Behaviour Support and Restrictive Practices Policy and Procedure

Participant Support Procedures > Behaviour Support and Restrictive Practices Policy and Procedure

Authorised by Chief Executive Officer

Revised Date: 22 January 2024

Purpose

The purpose of this policy is:

•     To support participants and their families/carers to access, implement and review behaviour support that is appropriate to their needs.

•     To apply the NDIS Practice Standards and Quality Indicators and ensure the rights of people with a disability who are subject to restrictive practices or compulsory treatment are protected.

•     To ensure behaviour support plans incorporate evidence-informed practice and comply with relevant legislation.

This procedure supports Kyeema to apply the NDIS Practice Standards & Quality Indicators, in particular: Module 2A: Implementing behaviour support plans.

Scope

The procedure applies to participants and the workers implementing restrictive practices in the delivery of NDIS supports and services.

PROCEDURE

When Kyeema accepts a behaviour support plan (BSP) containing a restrictive practice, Kyeema bears the risks and responsibilities for the implementation of that restrictive practice, positive support and fading strategies contained in the plan. The use of restrictive practices reduces freedom and decreases quality of life. The reduction in restrictive practices, through positive behaviour support, allows for greater freedoms and improved quality of life.

Quick Reference Guide

Definitions

Regulated Restrictive Practices (RRP)

Restrictive practices are defined as any intervention that is used to restrict the rights or freedom of movement of a person with a disability.

A restrictive practice is a regulated restrictive practice if it is, or involves, any of the following:

a)   seclusion, which is the sole confinement of a person with disability in a room or a physical space at any hour of the day or night where voluntary exit is prevented, or not facilitated, or it is implied that voluntary exit is not permitted;

b)   chemical restraint, which is the use of medication or chemical substance for the primary purpose of influencing a person’s behaviour. It does not include the use of medication prescribed by a medical practitioner for the treatment of, or to enable treatment of, a diagnosed mental disorder, a physical illness or a physical condition;

c)   mechanical restraint, which is the use of a device to prevent, restrict, or subdue a person’s movement for the primary purpose of influencing a person’s behaviour but does not include the use of devices for therapeutic or non-behavioural purposes;

d)   physical restraint, which is the use or action 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. Physical restraint does not include the use of a hands-on technique in a reflexive way to guide or redirect a person away from potential harm/injury, consistent with what could reasonably be considered the exercise of care towards a person.

e)   environmental restraint, which restrict a person’s free access to all parts of their environment, including items or activities.

•     Restrictive Practices Definition & Examples Guide BF-01

Further restrictive practices that are not classified as Regulated Restrictive Practices are:

•     Psychosocial restraint; for example where a person is told to stay in a particular place and does so because of the power relationship, or is not allowed to attend an activity because of their behaviour.

This is not a Regulated Restrictive Practice but is nevertheless a restrictive practice we should eliminate because it may not uphold the rights of the individual.

Unauthorised restrictive practice refers to a regulated restrictive practice that has been used without proper authorisation.

PROCEDURE - IMPLEMENTING BEHAVIOUR SUPPORT PLANS

Approval & Authorisation of Regulated Restrictive Practices

All regulated restrictive practices should be known to and must be approved by the APO prior to application. A behaviour support plan (BSP) must be developed by a registered practitioner and placed on the Restrictive Intervention Database (RIDS) for approval by the Victorian Senior Practitioner. Once the authorisation is received the BSP is uploaded to the NDIS Commission portal and then activated by the APO. Support staff must not apply any intervention that causes restriction without the approval from the APO unless in an emergency situation which will be reported as an emergency restraint and reported to the NDIS Commission via Incident Reporting.

A participant may only be subject to a regulated restrictive practice that meets Victorian Office of Senior Practitioner and the NDIS Quality and Safeguards Commission.

•     Regulated restrictive practices are to be used in accordance with a behaviour support plan (BSP) and all the requirements as prescribed in the NDIS Practice Standards

•     Workers maintain the skills required to use restrictive practices and support the participant and other stakeholders to understand the risks associated with the use of restrictive practices.

What is the role of the Authorised Program Officer (APO)? 

Kyeema’s Authorised Program Officers (APO) are responsible for authorisation of restrictive practices and behaviour support plans (BSP’s) through RIDS. APO’s must be approved by and registered with the Victorian Office of the Senior Practitioner.

The APO has a key role in helping chart a successful path towards the reduction of the use of restrictive practices by keeping an eye out for red flags and helping support the team review progress of behaviour support plans.

APO is an administrative role:

•      deciding what may or may not be a restrictive practise

•      be involved in ongoing discussions with the team

•      work collaboratively with key stakeholders, such as the behaviour support practitioner and the independent person

•      reviewing and authorising the BSP, lodging it on RIDS and seeking evidence of authorisation from VSP

•      ensure the participant has an independent person who is responsible for explaining the proposed restrictive practice to them

•      if restrictive practices are refused by the VSP, the APO and behaviour support practitioner update the plan and resubmit to RIDS for approval

Steps for getting regulated restrictive practices authorised by the Victorian Senior Practitioner (VSP):

1.   Develop an interim BSP for the participant in consultation with the participant, their family, and a specialist behaviour support practitioner.

2.   Once the APO is satisfied with the BSP, the APO gives the BSP to the independent person to review the plan with the participant.

3.   A copy of the plan is given to all relevant parties and submitted to the Victorian Senior Practitioner (VSP) through RIDS by Kyeema APO

•      https://www.dffh.vic.gov.au/information-authorised-program-officers

4.   To submit a regulated RP for approval in RIDS the APO must:

•      In RIDS, go to the participant or create a new BSP

•      Enter the details as stated in the BSP

•      Select the regulated restrictive practice that we need approval for

•      Upload the BSP

•      Submit the BSP for approval

5.   Once the BSP has been submitted, it will be reviewed by the RIDS assessor. The assessor will determine whether to approve or not approve a regulated restrictive practice.

6.   If the regulated restrictive practice is approved, the APO will receive notification through RIDS. The APO can then notify the behaviour support practitioner to submit the BSP to the NDIS Commission for approval.

7.   If the regulated restrictive practice is NOT approved, the APO will receive feedback from the RIDS assessor. The APO and behaviour support practitioner can then make changes to the BSP and submit for approval again.

8.   Once approved, the behaviour support practitioner submits the BSP to the NDIS Commission and then activated by the APO.

9.   Where this is an authorised BSP it is the responsibility of the APO to authorise and submit monthly reports via the NDIS Commission portal by the 5th day of each month.

10.  Review and update the BSP regularly to ensure that the plan is meeting the participants needs.

11.  Monitor and provide feedback to stakeholders on the reduction of restrictive practices

Authorisation of the Restrictive Practices in a BSP

The Victorian Senior Practitioner (VSP) will only authorise a restrictive practice if they are satisfied that the restrictive practice is:

•     necessary to protect the participant or others from harm

•     the least restrictive means of achieving the desired outcome

•     is consistent with the NDIS behaviour support rules

If the VSP approves the application, they will issue the provider with a letter of authorisation. The authorisation letter will specify the duration of the plan and the date of approval by the VSP. The authorisation process can be initiated by Kyeema APO at any time. However, the authorisation process may take time and the restrictive practice cannot be used until they have been received an authorisation letter from the VSP.

If the restrictive practice used is not authorised, then it is a reportable incident. Reportable incidents are to be reported to the NDIS Commission. For example:

•     medication is used to sedate a participant without authorisation

•     physical restraint is used without authorisation

Once the authorisation letter from VSP is received then the evidence of authorisation must be attached to a participant’s behaviour support plan record in the NDIS Commission Portal.

DFFH Using Restrictive Practices in Victoria Summary

1.   Kyeema appoints authorised program officer (APO) and gets approval from the Victorian Senior practitioner (VSP)

2.   Develop an NDIS behaviour support plan. A restrictive practice can only be used on an NDIS participant when it is a part of a BSP.

3.   Authorised Program Officer (APO) needs to authorise the use of restrictive practices on an NDIS participant

4.   The Victorian Senior Practitioner approves the restrictive practices in the BSP. The Victorian Senior Practitioner will send a letter to the provider confirming authorisation if the regulated restrictive practices in the BSP meet the requirements of the Disability Act (2006).

5.   Once the restrictive practices are authorised the NDIS behaviour support practitioner needs to upload the BSP and attach the letter of authorisation /approval from the Victorian Senior Practitioner onto the NDIS portal

6.   Reporting the use of restrictive practices. After the restrictive practices in the BSP have been authorised/approved by the Victorian Senior Practitioner, the Authorised Program Officer needs to report the use of restrictive practices every month to the NDIS Commission. If the restrictive practice is not authorised for the person with a disability and it is used by the provider, the provider is required to report the use of restrictive practices as Reportable Incidents on the NDIS portal.

7.   Reviewing the BSP. The NDIS behaviour support practitioner is required to review an NDIS interim behaviour support plan after 6 months, and an NDIS comprehensive behaviour support plan at least every 12 months, or as soon as there are changes to the regulated restrictive practices used or intended to be used.

For assistance with how to seek authorisation of a regulated restrictive practice in a behaviour support plan, contact the RIDS Helpdesk on 9096 8427 or email RIDS.Helpdesk@dhhs.vic.gov.au.

The Victorian Office of the Senior Practitioner has produced an authorisation checklist to support providers to ensure that BSPs meet the authorisation requirements in Victoria. Department of Families Fairness and Housing Victoria | Information for Behaviour Support Practitioners (dffh.vic.gov.au)

What if restrictive practices are refused by the Victorian Senior Practitioner?

It is the role of the APO who informs the behaviour support practitioner if any proposed restrictive practices are refused following review by the Victorian Senior Practitioner and to determine what amendments are required to the behaviour support plan to ensure it meets the legislative criteria. The behaviour support plan will be updated and resubmitted for approval by the VSP.

What is the role of the Behaviour Support Practitioner?

•     the behaviour support practitioner is supported to gather information for the functional behavioural assessment and other relevant assessments by the implementing provider/s

•     the practitioner will complete a behavioural assessment, develop a behaviour support plan, and implement strategies to increase a person's quality of life and support skill building.

•     a behaviour support practitioner observes the participant with behaviours of concern in all environments, as well as consult and gather information about all aspects of the person's life.

•     in conjunction with the person with a disability, an independent person such as a family member, advocate or friend, staff and any other relevant people including other services accessed by the person to whom the plan applies.

•     once the behaviour support plan is developed, it is their responsibility to work with the provider to implement the strategies included.

•     the APO and behaviour support practitioner should work collaboratively.

•     the practitioner uploads the BSP to the NDIS Commission

•     all BSP’s are reviewed at least every 12 months. Consideration is given to whether the participant’s needs, situation or progress create a need for more frequent reviews, including if the participant’s behaviour changes.

How will the engagement of a specialist behaviour support provider be facilitated and who’s responsible?

The purpose of engaging a behaviour support practitioner is to develop and implement strategies to support the person and reduce the need for restrictive practices. The process below can be used when a review of the BSP is required after an emergency use of a restrictive practice to ensure the plan is adequate.

1.   Contact the behaviour support practitioner. The team leader will contact a behaviour supports practitioner and request a meeting to discuss the person’s needs.

2.   Schedule a meeting. The team leader should invite the participant, their family and other relevant support workers to the meeting.

3.   Develop an interim BSP/review a plan. The behaviour support practitioner will work with the team leader and others to review or develop an interim BSP. The plan should identify the persons behaviours of concern, the underlying causes of those behaviours and strategies for addressing them.

4.   Interim plan to RIDS. The APO uploads the interim plan to RIDS for authorisation.

5.   Provide training and support. The behaviour support practitioner will provide training and support to the team on how to implement the behaviour support plan

Interim Behaviour Support Plans

Each participant with an immediate need for a behaviour support plan should receive an interim behaviour support plan based on evidence-informed practice, which minimises risk to the participant and others.

Once the interim plan has expired and there is no new/updated plan then the restrictive practice becomes a reportable incident.

•     Collaboration should be undertaken with all stakeholders including the relevant mainstream service providers (such as police and/or other emergency services, mental health and emergency departments, treating medical practitioners and other allied health clinicians) when contributing to an interim behaviour support plan developed by a specialist behaviour support provider.

•     Work is undertaken with the specialist behaviour support provider to support the development of the interim behaviour support plan.

•     Workers will be supported to receive training in the implementation of the interim behaviour support plan.

What is the role of the independent person?

The role of the independent person is another important safeguard for persons subject to regulated restrictive practices and is unique to the Victorian authorisation process. The role of the independent person is described in the Disability Act, and it is the independent person's role to explain to the person, subject to restrictive practices, the restrictive practice outlined in the behaviour support plan, and that the person has the right to seek a review of the proposed restrictive practices.

The independent person must explain to the person what the restrictive practice is, why the restrictive practice is being proposed, when it's going to be used, and how it's going to be used. The role of the independent person is best suited to someone from the person's social network, someone who, as the name suggests, is independent from the provider that is implementing the restrictive practices and independent from the person that is developing the behaviour support plan.

Examples of suitable independent persons include a family member, a friend, a neighbour, a member of the local club, or anyone in the community that the person might know well. The independent person should understand the person's communication abilities, know what a behaviour of concern is, understand behaviour support plans and what constitutes a regulated restrictive practice. An independent person is needed when a new behaviour support plan is developed and a restrictive practice is proposed or if a behaviour support plan is reviewed, potentially before that 12-month period, and a new restrictive practice is proposed.

Lodgement of behaviour support plans (BSPs)

1.   Kyeema APO lodges the BSP with the RIDS system (Victorian Office of Senior Practitioners). The APO is responsible to make sure that the details in the restrictive practice schedule match with the RIDS submission.

2.   Kyeema APO receives the VSP authorisation letter or receives a rejection letter. The APO reviews the BSP with the behaviour support practitioner and then return to step 1.

3.   The behaviour support practitioner lodges the VSP authorisation letter with the interim and comprehensive BSP online via the NDIS Commission Portal. They nominate Kyeema as the implementing provider.

4.   Kyeema authorised reporting officer (ARO) accepts the plan on the NDIS Portal.

Summary of key timeframes

Behaviour Support Plan Implementation

Positive behaviour support plans outline the supports the person and relevant stakeholders need to make positive changes and minimise or eliminate the use of restrictive practices. This plan should include strategies to develop the necessary skills and any environmental changes needed.

Restrictive practices will be documented in each person’s positive behaviour support plan. The restrictive practices section will include the type of restrictive practice that is being used, why it is being used, the time limits for use, date of approval by the positive behaviour support panel and any least-restrictive practices that have been tried.

When restrictive practices are required, all stakeholders relevant to the individual will be involved and the informed consent of the person, their family and/or guardian is required for any use, implementation and/or removal of restrictive practice.

All action plans are recorded on a restrictive practice register which is managed by managers.

•     Work is actively undertaken with the specialist behaviour support providers to implement each participant’s behaviour support plan and to align support delivery with evidence-informed practice and positive behaviour support.

•     Workers are supported to develop and maintain the skills required to consistently implement the strategies in each participant’s behaviour support plan

•     Specialist behaviour support providers are supported to train Kyeema workers implementing behaviour support plans in the use and monitoring of behaviour support strategies in the behaviour support plan, including positive behaviour support.

•     Workers receive training in the safe use of restrictive practices.

•     Collaboration is undertaken with other providers that work with the participant to implement strategies in the participant’s behaviour support plan.

•     Performance management ensures that workers are implementing strategies in the participant’s behaviour support plan appropriately.

Relevant documents used by Specialist Behaviour Support Practitioners:

•     Behaviour Support Plan - Interim and Comprehensive https://www.ndiscommission.gov.au/providers/behaviour-support

How do you complete monthly reporting?

Monthly reporting on the use of regulated restrictive practices needs to occur online via the NDIS Commission Portal.

For information on lodging monthly reports online, see:  NDIS Commission Portal User Guide. Implementing providers: Reporting on the use of regulated restrictive practices

This Guide gives step by step instructions on how to accept a plan and report. Pages from this guide are referenced in the following steps.

1.  Login to NDIS Commission Portal

2.  Select role: Approved Reporting Officer

3.  Select: Behaviour Support Plan

4.  Click on: Monthly Reporting of Restrictive Practices (Guide p.7)

5.  Click the Report button to enter a monthly report

Ø Report when RP is not used (refer to Guide p.7)

Ø Report the use of a routine RP (refer to Guide p.9)

Ø Report the use of a PRN (as needed) RP (refer to Guide p.12)

Ø Report RP where no BSP exists (e.g. not required due to other funding source) Create RP (no BSP) record (refer to Guide p.14)

6.     Submit monthly report

Ø Click on: Authorising Reporting Officer Report Submission tab

Ø Click Submit reports

Record Keeping: K:\General Items for All Staff\Behaviour Support & Restrictive Practices\BSP Reporting Spreadsheets

•   Participant RP Use for Monthly Reporting Template

When don’t you need to report to the NDIS Commission?

Behaviour support plans that do not contain a regulated restrictive practice do not need to be lodged with the NDIS Commission. 

NDIS Restrictive Practice Reporting Requirements

How we monitor, review and provide feedback on the use of restrictive practices

BSPs require review to ensure they reflect the participant’s ongoing need, work towards improving their quality of life, reduce behaviours of concern and reduce or eliminate the need for restrictive practices.

•     The implementation of the participant’s behaviour support plan is to be monitored through a combination of formal and informal approaches, including through feedback from the participant, team meetings, data collection and record keeping, other feedback and supervision.

•     Identification of circumstances where the participant’s needs, situation or progress create a need for more frequent review, including if the participant’s behaviour changes.

•     Strategies in a participant’s behaviour support plan are to be reviewed, with the primary focus of reducing or eliminating restrictive practices based on observed progress or positive changes in the participant’s situation.

Managers and Team Leaders are to evaluate the effectiveness of current approaches and aim at reducing and eliminating restrictive practices. Least restrictive options should always be considered where these strategies are possible. Where a behaviour support practitioner is available, managers and team leaders liaise with him/her regarding the above.

•     Monitor case notes

•     Toolbox topics re the use of RP’s

•     Educating staff re RP’s

•     Team leader coaching

•     Meeting minutes

•     Star Charts

•     Emails

Data gathered is used to provide feedback to workers, and with the participant’s consent, their support network, and their specialist behaviour support provider about the implementation of the behaviour support plan to inform the reduction and elimination of restrictive practices.

•     Feedback to Inform the Reduction of Restrictive Practice Use BF-05

Positive Behaviour Support - General Principles

•     Workers are trained in principles of positive behaviour support so that the participant’s needs and goals are met. This supports people’s rights to a good life and enhances the quality of the support they receive from our service.

•     Any participant may have a behaviour support plan but only those behaviour support plans containing a regulated restrictive practice must be lodged with the NDIS Commission. 

Some key features to the positive behaviour support approach are:

•     address the individual’s feelings and needs

•     value the person, deliberately build a sense of self-worth, and acknowledge all attempts at positive interaction

•     create situations where the person is placed at their best advantage

•     acknowledge and try to interpret what the person is communicating

•     analyse the reasons for the behaviour (Functional Behaviour Analysis)

•     teach the person other ways to meet their need or communicate their feelings

•     support the person to a calmer state if they are emotional

Related documents:

•     Positive Intervention Framework CCF-16

•     Program Group Outing Guidelines CFF-58

PROCEDURE – Reportable Incidents Involving the Use of an Unauthorised Restrictive Practice

What is a reportable incident?

The unauthorised use of a restrictive practice is a reportable incident.

What is an unauthorised restrictive practice (URP)?

•   no BSP which provides for the use of restrictive practices.

•   the NDIS BSP which provides for the use of restrictive practices BUT that use is NOT authorised by the APO or approved by the VSP (with a Letter of Authorisation)

•   emergency use of a restrictive practice where there is the imminent risk of harm to the participant and / or workers 

Flowchart: Restrictive practice / reportable incident

Each participant that is subject to an emergency or unauthorised use of a restrictive practice / no BSP or used differently from the behaviour support plan, must have the use of that practice reported and reviewed.

Record the use on BF-07 and report the unauthorised use of the RP to the NDIS Commission via the Portal.

•   URP Incident Reporting for APO / Team Leader BF-07

•   K:\General Items for All Staff\Data Bases\Incident Report Database (for URP’s)

Timeframes for reporting

•     

Where do I record / report the incident?

TL/Manager:

•   K:\General Items for All Staff\Data Bases\Incident Report Database

•   Incident Report Database (for URP’s)

APO

•   Report the use of a RP that is not authorised to the NDIS Commission

APO / TL (for participants with a BSP):

•   K:\General Items for All Staff\Behaviour Support & Restrictive Practices\BSP Reporting Spreadsheets

•   Routine Unauthorised use of Restrictive Practice (URP)

Worker/TL

•   BF-07 URP Incident Reporting for APO / Team Leader (for participants with a BSP)

•   Carelink+ shift notes

•   Internal incident reporting CCF-30 and CCF-31

How do I notify the NDIS Commission about a reportable incident?

Registered NDIS providers should use the NDIS Commission Portal 'My Reportable Incidents' page to notify and manage all reportable incidents and must complete the following steps.

Follow the steps in the NDIS Commission guide below to report to the NDIS Commission

•   https://www.ndiscommission.gov.au/providers/complaints-and-incidents/notify-us-about-reportable-incident

All unauthorised uses of a restrictive practice must be submitted through the NDIS Commission Portal. Once submitted, the Commission will review the notification. If the unauthorised routine chemical or routine environmental restrictive practice is suitable for weekly reporting, the NDIS Commission will make contact to give further instructions on weekly reporting.

Every unauthorised use needs to be reported eg. each use of chemical restraint – given 3 times a day = 3 reports a day unless the NDIS Commission has given permission to report the unauthorised use on a weekly basis. In these cases, Kyeema can give information once for all the uses that are under a single reportable incident ID.

Unauthorised restrictive practice to be written in shift notes and documented in the spreadsheet:

K:\General Items for All Staff\Behaviour Support & Restrictive Practices\BSP Reporting Spreadsheets

•   Incident Report Database (for URP’s)

How to report an incident involving a restrictive practice?

To report an incident:

o  Incident Reporting for Support Workers Poster CCF-30

o  Kyeema Incident Reporting Chart CCF-31 (for team leaders/managers)

o  Incident, Complaint, WHS Record Form CCF-65

If the reportable incident involves a participant with a BSP use:

o  URP Incident Reporting for APO / Team Leader CCF-07

o  K:\General Items for All Staff \ Behaviour Support & Restrictive Practices \ BSP Reporting Spreadsheets \ Routine Unauthorised use of Restrictive Practice (URP)

1.   If unauthorised restrictive practices are applied due to an incident, the incident and the restrictive practice must be reported immediately to your manager/team leader and on an incident report form within 24 hours. The team leader will support staff to complete the incident report form as needed.

2.   Exception - when the unauthorised use of a RP involves a participant with a BSP, then report to the NDIS Commission within 5 business days.          

3.   The support manager will ensure appropriate support is given to relevant stakeholders and the participant when a reportable incident occurs while providing support through a behaviour support plan that includes restrictive practices. This includes ensuring participants involved in reportable incidents are immediately referred to a medical practitioner for assessment where necessary.

4.   Following a reportable incident, Kyeema will collaborate with relevant mainstream services such as the police, other emergency services, mental health and emergency departments, treating medical practitioners and other allied health clinicians to ensure the incident is effectively responded to.

5.   When an unauthorised restrictive practice is used, staff involved in the use, along with Kyeema’s management team and other relevant providers, must debrief to identify areas for improvement and to inform the proper use of future behaviour management strategies. The outcomes of these meetings must be documented.

o  Debrief After Unauthorised Restrictive Practice CCF-14

6.   All reportable incidents must also be reviewed. Outcomes of reviews must inform a review of the relevant behaviour support plan and where required; the supports provided to the impacted participant. If required, supports provided to the participant must be adjusted.

7.   If the participant did not have a behaviour support plan, a behaviour support practitioner may need to develop one for them. If a behaviour support plan was in place, the behaviour support practitioner should review the participant’s behaviour support plan to ensure it is adequate.

8.   The participant, and (with their consent) their support network, will be involved in the review of reportable incidents that impact them, including where they involve the use of an unauthorised restrictive practice.

BSP under different funding

The “RP Record (no BSP)” function in the portal is designed to enable implementing providers to report the use of regulated restrictive practices in exceptional circumstances where a participant has a behaviour support plan (BSP) and authorisation that covers the use of restrictive practices, but the behaviour support plan is not required to be lodged with the NDIS Commission.

Create an RP Record in the NDIS Commission Portal. This establishes the schedule of restrictive practices that the person is subject to and allows monthly reports on the use of practices to be entered into the Portal.

Quick ref guide p.14

•     https://www.ndiscommission.gov.au/providers/understanding-behaviour-support-and-restrictive-practices-providers/reporting-use

Responsibilities

Team Leader / support workers

Team Leaders / support workers are responsible for advising the APO of any changes to a chemical restraint medication for any participant who requires this medication to be administered during hours of support. They are to advise the APO of any environmental, mechanical, or physical restraints that are in place.

Team leaders / APO are to request an annual review of the BSP or earlier if recommended by the carer / participant. Plan review request is sent to the participants behaviour support practitioner or their support coordinator.

Training Officer is to monitor the review cycle of BSP’s and ensure staff are trained in specific directions in the Behaviour Support Plans. The training officer is responsible for organising participant specific training. The training officer maintains a register of staff training

•   K:\Admin\Training\Participant Specific Training - BSP Implementation.xlsx

Support Coordinator

Request an annual review of the BSP from the specialist behaviour support practitioner or earlier when recommended by the team leader / APO / carer / participant.

Workers are responsible for the continued identification and reporting of new restrictive practices.

Workers are responsible for following and using practices in accordance with the plan.

Workers must follow the person with disability’s positive behaviour support plans and support the elimination of restrictive practices. Workers are required to undertake mandatory training and must comply with the requirement in the nominated timeframe.

The supports manager monitors practice for effectiveness, and this includes ensuring staff have sufficient skills, knowledge, and ability to meet the requirements. The supports manager or delegated individual is responsible for ensuring all unplanned restrictive practices are added to the register.

The Authorised Program Officer APO is the person responsible for uploading BSP's / information to VSP via RIDS and regularly monitoring the appropriate use of restrictive practices (needs eBusiness account to access RIDS).

The Authorised Reporting Officer (ARO) is the person who accepts/approves the BSP on the NDIS Portal and completes monthly reports (needs PRODA account to access NDIS Portal).

Monitoring & Reporting

The team leader will monitor workers case notes and information they receive in relation to the BSP implementation. The team leader and manager will review the data collected and provide feedback to workers and stakeholders.

Feedback to Inform the Reduction of Restrictive Practice Use BF-05

Review and Evaluation

A NDIS behaviour support practitioner is required to review an NDIS interim behaviour support plan after 6 months, and an NDIS comprehensive behaviour support plan at least every 12 months, or as soon as there are changes to the regulated restrictive practices used or intended to be used.

Incidents are to be regularly reviewed and assessed as to whether there is a pattern of behaviour where restriction has been used, then evaluate whether to review or recommend a BSP. Kyeema will notify the behaviour support practitioner if there have been a change in circumstance that requires the BSP to be reviewed.

The review process examines whether the person with disability’s current needs are being met. It also includes a review of whether the person requires support to make decisions, the type of restrictive practices being used, why they are being used and the implications if restrictive practices were removed.

The review may include staff members, family members and external representatives.

Awareness and Training

All policies, procedures and required documents are available on the Kyeema QMS and are accessible for support workers and team leaders/managers. Information on Behaviour Support procedure is available on the QMS and worker training days.

All workers are aware of, trained in and comply with the required procedures in relation to behaviour support.

Any significant changes in this policy or process will be advised to workers through the organisation’s intranet and if appropriate, training workshops will be offered.

APO Training Sentrient (VSP modules)

•     Authorised Program Officer – 5 part E learning module 

Participant specific training with a healthcare professional and the worker/s

•     Participant Specific Training Attendance Sheet HRF- 46

•     K:\Admin\Training\Particpant Specific Training-BSP Implementation

Training records are on Sentrient LMS

•     Positive behaviour support - NDS Zero Tolerance

•     Recognising and safe use of restrictive practices – NDS Zero Tolerance

•     What are Restrictive practices?

•     Annual refresher training – restrictive practices

•     Team leader training

•     APO training

Record Keeping

If a regulated restrictive practice is used a reporting form BF-03 is used to record the detail.

•     Regulated Restrictive Practices Recording Form BF-03

A manager or team leader will then place this information on a Restrictive Practices register on Kyeema’s K Drive. The information will be used for the monthly reporting of the use of Regulated Restrictive Practices to the NDIS Commission.

Systems to support reporting:

K:\General Items for All Staff\Behaviour Support & Restrictive Practices\BSP Reporting Spreadsheets

•     Behaviour Support Plan (BSP) Report Tracking for NDIS & Restrictive Practice (RP) Register

•     Routine Unauthorised use of Restrictive Practice (URP)

•     Participant RP use for Monthly NDIS Reporting Template

K:\General Items for All Staff\Data Bases\Incident Report Database

•     Incident Report Database (for URP’s)

Support workers to note any changes in behaviour in Carelink+ shift notes and communication book.

Making note where possible of the following;

•     the types of behaviour being displayed

•     patterns of when the behaviour is occurring

•     previous interventions or supports

•     the potential triggers of the behaviour, including the participant's communication and sensory needs, environmental factors, the type of activity, or the relationship factors with employees and other participants

•     Other information that may be made available, including from the participants doctor, psychologist or other professional reports.

Relevant legislation and references

Disability Act 2006

National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018

NDIS Practice Standards and Quality Indicators

Changes to regulation of behaviour support and restrictive practices in Victoria from 1 July 2019. Factsheet for service providers – June 2019

Victorians authorisation process for the use of regulated practices for NDIS participants https://www.vic.gov.au/ndis-quality-and-safeguards#ndis-behaviour-support-and-restrictive-practices

NDIS (Incident Management and Reportable Incidents) Rules 2018.

Changes to regulation of behaviour support and restrictive practices in Victoria from 1 July 2019. Factsheet for service providers – June 2019

What Victorian services need to know about authorising environmental restraint. Fact Sheet DHHS February 2020

Frameworks:

•     Positive Behaviour Support Capability Framework (2021)

•     NDIS Practice Standards and Quality Indicators

•     DHHS Positive Practice Framework (2017)

•     NDS Zero Tolerance Framework, 2018

Related Policies, Procedures and Documents:

Consent to Exchange Information and Use Photos CCF-01

Medication Purpose Form - Doctor Approved CCF-09

Participant Treatment Sheet - Summary of Doctor Approved Medication CCF-28

Participant Treatment Sheet - Over-the-Counter Medication CCF-36

Consent to Share Information - Easy Read CCF-57

Restrictive Practices Register  BF-09

Restrictive Practices Definition & Examples Guide BF-01

NDIS Restrictive Practice Portal Reporting BF-02

Regulated Restrictive Practices Recording Form BF-03

Debrief After Unauthorised Restrictive Practice BF-04

Feedback to Inform the Reduction of Restrictive Practice Use BF-05

URP Incident Reporting for APO / Team Leader BF-07

Positive Intervention Framework CCF–16

STAR Behaviour monitoring Chart CCF-45

Participant Behaviours of Concern Information Sheet CCF-87

Behaviour Support Plan - Staff Acknowledgement CCF-73

Participant Specific Training Attendance Sheet HRF- 46

Incident Reporting for Support Workers Poster CCF-30

Kyeema Incident Reporting Chart CCF-31 (for team leaders/managers)

Incident, Complaint, WHS Record Form CCF-65

Weekly Reporting of URPs to NDIS Commission PF-01

Restrictive Practices Monthly Reporting NDIS Commission Guidelines PF-02

Positive Behaviour Support on Activities Procedure

Incident Reporting Policy & Procedure

Behaviour Support Plan - Interim and Comprehensive