Kyeema Common Operational Procedures > Restrictive Intervention Guidelines & Reporting
Authorised by Chief Executive Officer
Revised Date: 9 October 2015
Purpose
To outline the organisation’s responsibilities in minimising the use of restrictive interventions and in reporting their use to the Office of Professional Practice (OPP) in accordance with the Disability Act 2006.
Reference: Disability Act 2006 Implementation Guide – Restrictive Interventions v 1.0 (DHHS). For current information on this issue access www.dhs.vic.gov.au and search Publications.
To ensure that the rights of people with a disability who are subject to restrictive interventions or compulsory treatment are protected.
Policy
Restrictive intervention is defined in Part 1, section 3 of the Disability Act 2006 to mean ’any intervention that is used to restrict the rights or freedom of movement of a person with a disability including chemical restraint, mechanical restraint and seclusion’. These interventions tend to be used when a person with a disability has what is termed “behaviours of concern”; behaviours that may injure or endanger themselves or others, or damage property.
Interventions that may also be deemed as restrictive include, but are not limited to, locked doors and windows, physically holding a person or blocking access to a common area of the day program or accommodation service such as a kitchen.
The use of safety equipment required by law, and methods to ensure that a person complies with the legal requirement or therapeutic supports, are not considered restraint, for example: the use of seatbelts and buckles while in a moving vehicle, support straps to ensure a person does not fall from a wheelchair, splints applied for therapeutic purposes. Support straps used on chairs to stop a person standing is restraint.
Chemical restraint - The use of chemical restraint must be in accordance with the Act and directions from the Office of Professional Practice. Chemical restraint medication must also be authorised and administered in accordance with Kyeema’s medication policy.
Support staff should be aware that changes to any medication a person is prescribed may impact on the effect of medications administered as chemical restraint. Any medication change that increases or decreases the effect of a chemical restraint, even if the chemical restraint medication dose has not altered, must be reported to Kyeema’s Authorised Program Officer (APO), Julie Amor, as well as the Senior Practitioner to determine variation requirements to a person’s plan. Chemical restraint must be reviewed, by the treating doctor, at least every four months or as determined during the planning process.
The Senior Practitioner is responsible for defining restrictive interventions and the reporting requirements of any intervention. Support staff, supervisors and managers should seek further information from the APO or the Office of Professional Practice whenever there is any doubt.
In determining whether an intervention is restraint or seclusion, the key is whether the intent or primary purpose of such an intervention is behaviour control. If the intent or purpose is unclear, the intervention might still be restraint or seclusion and should be approved and reported.
All restrictive Interventions should be known to and must be approved by the APO prior to application. The Senior Practitioner must be provided with a copy of the Behaviour Support Plan (BSP) within two working days of the commencement of restraint. Support staff must not apply any intervention that causes restriction without the approval from the APO.
The Office of Professional Practice has the right to query the need or the use of any restrictive intervention outlined in the BSP.
Kyeema has a responsibility to minimise where possible the need for restrictive interventions, through positive support strategies that empower participants, increase their quality of life and reduce their behaviours of concern.
Procedure for reporting Behaviour Support Plans
The use of chemical or mechanical restraint and seclusion must be included in a Behaviour Support Plan (BSP) for every person who is subject to restrictive Interventions whilst accessing any service within Kyeema.
The BSP will be developed in conjunction with the person with a disability, an independent person such as a family member, advocate or friend (as prescribed by the OPP) agency staff and any other relevant people including other services accessed by the person to whom the plan applies. All BSP’s are reviewed at least every 12 months.
The Behaviour Support Plan needs to be approved by one of the agency’s Authorised Program Officers (APOs). The current APO at Kyeema is Julie Amor.
The APO must ensure that an independent person has explained the use of the restrictive interventions, chemical or mechanical restraint or seclusion to the person and the person’s right (under Section 146 of the Disability Act 2006) to a review of this decision by VCAT. A copy of the plan is given to all relevant parties and submitted to the Office of the Senior Practitioner). All restrictive interventions are recorded (including medication charts) and sent to the Program Manager who enters the information onto the Restrictive Intervention Data System (RIDS) on a monthly basis (must be submitted by the 7th day of each month). The RIDS reporting system is overseen by the OPP, Department of Health & Human Services.
Emergency Use of restraint and Seclusion
Section 147 of the Act directs the circumstances where restraint and seclusion may be used in an emergency. Emergency restraint and seclusion can be used where a person with a disability does not have a behaviour support plan approved by an Authorised Program Officer which provides for the use of restraint or seclusion; if the approved disability service provider believes:
•there is imminent risk of the person with a disability causing serious physical harm to themselves or any other person
and
•it is necessary to use restraint or seclusion to prevent that risk.
•In these cases, the following conditions apply:
•The use and form of restraint or seclusion must be the option that is the least restrictive alternative possible in the circumstances.
•The use of restraint or seclusion must be authorised by the person in charge.
•The APO must be notified without delay of the use of restraint or seclusion. On -call support must be notified if intervention occurs after hours.
Procedure for Restrictive Interventions Reporting to the OPP
1. Access the Department of Health & Human Services (DHHS) website
2. Log in to ebusiness
3. After logging in the applications you are registered for will show./ Choose Restrictive Intervention Day System
4. Next choose “Report on RIs”
5. Choose “Add RI Transaction” from menu on left of screen
6. Choose whether reporting on Otway Street or Lalor Street. If multiple people registered at the site, choose individual from drop-down.
7. Choose Intervention Type Chemical Mechanical Seclusion
8. Put in start date and end date: BSP dates will show up. Key in remainder of data from sheets provided by Program Managers.
9. Click on submit or submit and add another
End of Month Reporting
After completing the individual RI Transactions, go to End of Month
Reporting on menu
1. Click on “Submit Monthly Reports to Senior Practitioner”
2. Submit
3. “Generate Reports”
4. Check boxes next to work sites
5. Press Submit
After submitting successfully, an email receipt will be sent immediately from the OSP.
Measure
Kyeema reviews and reports all restrictive interventions to the Office of Professional Practice
Restrictive Intervention Recording Form
Regulated Restrictive Practices Reporting Form CCF-14