Strengthened restraint regulations
Legislative requirements regarding the use of physical and chemical restraints are contained in the Quality of Care Principles 2014 (Principles). The restraint requirements were first introduced to the Principles effective from 1 July 2019, with amendments strengthening the legislation applicable from 29 November 2019. These amendments place explicit obligations on providers to minimise chemical and physical restraints in residential care settings.
- makes it clear restraints must always be used as a last resort;
- requires services to exhaust all alternative strategies;
- requires providers to satisfy a number of conditions before restraint can be used, including assessment by an approved health practitioner (for physical restraint) and assessment by a medical practitioner or nurse practitioner who has prescribed medication (for chemical restraint);
- refers to state and territory legislation which regulates the responsibility for prescribers to gain informed consent for chemical restraint; and
- ensures restraints are regularly monitored and reviewed;
- requires a review of the first 12 months of the operation of the restraint regulations to ensure they are minimising the use of inappropriate restraint in aged care facilities.
Assessment of compliance with the requirements
The use of restraints may be assessed under a number of the Aged Care Quality Standards (Quality Standards), which came into effect on 1 July 2019. The Quality Standards require that clinical care is best practice and supported by a clinical governance framework that minimises the use of restraint. The Quality Standards also require organisational wide governance systems for regulatory compliance, which includes compliance with the Principles on minimising the use of restraint.
Please note, reporting physical restraint under the National Aged Care Mandatory Quality Indicator Program is a separate and distinct process to the Commission’s assessment of restraints under the Quality Standards. Information about the National Aged Care Mandatory Quality Indicator Program can be found on the Department of Health website.
A Self-Assessment Tool for Recording Consumers Receiving Psychotropic Medications has been developed by the Commission for providers, to support their process of continuous improvement in relation to the standard of care and services.
- The Commission has released resources to support providers understanding of their requirements. Providers are encouraged to review the full suite within the Minimising the use of restraint Resources.
- The Guidance and Resources for providers has also been updated to include best practice resources.
These resources make it clear that the use of physical restraint at the request of the consumer or for the consumer’s safety is still considered restraint. This does not mean these restraints cannot be used. Rather, restraint is only to be used appropriately and within the current legal framework. The requirements of the Principles must be met and documented for each consumer.