Restrictive Practice Awareness for Everyday Support Teams

One fear shared by all behaviour support practitioners is that, during a process of discovery, they find the restrictive practices being used around a person and no member of the household would use that term. Sensible locked pantry, just sensible. The medicine that's just the doctor's orders. The door to the bedroom is closed for a few minutes as it calms him. Last time the support worker came out it was dangerous so that's why he's standing in the doorway. None of it recorded, none of it authorised, all done by decent people who would be appalled if they knew how it was framed, and all sitting exactly where the NDIS quality and safeguarding framework and a person's basic rights say it should not sit, in the dark.

The protection is the awareness of every member of the support team, not training the practitioners to do restrictive practices, but training every individual around the participant to be aware of restriction when they see it, why it is restricted and know what to do next. It's a legitimate part of implementation work to build that awareness, and this article will provide that.

What every support team member should understand

Restriction does not mean “for the purpose of restricting”. A restrictive practice is a practice which restricts a person's rights or freedom of movement; the recognised categories are seclusion, chemical restraint, mechanical, physical and environmental restraint and are easily identifiable by common practice in the workplace, e.g. locked fridge, medication used to manage behaviour, lap belt beyond its clinical purpose, held door, blocked exit. The most important teaching point is that kindness does not exempt: Acts of kindness developed through true caring and safety are still restrictions, and that is why there is a lawful monitored path for them.

Regulated doesn't mean forbidden and that's protection for everyone. Teams that hear “restrictive practices are bad” bury them, teams that understand the context surface them. There is a suitable pathway for the implementation of a restrictive practice where there is a genuine need for safety, authorisation by arrangements as they apply in the relevant state or territory, inclusion in a behaviour support plan as the intention is to reduce restrictive practice over time, use of the restrictive practice as authorised, and reporting as provided by the rules. The worker-level translation is easy and liberating; one never has to pick between safety and rules; one has to take the safety problem to the people who have the authority to approve a legitimate action on it.

Unauthorised restriction is not a work around! The behavioural rule for all team members: If you are restricting, or you inherit a house restriction, it comes up the line today to the provider and the practitioner. Blame-free reporting is exactly what surfaces what has been buried for years by the blame model.

The practitioner’s role in building the awareness

This is a delivery mechanism that already exists in this series: strategy summary, briefing gate. A section of the summary lesson must include a restrictive-practice awareness; plain examples must include it; the report-it-today rule must include it; every core-team session must include the topic, which should be taught through the house's grey areas rather than abstractions; the question “is the pantry lock one?” asked in the open during training is the same question that is answered in silence in kitchens around the world. If there are authorised practices in the plan, the burden of the briefing increases proportionally: What is authorised, the circumstances, how to record, and the reduction goal is phrased as an “authorisation as a waypoint” and not an “authorisation as a destination”. This is where the practitioner's audit habit comes in, also addressed in the drift article; environmental walk-throughs and curious conversations bring restrictions to light, and bringing them to light early is the difference between correction and reportable history.

How this plays out in practice

Imagine that a practitioner starts working with a new person in shared accommodation and conducts the normal awareness briefing with the team. In the everyday example, a worker pauses, and says that the front door deadlock is on after dinner because one of the house mates left at night. The moment is dealt with exactly as the framework suggests: thanked and not blamed, raised with the provider that day, the safety need properly assessed and the response redesigned, with an authorised arrangement documented, reported and to be reviewed and reduced for a set period. It had been two years since the lock of this house had been used. One 15 minute briefing brought it into the light, so that is what being aware is.

Next steps

Include the following restrictive-practice awareness section in your strategy summary for the month: the categories in everyday examples, the kindness-does-not-exempt line, and the report-it-today rule. It's half a page, and it's the half page that's most likely to be helpful to someone.