Key Management Personnel means Supriya Thapa and other key management personnel involved in Disability and Mental Health Care Pty Ltd from time to time.

Worker means a permanent, fixed term or casual member of staff, a contractor or volunteer employed or otherwise engaged by Disability and Mental Health Care Pty Ltd, and includes the Director.

The Care Web means the Disability and Mental Health Care Pty Ltd service-delivery platform (thecareweb.com.au) that holds our booking, credential, incident, complaint and roster records.

Regulated restrictive practice means any practice or intervention that has the effect of restricting the rights or freedom of movement of a person with disability. The five regulated types are:

• Seclusion: sole confinement of a person in a room or space from which free exit is prevented, implied to be prevented, or not facilitated.
• Chemical restraint: use of medication or a chemical substance to influence behaviour, other than medication prescribed for the treatment of, or to enable treatment of, a diagnosed condition.
• Mechanical restraint: use of a device to prevent, restrict or subdue movement for the primary purpose of influencing behaviour (excluding devices for therapeutic or non-behavioural purposes).
• Physical restraint: use 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.
• Environmental restraint: restricting a person's free access to all parts of their environment, including items and activities (for example, locking the fridge or front door).

Behaviour support plan (BSP) means a plan developed by an NDIS behaviour support practitioner that addresses a participant's behaviours of concern and, where necessary, contains authorised restrictive practices.

Procedures

Positive behaviour support in everyday practice

• Workers seek to understand what a behaviour is communicating (pain, fear, frustration, unmet need, environment), and respond by adjusting supports, environments and communication first.
• Proactive strategies are recorded in the Participant Support Plan: known triggers, early warning signs, preferred calming approaches, meaningful activities and routines.
• Workers use de-escalation: calm voice, space, reduced demands, offering choices, and changing the environment. Workers never respond with threats, punishment, humiliation, or the withdrawal of essential supports.
• Behaviours of concern are recorded factually (what happened before, during and after) in shift notes so patterns can be identified.

When behaviours of concern emerge or escalate

• Disability and Mental Health Care Pty Ltd raises the need for specialist behaviour support with the participant and their support coordinator, and recommends a referral to an NDIS behaviour support practitioner for a functional behaviour assessment and, where needed, a behaviour support plan.
• The participant leads this process. Their consent, communication needs and chosen supporters are respected in line with the Supported Decision-Making Procedure.
• Until a plan is in place, supports continue using positive strategies only. Interim risk controls are recorded in the Participant Risk Assessment.

If a participant has a behaviour support plan containing restrictive practices

• Disability and Mental Health Care Pty Ltd may implement a regulated restrictive practice only where all of the following are true: it is included in the participant's current BSP; it is authorised in accordance with the relevant state or territory process; it is used as a last resort, in the least restrictive form, for the shortest time; and every use is reported to the NDIS Commission as required (including monthly reporting of routine authorised use).
• Every Worker supporting that participant is trained in the plan before delivering support, and the training is recorded in the Training and Development Register.
• The plan is reviewed with the practitioner at the intervals it specifies, and immediately if it is not working or circumstances change.

Unauthorised restrictive practice: absolute prohibition and reporting

• No Worker may use a restrictive practice that is not both authorised and contained in a current BSP. Doing so is a reportable incident and may constitute assault.
• In an emergency, Workers may take the minimum action necessary to prevent immediate serious harm (for example, guiding a person away from traffic). Any such action that meets the definition of a restrictive practice is treated as an unauthorised use.
• Any use of an unauthorised restrictive practice (including emergency use) is reported immediately through the incident system, is flagged as reportable, and is notified to the NDIS Commission within five business days. The Care Web incident register applies this deadline clock automatically.
• Following any such incident, a debrief is held with the participant and Worker, the Participant Risk Assessment is reviewed, and a referral for behaviour support is made or expedited.

Records

The incident register (maintained in The Care Web with quarterly exports filed in the Core Documents folder) is the register of any use of a restrictive practice. Behaviour support plans, authorisations and training records are held in the participant and worker files.

Policy review and updates

This document is to be amended and updated as required to remain compliant with applicable law, the NDIS Practice Standards, and the conditions of registration. It will be reviewed no later than the review date below, and earlier if legislation, the Practice Standards, or our operations change.