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The release of the Exposure Draft of the Aged Care Legislation Amendment (Royal Commission Response No. 1) Principles 2021 provides clarity around the expectations of  residential and flexible care Approved Providers in relation to the use and monitoring of restrictive practices.

These Principles are made under the Aged Care Act 1997.

Restrictive Practice:

  • Has a  significant impact on the dignity of the consumer
  • Presents a high impact clinical risk for the consumer.

Additional categories of restrictive practice have been added to the existing suite of named restrictive practices.

From 1 July 2021 the suite of restrictive practices under these Principles are:

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

This suite of restrictive practices has been harmonised with those in the National Disability Insurance Scheme (NDIS).

There are changes to the existing definitions of restrictive practice. These new definitions are contained in the Exposure Bill.

There is detailed information in Division 3-Circumstances for the use of restrictive practices 15FA that sets out the requirements for the use of any restrictive practice with a particular focus on the use of chemical restraint.

One area of ongoing confusion has been the emergency use of restrictive practice. Information regarding this is found in Division 3 5GB Responsibilities following emergency use of restrictive practice.

Aligned with these Principles are the National Quality Indicator Program (NQIP) requirements.

The use of restrictive practices must be risk assessed and have informed consent from the consumer of the consumer’s Substitute Decision Maker. Documentation requirements will also change. Planning for these changes will be a priority for Continuous Improvement as the lead in time will be short.

Dr Irene Stein

Head of Clinical Governance

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