Reforming Queensland’s authorisation framework for the use of restrictive practices in NDIS and disability service settings

Why is it important?

Aligning Queensland’s restrictive practice definitions with those in the Rules would set clear and consistent expectations for registered NDIS providers in relation to the provision of disability supports to NDIS participants, and the application of authorisation processes where the use of restrictive practices may be required.

What do our current laws say?

Part 6 of the DSA applies to adults with an intellectual or cognitive disability, meaning an adult with a disability who has a condition attributable to an intellectual or cognitive impairment, or a combination of the impairments.

The DSA regulates the following types of restrictive practices:

• containment: means physically preventing the free exit of the adult from premises, other than by secluding the adult, in response to the adult’s behaviour of harm. This may include locking doors, windows or gates, however it is not considered containment if an adult has a lack of road safety skills and a door is locked to prevent them wandering close to a road.
• seclusion: means physically confining the adult alone, in a room or area from which free exit is prevented, in response to the adult’s behaviour of harm.
• chemical restraint: means the use of medication for the primary purpose of controlling the adult’s behaviour of harm. This does not include using medication for treating a diagnosed mental illness or physical condition.
• physical restraint: means the use of any part of another person’s body to restrict the free movement of the adult in response to the adult’s behaviour of harm.
• mechanical restraint: means the use of a device to either restrict the free movement of an adult in response to the adult’s behaviour of harm, or to prevent or reduce self-injurious behaviour.
• restricted access: means restricting the adult’s access to an object, for example a kitchen drawer with knives, in response to the adult’s behaviour of harm.

The practice of locking of gates, doors and windows to prevent physical harm being caused to an adult with a skills deficit (for example, an adult with an intellectual or cognitive disability who cannot leave the premises unsupervised because he or she lacks road safety skills) is not within the definition of a ‘restrictive practice’ for the purposes of Part 6 of the DSA. However, the practice is still regulated under Part 8, Division 2 of the DSA to ensure protection of a person’s rights and liberties.

The DSA outlines who is the appropriate decision-maker for the authorisation of restrictive practices, which is different for different forms of restrictive practices (this is discussed in more detail in section 4.4). The DSA also includes the requirement that authorisation is dependent on a compliant positive behaviour support plan being in place. A positive behaviour support plan must be reviewed at least once every 12 months. This timeframe mirrors the Rules and is not proposed to be changed.

Other important information

NDIS (Restrictive Practices and Behaviour Support) Rules 2018 (Cth)

The Rules apply to regulated restrictive practices which includes seclusion and chemical, mechanical, physical and environmental restraint. The key difference between the Rules and Queensland’s authorisation framework is the definition of environmental restraint under the Rules.

Under the Rules, environmental restraint means a person’s free access to all parts of their environment, including items or activities, is restricted. This broad definition encompasses both containment and restricted access as defined in the DSA.

In addition, the locking of gates, doors and windows in all circumstances is considered a restrictive practice within the definition of environmental restraint under the Rules. Unlike under Queensland’s framework, there are no unique provisions that apply where gates, doors and/or windows are locked to prevent physical harm being caused to an adult with a skills deficit.