Restraining restraint in aged care
Regulatory changes to the use of restraint in aged care (now referred to as restrictive practices, in line with the NDIS Standards) came into effect on 1 July 2021. These amendments require that aged care providers ensure restrictive practices ‘must only be used in a way that supports good clinical practice and provides safe and improved care for consumers’.
The strengthening of the regulations essentially means that aged care providers must have a clinical governance framework to minimise the use of restrictive practices. This framework should address, at a minimum, all requirements set out in the Quality of Care Principles 2014 as amended. These include ensuring that any use of a restrictive practice is in proportion to the risk of harm (to the care recipient or others), that informed consent has been obtained for the use of the restrictive practice, and that the care recipient is regularly monitored and reviewed where any restrictive practice is applied.
Clinical governance to minimise the use of restraint is already an expressed requirement of the Aged Care Quality Standards. The recent changes add rigour and breadth to this. As such, the focus of the Aged Care Quality and Safety Commission ‘continues to be on ensuring that risks to consumers’ safety, health and well-being through the use of restrictive practices are minimised, and consumers are treated with dignity and respect.’
Regulation is one piece of the dynamic puzzle that is clinical governance. It can help keep us anchored while responding to changing consumer needs - reminding us that any intervention must always be balanced against consumer rights and preferences, potential benefit, and risk of harm.
•The Aged Care and Other Legislation Amendment (Royal Commission Response No.1) Bill 2021 and Explanatory Memorandum, Aged Care and Other Legislation Amendment (Royal Commission Responses No.1) Bill 2021: https://www.aph.gov.au/Parliamentary_Business/Bills_LEGislation/Bills_Search_Results/Result?bId=r6723
Quality of Care Principles (Minimising the Use of Restraints) Principles 2019 https://www.agedcarequality.gov.au/providers/assessment-processes/minimising-restrictive-practices
Quality of Care Principles 2014 and Aged Care Quality Standards
Aged Care Quality and Safety Commission Regulatory Bulletin, ‘Regulation of restrictive practices and the role of the Senior Practitioner, Restrictive Practices’: https://www.agedcarequality.gov.au/resources/rb2021-13-regulation-restrictive-practices-role-senior-practitioner?utm_source=commissioner-letter&utm_medium=email&utm_campaign=restrictive-practices-regulation