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Guidelines for Information Gathering

Relating to Applications to the Senior

Practitioner, Disability and Community Services for approval of Restrictive Interventions

Disability Services Act 2011

Senior Practitioner 2017

Table of Contents Introduction 3

Fact Sheet – Environmental Restrictions 4

Fact Sheet – Personal Restrictions 6

Application Flow Chart for Planned Use of Restrictive Intervention 9

Fact Sheet – Process for Application for Planned Use of Restrictive Intervention – Frequently Asked Questions

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Protocol Template 13

De-identified Examples of Protocol 14

Consistency Check List 17

Forms 18

Restrictive Intervention Guidelines 19

Supporting Information to be provided with Application when nominating Restrictive Practice

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Contact Details 28

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Introduction This package is designed for those considering the use of a restrictive intervention.

The package is designed to be worked through to help determine which pathway you are required to follow and what documentation you will be required to provide if you decide to make an application for the use of a Restrictive Intervention.

The checklist at the end of the document will also help you determine if your application is ready for forwarding, or if additional information needs to be collected or a referral made.

If you have any questions, contact details are provided at the end of the documentation.

Please work through the checklist at the end of the documentation to ensure your application will be complete.

The following practices require NOTIFICATION to the Senior Practitioner but not approval: Interventions in place for safe

transportation

Interventions required for therapeutic reasons

See 4.3.2 in the Restrictive Intervention Guidelines 2012.

Environmental and personal interventions require APPLICATION for approval for use. See 4.3.3 in Restrictive Intervention Guidelines 2012

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Department of Health and Human Services DISABILITY AND COMMUNITY SERVICES

Fact Sheet - Environmental Restrictions This Fact Sheet provides practitioners, service providers and disability support workers with information about the authorisation and use of environmental restriction as applied to those who have a disability as defined in the Disability Services Act 2011.

The reduction and even elimination of the use of restrictive practices is the ideal. Regardless of the intent of the use of restriction, there is significant evidence to demonstrate the inappropriate use of restrictive practices can lead physical and psychological injuries and lead to long term implications (Australian Psychological Society, 2011).

Definition of Environmental Restriction

"Environmental restriction, in relation to a person with disability, means a restrictive intervention in relation to the person that consists of the modification of an object, or the environment of the person, so as to enable the behavioural control of the person but does not include a personal restriction".

A restrictive intervention does not include an action that is taken for therapeutic purposes or enables safe transportation.

Essentially lack of free access to all parts of a person’s environment is defined as an environmental restriction.

Other examples may include but are not limited to:

Restricted access to valued items or activities as a method to control behaviour

'Response cost'

Increasing supervision as a means of controlling behaviour or managing risk

Locking cupboards, fridges, barriers preventing access to kitchen, locking access to food items.

Can environmental restriction ever be considered?

Attention may be given for the use of an environmental restriction for use by disability service provider or funded private person under the following considerations:

• That it is in the best interests of the person with disability

• The consequences to the person with disability if restrictive intervention of that type is carried out

• Any alternative methods reasonably suitable and able to be used

• The nature and degree of risk if the intervention is carried out 4

• Whether the use of the intervention will promote or reduce the safety, health and well-being of the person with disability

• As part of a positive behaviour support plan that promotes positive outcomes for the adult and supports the reduction or elimination of restrictive practices.

Who can authorise the use of environmental restriction?

Under the Disability Services Act 2011 approval for the use of an environmental restriction may be granted under certain conditions. Approval for the use of an environmental restriction is sought from the Secretary, following recommendation from the Senior Practitioner.

For further information, refer to the Fact Sheet, Authorising Restrictive Practices.

Further Information

For more information, please refer to the following policies and procedures:

• Disability Services Act 2011

• Restrictive intervention guidelines 2012

• Senior practitioner fact sheet

• Authorising restrictive practices fact sheet

• Australian Psychological Society (2011). Evidence-based guidelines to reduce the need for restrictive practices in the disability sector.

How do I contact the Senior Practitioner?

Telephone: (03) 61663567

Mobile: 0428 197474

Email: seniorpractitionerdisability@dhhs.tas.gov.au

Web: www.dhhs.tas.gov.au/disability/projects/senior_practitioner

Please note: The information contained in this document is provided as an initial guide only. It is not intended to be and is not a substitute for legal advice. Service providers should seek their own independent legal advice with reference to the implementation of the legislation.

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Department of Health and Human Services DISABILITY AND COMMUNITY SERVICES

Fact Sheet – Personal Restrictions

This Fact Sheet provides practitioners, service providers and disability support workers with information about the authorisation and use of personal restriction as applied to those who have a disability as defined in the Disability Services Act 2011.

The reduction and even elimination of the use of restrictive practices is the ideal. Regardless of the intent of the use of restriction, there is significant evidence to demonstrate the inappropriate use of restrictive practices can lead physical and psychological injuries and lead to long term implications (Australian Psychological Society, 2011).

Definition of Personal Restriction

“Personal restriction, in relation to a person with a disability, means a restrictive intervention in relation to the person that consists wholly or partially of:

(a) Physical contact with the person so as to enable the behavioural control of the person

(b) The taking of an action that restricts the liberty of movement of the person.

This includes the prolonged use of a person’s body to restrict the movement of another as well as the use of devices such as straps to restrict a person’s movement or to prevent them from self-injuring.

A restrictive intervention does not include an action that is taken for therapeutic purposes or enables safe transportation.

An example of a Personal Restriction

A attends a day support center that includes 20 other participants. A has an intellectual disability. A has a tendency to hit other people in the head when they get too close to her. Staff can see when this is about to happen and they grab hold of her hands and keep holding until the other person moves away. Staff do this to prevent injury to A and to the others around her.

Other examples may include but are not limited to:

• The use of clothing to restrict movement for the purpose of controlling behaviour-for example jumpsuits, bodysuits, overalls, reversing garments so that openings are out of reach, using fasteners that cannot be opened by the person, using mittens to stop someone scratching.

• Protective holding or escorting.

• The securing of a person to a bed or chair with restraint by some form of mechanical device including straps or clothing.

• Arm splints to prevent self-injury.

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• Applying the brakes to a wheelchair to prevent a person from moving independently.

• Placing a wheelchair in a position that prevents the person from maneuvering it.

• Placing furniture or other items in order to block a person’s movement.

• Non-punitive physical intervention strategies, for example, standing restraints, escort positions, wall restraints.

Personal restraint does not include physical assistance or prompting or support related to activities of daily living.

Can physical restriction ever be considered?

Attention may be given for the use of a physical restriction for use by disability service provider or funded private person under the following considerations:

• That it is in the best interests of the person with disability.

• The consequences to the person with disability if restrictive intervention of that type is carried out.

• Any alternative methods reasonably suitable and able to be used.

• The nature and degree of risk if the intervention is carried out.

• Whether the use of the intervention will promote or reduce the safety, health and well-being of the person with disability.

• As part of a positive behaviour support plan that promotes positive outcomes for the adult and supports the reduction or elimination of restrictive practices.

Who can authorise the use of personal restriction?

Under the Disability Services Act 2011 approval for the use of a personal restriction may be granted under certain conditions. Approval for the use of a personal restriction is sought from the Guardianship and Administration Board, following consultation with the Senior Practitioner.

For further information, refer to the Information Sheet, Authorising Restrictive Practices.

Further information

For more information, please refer to the following policies and procedures:

• Disability Services Act 2011

• Restrictive intervention guidelines 2012

• Senior practitioner fact sheet

• Authorising restrictive practices fact sheet

• Australian Psychological Society (2011). Evidence-based guidelines to reduce the need for restrictive practices in the disability sector.

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How do I contact the Senior Practitioner?

Telephone: (03) 61663567

Mobile: 0428 197 474

Email: seniorpractitionerdisability@dhhs.tas.gov.au

Web: www.dhhs.tas.gov.au/disability/projects/senior_practitioner

Please note: The information contained in this document is provided as an initial guide only. It is not intended to be and is not a substitute for legal advice. Service providers should seek their own independent legal advice with reference to the implementation of the legislation.

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APPLICATION FLOWCHART FOR PLANNED USE OF RESTICTIVE INTERVENTION

Is this a restrictive intervention?

Yes No

For the purpose of transportation or therapeutic purposes?

Is the intervention approved through a formally appointed Guardian or Mental Health

Yes No

Yes No Approval not required through this process S 4(1)

Is the restriction defined as environmental?

Yes

Environmental restriction? Complete the application form “application for approval to carry out restrictive intervention”. Submit to the senior practitioner with Behaviour support plan.

Personal restriction? You are required to complete the GAB form 10 and attach a statement from the Senior Practitioner. Thus, you will need to advise the SP you are applying for the use of the intervention.

Yes

The applicant and the person to whom the intervention relates will be notified in writing of the outcome of the application.

See disability services restrictive intervention guidelines 2012. Formal approval not required through this process if for transportation or therapeutic purposes- however consultation with the SP is required.

This process does not need to be followed

Is the restriction defined as personal?

Work through “information and information gathering guidelines”

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Department of Health and Human Services DISABILITY AND COMMUNITY SERVICES

Fact Sheet Process for Application for Planned Use of Restrictive Intervention

Frequently Asked Questions

We have approval for the use of a practice through the old ethics committee, do I need to seek approval through the new process?

Yes, the organisation will need to apply through the new process outlined in the Disability Services Act 2011 for the use of the intervention if they wish to use the intervention.

We think we need to use a restrictive intervention for one person in a group home, but it will inadvertently affect the others in the house. What should we do?

If after examining alternatives (eg alternatives to the intervention, alternative accommodation environments etc) you feel application is still required; you will need to demonstrate how the effect of the intervention will be minimised for others in the house. For example, if the application is for approval to lock the front door to the home to prevent one person from running on the road, how do you propose to mitigate the effects of this for the other people residing in the house? For example, you may explain to the others they can leave, they just need to ask for the door to be unlocked, or have their own key- for example.

Why do we need to apply for the use of a restrictive intervention?

Our aim is to protect the people we are supporting, their families and supporters. Our aim is to improve practices in relation to restrictive interventions and the use of behaviour management techniques that may obviate the need or minimise the need for restrictive interventions.

What makes a good support plan?

A good support plan includes all the elements as outlined in the link below. This includes elements for implementation and monitoring of the plan- see “factsheet- evaluation criteria”. http://www.dhhs.tas.gov.au/disability/senior_practitioner

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Why is there so much focus on the need for a behaviour support plan?

A behaviour support plan can help to identify the function of a behaviour of concern. Research suggests if we know why a person uses a behaviour we can reduce the behaviour by half.

The focus of a behaviour support plan is positive behaviour support. Research indicates we can reduce behaviour of concern by around 80 per cent if we use positive behaviour support.

This should in turn lead to a decrease in amount of restrictive interventions used.

How to I apply for the use of a restrictive intervention?

If you are proposing a personal restriction you will need to complete the Guardian and Administration Board form 10. If you are proposing an environmental restriction you can complete the form titled “application for approval to carry out a restrictive intervention”. In both cases, you will also need to contact the senior practitioner.

What happens at the end of the approval period – e.g. 90 days for an environmental restriction?

If the intervention is still required, you will need to re-apply for its use. If you don’t want a break in approval periods you will need to re-apply for the use of the intervention prior to the expiry of the 90 days.

What happens if we use a non-approved restrictive intervention-for example, grab someone to stop them running on the road?

The Act states that the senior practitioner must be notified as soon as practicable after the event. This applies even if the intervention was used for reasons of duty of care.

What if an appointed guardian says the use of a restrictive intervention is OK.

If the intervention is authorised under any enactment relating to guardianship, then approval is not required through the Disability Services Act 2011.

What if the practice is intended for safe transportation? E.g. a buckle guard?

The definition of ‘restrictive intervention’ does not include an action that is taken to enable the safe transportation of a person, therefore this does not require formal approval. However, the disability services Restrictive Interventions Guidelines 2012 state that the Senior Practitioner must still be consulted prior to implementing such a practice.

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What if I have a question about whether something is a restrictive intervention - or not, or a general enquiry?

You are welcome to email or phone the senior practitioner. The fact sheets on the website may also be able to answer your question.

Telephone: 6166 3567

Email seniorpractitionerdisability@dhhs.tas.gov.au

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Protocol Template

Name of Contact and Agency:

Protocol Description:

Name of Person Protocol relates to:

Protocol Date:

List of Related Documentation:

Background/Context ie Why is this Restrictive Practice in place?

Protocol/Procedure described (please list)

• • • •

Review Date

Protocol Training Schedule for Staff:

Signature:

Name of Organisation

Organisation’s Logo

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De-Identified Example of Protocol

Name of Organisation

Organisation’s Logo

Protocol: Response to ‘Outburst Behaviour’ protocol

Name: XXXXX

Written:

Author:

Status:

Revision Date:

Rationale

XXX can become anxious and frustrated if something doesn’t work out to his expectation. This frustration can quickly escalate to ‘Outburst’ behaviour if not diffused early. The key to this strategy is therefore to intervene as soon as possible once early warning signs have been noted and before XXX’s emotional and bodily reactions get too large for him to control.

Early Warning Signs

Early warning signs have been found to include:

• Pacing

• Increased heavy sighing (‘huffing and puffing’)

• Grimacing and teeth grinding

• Slamming doors

• Muttering to himself

• Playing music very loud

• Asking repetitive questions

• Fixation on an item/topic.

Procedures

Strategies for early warning signs

If staff members see XXX start exhibiting any of the behaviours listed above they should try one or more of the following:-

• Stay calm, confident and attentive

• Speak in short simple sentences and in a low voice

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• Reassure XXX that all is OK and try to fix whatever has troubled him (if possible)

• Encourage XXX to sit down

• Encourage him to try to talk about his feelings

• Offer a diversion to a preferred activity (e.g. play cards, look through catalogues, watch a DVD, draw cartoons of people XXX knows, go for a hot chocolate)

• Use humour or a funny catch phrase (e.g. ‘I’ll fix your wagon’, ‘Am I a deaf old lady ?’, ‘Need to check your knickers – they seem to be in a knot’)

• Suggest going outside for a walk

• Move away from XXX and sit down quietly

• Remind XXX to use his breathing and relaxation strategies

• Assist XXX to phone Coordinator

• Use PRN medication.

Guide for using PRN medication

If the outlined strategies are not working and it seems likely the behaviour will escalate, offer PRN medication. (1 x 10mg Zyprexa wafer daily).

If a second PRN is required in a 24 hour period, 1 x 5mg Serenace may be administered.

The Supervisor must be contacted before any PRN medication is given.

Outburst Behaviour

XXX’s ‘Outburst’ Behaviour includes the following:

• Smashing windows

• Kicking holes in walls

• Breaking his personal items

• Damaging internal fittings/items of his unit

• Yelling, swearing and/or using verbal threats

• Damaging cars parked near his unit.

Strategies for ‘Outburst’ Behaviour

If XXX’s behaviour escalates and he starts exhibiting any of the behaviour listed above staff members should:

• Alert house manager if not already done so

• Keep your distance from XXX

• Call the police if advised by house manager.

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Pass/Fail Criteria

The pass criterion of this protocol is that data collected over time will show a decrease in the severity of XXX’s ‘Outburst’ behaviour.

If using this protocol doesn’t result in a reduction in severity a review of the protocol will occur and modifications made based on staff feedback and analysis of behavioural data.

Data Collection

Occurrences of ‘Outburst’ behaviour will be collected on Disability & Community Services’ BAFs.

Consistency Checklist

Consistency checks should be carried out with staff at every monthly staff meeting and should be recorded into the procedural reliability check log. A score of 85% or better should be obtained for verbal competency of the key steps of the protocol (see Appendix A).

Signed:

DAAT Team Leader

Date:

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Consistency Check List

Step in Protocol

Achieved (Y/N)

Early warning signs (6 out of 8 items):- Pacing; Increased heavy sighing (‘huffing and puffing’); Grimacing and teeth grinding; Slamming doors; Muttering to himself; Playing music very loud; Asking repetitive questions; Fixation on an item/topic. Strategies for early warning signs 10 out of 12 items):- Stay calm, confident and attentive; Speak in short simple sentences and in a low voice; Reassure XXX that all is OK and try to fix whatever has troubled him (if possible); Suggest he sits down; Encourage him to try to talk about his feelings; Offer a diversion to a preferred activity; Use humour; Suggest going outside for a walk; Move away from XXX and sit down quietly; Remind XXX to use his breathing and relaxation strategies; Assist XXX to phone manager; Use PRN medication. PRN Guidelines : Strategies for Outburst Behaviour :- Alert manager if not already done so; Keep your distance from XXX; Call the police if advised by manager

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Forms

Application for Approval to Carry-out Restrictive Intervention and Reporting use of Unauthorised Restriction can be found at:-

http://www.dhhs.tas.gov.au/disability/senior_practitioner

The Guardianship and Administration Board – Form 10 and Health Professional Report Form for use to approve personal restrictions can be found at:-

http://www.guardianship.tas.gov.au/forms2

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Department of Health and Human Services DISABILITY AND COMMUNITY SERVICES

Restrictive Interventions in Services for People with Disability Guidelines

SDMS Id Number: P2012/0177-005

Effective From: June 2014

Replaces Doc. No:

Custodian and Review Responsibility:

Disability Services Policy and Programs

Contact: Senior Practitioner, Disability and Community Services

Applies to: All services directly managed by Disability and Community Services and all community based organisations funded by Disability and Community Services. All Managers and Support Staff.

Review Date: June 2017

Keywords: restrictive, senior practitioner, disability

Routine Disclosure: Yes

Approval

Prepared by Senior Program Officer Disability and Community Services

1300 135 513 4 October 2013

Through Senior Practitioner Disability and Community Services

1300 135 513 6 December 2013

Through Director Disability and Community Services

1300 135 513 25 February 2014

Approved by Deputy Secretary Disability, Housing and Community Services

1300 135 513 25 February 2014

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Introduction The purpose of this Guideline is to ensure that the inherent dignity and individual autonomy, including the freedom to make choices, of persons with disability are respected. This Guideline provides staff and management with a clear set of requirements to be followed for the acceptable, and legal, use of practices that are, or have the potential to be, restrictive. The Guidelines outline the requirements for the authorisation, reporting and monitoring of such practices and ensures that the provisions regarding the regulation of restrictive interventions under the Tasmanian Disability Services Act 2011 (the Act) are complied with. The intent of this guideline is to assist service providers to meet the requirements of the Tasmanian Disability Services Act 2011 in regard to restrictive interventions as well as to uphold the objectives, principles and standards contained within the Act and provides details of the processes that must be followed by service providers when considering the use of restrictive practices in the provision of services to people with disability.

Mandatory Requirements • The Tasmanian Disability Services Act 2011 is the legislative basis for the provision of specialist

disability services.

• Regulation of Restrictive Interventions in the Tasmanian Disability Services Act 2011 (Part 6) interprets:

o Environmental restriction, in relation to a person with disability, as meaning a restrictive intervention in relation to the person that consists of the modification of an object, or the environment of the person, so as to enable the behavioural control of the person but does not include personal restriction.

o Personal restriction , in the Tasmanian Disability Services Act 2011 relates specifically to a person with disability, meaning a restrictive intervention in relation to the person that consists wholly or partially of:

(a) Physical contact with the person so as to enable the behavioural control of the person: or

(b) The taking of an action that restricts the liberty of movement of the person.

• The Restrictive Interventions in Services for People with Disability Guideline must be read in conjunction with the Restrictive Interventions in Services for People with Disability Policy P2012/0177-001.

• This is a Department Health and Human Services (DHHS) wide policy, the policy must not be re-interpreted and no other policy replaces it.

• Failure to comply with this policy, without providing a good reason for doing so, will lead to disciplinary action.

• Disciplinary action in this context may be a Penalty under the Tasmanian Disability Services Act 2011 or constitute a breach of your Funding Agreement with the Department Health and Human Services (DHHS)

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Guidelines Disability Service Providers and Funded Private Persons

Use of a restrictive intervention

• Apart from the exceptions noted in the Tasmanian Disability Services Act 2011, restrictive interventions should only be used as part of a behaviour support plan which has been developed in consultation with the client or a person nominated by the client, persons who have expertise in carrying out the proposed restrictive intervention and the senior practitioner; and who have approval for the use of the restrictive intervention.

• A restrictive intervention must only be used if the particular intervention has been endorsed by the Senior Practitioner and approved by the Secretary of the Department as required under section 38 of the Tasmanian Disability Services Act 2011(environmental restriction) or approved by the Guardianship and Administration Board under section 42 of the Tasmanian Disability Services Act 2011(environmental or personal restriction).

• A relevant authorisation for the use of a restrictive intervention also exists if there is in place an authorisation by the Chief Forensic Psychiatrist under the Mental Health Act (2013) or Guardianship.

Approval process

• An environmental restriction can be approved by the Secretary of the Department for up to 90 days or by the Guardianship & Administration Board for up to 6 months after a hearing (section 38).

• A personal restriction can be approved by the Guardianship & Administration Board for up to 90 days without a hearing or for up to 6 months after a hearing(section 42).

• For those practices requiring approval under section 38 of the Tasmanian Disability Services Act 2011:

o The form “application for approval to carry out Restrictive Intervention” should be completed and forwarded to the Senior Practitioner.

o The applicant will need to provide a behaviour support plan to support the application.

o The Senior Practitioner will seek additional information upon receipt of this application form.

• For those practices requiring approval under section 42 of the Tasmanian Disability Services Act 2011:

o The Guardianship and Administration form 10 and the Health Care Professionals report and forward the Senior Practitioner. The Senior Practitioner will indicate the additional information required upon receipt of the application

o An application made to the Guardianship and Administration Board under section 42 of the Tasmanian Disability Services Act 2011Act must have the approval of the Senior Practitioner

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If approved, the Senior Practitioner will forward the application and statement of approval to the Guardianship and Administration Board. The Guardianship and Administration Board will then contact the applicant to determine the next course of action.

• The use of an unauthorised restrictive intervention is prohibited (part 6, section 36). If an intervention is deemed necessary to protect a person with disability, or another person from serious harm, this needs to be reported to the Senior Practitioner.

o The form “reporting unauthorised restriction” needs to be completed as soon as practicable and forwarded to the Senior Practitioner. The Senior Practitioner will advise if further action is required.

Roles and Responsibilities/Delegations Disability Service Providers and Funded Private Persons

• Must comply with the Tasmanian Disability Services Act 2011 and recognise the set of principles that apply to organisations and services funded by Disability and Community Services to provide services to people with disability.

• Must communicate to all staff that the use of unauthorised restrictive, aversive and intrusive interventions is prohibited.

• Educate all staff on the relevant principles in relation to restrictive interventions as summarised below:

o The needs and best interests of persons with disability are to be promoted and, as far as practicable, decisions or actions that may directly affect a person with disability should only be taken after the person has been consulted and their wishes have been taken into account. (Tasmanian Disability Services Act 2011 section 5 (2) (a) and (b)).

o Relevant activities and decisions taken by service providers should only result in the restriction of the freedom of decision and action of the person, if at all, to the smallest extent that is practicable in the circumstances.

• Uphold at all times a clear moral, professional and legal responsibility to provide an environment for clients that is the least restrictive possible under the circumstances.

• Design and administer all Services and Programs so as to respect the rights of persons with disability to privacy and confidentiality.

• Comply at all times with the duty of care to protect the person with disability or others from harm, it may be necessary to use restrictive or intrusive practices in emergency situations (e.g. restraining a person from running onto a busy road).

• All emergency situations where an unauthorised restrictive intervention is used must be reported as soon as possible to the Disability and Community Services Senior Practitioner.

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• Must ensure that a type of restrictive practice intervention is not carried out in relation to a person with disability who is under the care or control of the disability services provider or a funded private person (Tasmanian Disability Services Act 2011 Part 6 section 36 subsection (1)).

• The right of an individual with disability is treated with dignity and respect and remains free from harm and abuse as per the United Nation’s Declaration on the Rights of Mentally Retarded Persons 1971, the United Nation’s Declaration on the Rights of Disabled Persons 1975, and the United Nations Convention on the Rights of Persons with Disability 2006.

o Communicate to all staff:

The role and responsibilities of the Senior Practitioner that has been established under the Tasmanian Disability Services Act 2011 to protect these rights.

The primary functions of the Senior Practitioner including the authorisation and monitoring of restrictive practices in Disability and Community Services provided or funded services.

The Senior Practitioner provides advice and information to the Guardianship and Administration Board on matters related to restrictive practices.

Aversive therapy/treatment practices are not to be used under any circumstances by services managed or funded by Disability and Community Services.

Under the provisions of the Criminal Code Act 1924 and the Police Offences Act 1935, certain forms of aversive practices may constitute an assault (e.g. [physical abuse, threats, or confinement without consent) and those responsible may potentially face criminal charges and prosecution by the police.

Key Definitions Adaptive equipment

Equipment that improves functioning, comfort, mobility or the ability of a person to carry out tasks independently.

Applicant

The person who applies on the application that is made to the Guardianship and Administration Board.

Aversive treatment practices

An aversive practice is one that uses unpleasant physical or sensory stimuli in an attempt to reduce undesired behaviour and usually cannot be avoided or escaped and/or is pain inducing. Also refers to any withholding of basic human rights or needs, or of a person’s goods, belongings or favoured activity for the purpose of behaviour management or control.

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Behaviour support plan

A personal plan that includes a functional assessment of behaviour and describes methodologies for avoiding, minimising or managing specific behaviours.

Duty of Care

A component of the common law of negligence which allows for people or organisations to be held responsible if their actions do not meet an acceptable standard of care in relation to protecting a person with disability, or other persons, from harm, injury or loss.

Emergency situations

Situations where the safety or wellbeing of the person with disability, support staff or other persons is put at significant risk. Emergency situations require an immediate response to reduce or eliminate the risk.

Intrusion/ intrusive practices

Approaches that are placed or forced upon an individual without their invitation, consent or the right to do so. Includes, but is not limited to, entering without right or welcome into a person’s personal environment, personal space or impinging on the rights or freedoms of a person by divulging personal information, making major life decisions without consent. Also includes using equipment that impinges on or reduces personal privacy, such as monitoring devices.

Least restrictive alternative

A practice that (a) is not more restrictive or intrusive than necessary to prevent the person from inflicting harm on themselves or others; and (b) is applied no longer than necessary to prevent harm or danger.

Legal Guardian

A person appointed by the Guardianship and Administration Board to make decisions and provide consent on behalf of another person.

Mechanical devices

Equipment of appliances used to prevent injury caused by involuntary movements of the body or parts of the body.

Restrictive intervention

As per the Tasmanian Disability Services Act 2011, any action that is taken to restrict the rights or freedom of movement of a person with disability for the primary purpose of the behavioural control of the person.

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Senior Practitioner

As per the Tasmanian Disability Services Act 2011, a person appointed by the Secretary of the Department of Health and Human Services who, among other things, regulates and monitors the use of restrictive interventions.

Significant others

Family members, relatives, close friends or other persons that are important or influential in the life of the person with disability – all those who should be consulted about major changes in the person’s life.

Environmental restriction

In relation to a person with disability, a restrictive intervention that consists of the modification of an object, or the environment, so as to enable the behavioural control of the person, but does not include a personal restriction.

Person Responsible

As per the Guardianship and Administration Act 1995, a ‘person responsible’ can give consent or substitute consent to medical or dental treatment when the person with disability is unable to consent because of the nature of their disability.

Personal restriction

In relation to a person with disability, a restrictive intervention that consists wholly or partly of physical contact to enable the behavioural control of the person or taking an action that restricts the liberty of movement of the person.

The Act

The Tasmanian Disability Services Act 2011.

Therapeutic purposes

Within the context of these Guidelines, the use of restraint designed to enable the treatment of disease, illness, injury or to improve the person with disability’s ability to function.

Related Documents/Legislation Tasmanian Disability Services Act 2011 Criminal Code Act 1924 Police Offences Act 1935 Personal Information Protection Act 2004 Anti-Discrimination Act 1998 Health Complaints Act 1995 Guardianship and Administration Act 1995 Mental Health Act 1996 Criminal Justice (Mental Impairment) Act 1999 Children, Young Persons and their Families Act 1997

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United Nation’s Declaration on the Rights of Mentally Retarded Persons 1971 United Nation’s Declaration on the Rights of Disabled Persons 1975 United Nations Convention on the Rights of Persons with Disability 2006.

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Supporting Information to be provided with Application when nominating Restrictive Practice Check List

1. Personal Profile/contact details of person to which the Restrictive Practice applies.

2. Have you discussed with client’s Nominated Person (e.g. family member, Advocate).

3. Brief description of Person’s Behaviour that leads to Restrictive Practice (eg What does the behaviour look like; How often does it occur; In what environments does this occur; What is the impact of behaviour on the client; what is the impact of the behaviour on others).

4. Description of Restrictive practice (e.g. Indicate if this practice is Environmental or Personal).

5. Description of impact of Restrictive Practice on others.

6. Evidence Supporting Application.

a. DAAT Report.

b. GP report.

c. Behaviour Intervention Plan.

d. Specialist reports.

e. Person responsible opinion.

7. Alternative interventions trialled (e.g. different clothing; avoiding situations; distraction; staff education and training.)

8. Results of trials i.e. – worked/didn’t work – links to point seven.

9. Protocol for use of Restrictive Practice- (see example in package).

10. Evidence of staff knowledge and understanding of protocol.

11. Options available to the person and others affected by Restrictive Practice that mitigate restriction e.g.:- visual choice boards to ask for items in a locked fridge.

12. Are similar interventions in place for the client in other services accessed by the client – include relevant information.

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Contact Details Office of Senior Practitioner Executive Officer

Phone: (03) 6166 3578

Email: seniorpractitionerdisability@dhhs.tas.gov.au

Senior Practitioner

Phone: (03) 6166 3567

Email: seniorpractitionerdisability@dhhs.tas.gov.au

Disability Assessment and Advisory Team (DAAT)

North: (03) 6771060

North-West: (03) 64777609

South-West: (03) 61661127

South-East: (03) 61661127

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