Restrictive practices

When you restrict the rights of someone you are caring for, or stop them from doing something they want to do, to protect their safety or the safety of others, this is called a restrictive practice.

What is a restrictive practice?

Decision-makers can give approval for:

Chemical restraint – medication that changes someone’s behaviour
Environmental restraint – restricting access to things like unsafe kitchen items
Mechanical restraint – a device that restricts someone’s movement for behavioural purposes.

Some types of restrictive practices require SACAT’s specific authorisation. This is called Special Powers.

Who can approve a restrictive practice?

In South Australia, there are now two pathways for approval restrictive practices:

one for NDIS participants
one for people living in Aged Care Facilities.

If the person is not living in an Aged Care Facility and is not an NDIS participant, there is no legal requirement for approval.

These decisions, made informally or by appointed guardians or substitute decision-makers, should be the 'least restrictive' option.

If a person living in an Aged Care Facility does not have decision-making capacity, approval for restrictive practices can be given by:

A Person Responsible, who makes health care decisions

as long as no force is used, and
the restrictive practices are provided by a registered health practitioner.

A substitute decision-maker (SDM), who is appointed under an Advance Care Directive (ACD)

as long as no force is used, and
the ACD gives the SDM the power to give approval.

A health care guardian, who is appointed by the South Australian Civil and Administrative Tribunal (SACAT).

as long as no force is used, and
the Guardianship Order gives the guardian the power to give approval.

These restrictive practices are regulated by the Aged Care Quality and Safety Commission and the aged care facility needs to keep documentation that independent authorisation has been obtained.

Approving restrictive practices

You can apply to SACAT:

to appoint a guardian, who can approve restrictive practices
to make an order that gives you Special Powers, if you are an appointed guardian or substitute decision-maker
to change (vary, review, or revoke) Guardianship Orders and Special Powers.

Restrictive practices for NDIS participants has a new approval process. This started on 30 May 2022.

The Department for Human Services (DHS) has formed a Restrictive Practices Unit. This unit now approves most of the restrictive practices for the NDIS sector.

Family members, private guardians and OPA guardians must still be informed and consulted, but can no longer give restrictive practice approval for an NDIS participant.

Transition to the new system should be completed by 30 September 2022.

After this, the Office of the Public Advocate will no longer approve restrictive practices for NDIS participants. The OPA will continue to make other decisions, depending on individual Guardianship Orders.

More information is available on the SA.GOV.AU website - including dates for upcoming webinars and resources.

If the person is an NDIS participant and living in an Aged Care Facility, contact DHS for assistance.

Behaviour Support Plans and Restrictive Practices

Restrictive practices are a last resort. If restrictive practices are being used, it is a requirement that a Behaviour Support Plan is in place.

This plan outlines:

why the restrictive practice is necessary
what other options have been tried
under what circumstances the restrictions can be removed.

This applies to both Aged Care Facilities and NDIS participants.

More information

You can get more information about restrictive practices by:

calling the Office of the Public Advocate (OPA) on 1800 066 969
contacting the Restrictive Practices Unit in DHS
contacting a private lawyer or the Legal Services Commission for legal advice
talking with the National Disability Insurance Association (NDIA), if you are an NDIS service provider or hospital:
visiting the SACAT website.