Code of Practice - A guide for the elimination of … · Web viewThere are various interpretations in the disability services sector of key terms associated with the identification,

Code of Practice: A Guide for the Elimination of Restrictive PracticesThird Edition

Code of Practice: A Guide for the Elimination of Restrictive Practices

Table of contentsDocument control..........................................................................................2

To support disability sector-wide engagement in the elimination of restrictive practices.......................................................................................3

Overview.........................................................................................................3

Part one – Context of the Code.....................................................................4Accessibility....................................................................................................................... 4

Context................................................................................................................................4

Key terms............................................................................................................................4

Part two – Development of operational policy and guidelines to assist with service implementation.........................................................................5Positive Behaviour Support and systemic Change in service delivery........................5

Service guidelines..............................................................................................................5

Use of restrictive practices................................................................................................7

Consent 7

Behaviour Support Plans and the use of restrictive practices..............................................8

Use of restrictive practices in emergency situations.............................................................9

Withdrawing restrictive practices.....................................................................................9

Issues to consider in defining a restrictive practice.....................................................10

Use of a therapeutic device................................................................................................10

Use of medication...............................................................................................................10

Disagreements about restrictive practice use...............................................................11

Appendix 1: International, national and State obligations.......................12

Appendix 2: Definitions and key terms......................................................13

Appendix 3: Challenging Behaviour and Restrictive Practices Decision-making Flow Chart.......................................................................................17

Appendix 4: Resources...............................................................................18

Notes.............................................................................................................19

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Document controlPublication date February 2019

Review date July 2020

Owner Executive Director – Sector Engagement and Development

Custodian Sector Service Development Manager

AmendmentsVersion Date Author Description

1 February 2019 Sector Engagement and Development

Third edition of the Code

2 Month/year [position title – not name]




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To support disability sector-wide engagement in the elimination of restrictive practices

OverviewThis revised Code of Practice: A Guide for the Elimination of Restrictive Practices (the Code) is a document to support the reduction and elimination of restrictive practices in the Western Australian (WA) disability sector. The purpose of the Code is to:

raise awareness of the human rights of people with disability contribute to the elimination of the use of restrictive practices for people with

disability who experience challenging behaviours.

This document should be read in conjunction with the:

National Framework for Reducing and Eliminating the Use of Restrictive Practices (2014)

United Nations Convention on the Rights of Persons with Disabilities (2006) National Standards for Disability Services (2013).

The Code supports service providers to meet some of the elements of Standard 1 of the National Standards for Disability Services: “The service promotes individual rights to freedom of expression, self-determination, decision-making and actively prevents abuse, harm, neglect and violence.”

The Code recognises there are exceptional circumstances in which the use of restrictive practices may be necessary, such as emergency situations or to address risks as part of a Behaviour Support Plan. There are a range of considerations in relation to the use of restrictive practices, including that they should only be used as a last resort after considering alternative strategies, and in accordance with a behaviour support plan. Where a provider is uncertain of the implications of using a restrictive practice, the provider should seek independent advice.

The Code can assist the disability sector to develop operational policies and guidelines for eliminating the use of restrictive practices. This ensures that appropriate safeguards are in place where there is no alternative but to use restrictive practices to protect the safety and welfare of individuals and others.

The Code was first developed by a coalition of partners across the disability sector. This updated version of the Code reflects the outcome of consultations held in 2016-17 with Aboriginal stakeholders regarding restrictive practices and culturally competent services. Service providers are encouraged to understand relevant cultural protocols and engagement processes, especially in relation to the diversity within the Aboriginal communities of WA.

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The roll-out of the Australia-wide National Disability Insurance Scheme (NDIS) represents a significant change in the way disability support is funded and accessed in WA. As part of the NDIS, a quality and safeguarding system will be implemented. This will include reporting and oversight arrangements to reduce and eliminate the use of restrictive practices.

Part one – Context of the CodeAccessibilityThe Code is available in plain English format. Other formats to meet the communication and cultural needs of diverse stakeholders can be made available on request. In addition, a related document titled “Restrictive practices – what are your rights?” is available as an information guide for people with intellectual disability.

ContextIn WA, the Code is one of a number of related strategies implemented to support a WA Government initiative known as the Positive Behaviour Framework, which promotes a coordinated, State-wide approach to Positive Behaviour Support.

Positive Behaviour Support is a set of research-based strategies used to increase quality of life and decrease challenging behaviour by teaching new skills and making changes in a person’s environment. Positive Behaviour Support strategies are considered effective when intervention results in increases in a person’s success and personal satisfaction, and the enhancement of positive social interactions across work, academic, recreational and community settings. Valued outcomes include improved quality of life, as defined by the person’s unique preferences and needs, and positive lifestyle changes that increase the person’s social belonging (source: http://www.apbs.org/).

Additional resources on the implementation of Positive Behaviour Support strategies are available at Appendix 4. These include the Effective Service Design report, which was developed after WA sector-wide consultations. In addition, a study of conditions supporting or impeding the implementation of Positive Behaviour Support by WA providers was completed by the University of WA in 2016. Both the report and the study highlight those elements of service design and delivery that, if applied, would lead to a significant reduction or elimination in the need for restrictive practices.

International, national and State obligations and legislation in relation to the human rights of people with disability have informed the development of the Code (refer to Appendix 1).

Key termsKey terms associated with the identification, reduction and elimination of restrictive practices are defined in Appendix 2.

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http://www.apbs.org/


Part two – Development of operational policy and guidelines to assist with service implementationPositive Behaviour Support and systemic Change in service deliveryThe implementation of the Code may require systemic organisational change. Evidence suggests that implementation of Positive Behaviour Support is effective in safeguarding the interests and welfare of people with disability. Service providers promoting person-centred and capacity-building environments that address factors contributing to the use of restrictive practices can successfully reduce or eliminate restrictive practices. The wellbeing and safety of people with disability, their families and/or carers and the staff who provide services, should be primary considerations as the Code is implemented and embedded in policy and practice.

To reduce and eliminate restrictive practices, service providers may need to plan for:

the development of a positive, safe and collaborative organisational culture that engages staff at all levels

significant changes in service design, policies, practices, training and tools to support person-centred practice and Positive Behaviour Support

increased interdisciplinary liaison and collaboration between service providers, and between the disability services sector and other sectors

supporting the cultural competence and awareness of staff, including training and support to interact effectively with people of culturally diverse backgrounds

closer and more informed relationships between service providers, people with disability, families and carers.

Operational implementation of the Code should take into account the types of services provided, the assessed needs and abilities of each person for whom the services are provided and any cultural differences and practices that may apply.

Service guidelinesThese service guidelines are underpinned by recognition that people with disability are in the best position to make decisions and communicate choices for themselves. The following guidelines are to be considered when delivering services to people who experience challenging behaviours.

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Service providers should:

develop services that uphold human rights and the wellbeing, inclusion, safety, quality of life and substantive equality for people with disability.

recognise that people with disability have the same rights as all people to equality before the law and to equal protection under the law, without discrimination.

have policies, procedures and tools in place to safeguard the rights of people with disability and to identify and monitor the use of restrictive practices.

ensure that services are person-centred, proactive and enhance the quality of life for the person.

adopt practices that recognise and support the person’s authority in decision-making, choice and control.

ensure necessary supports are put in place to help people with disability communicate their wishes.

actively facilitate the person’s engagement with family, carers, other friends and advocates who know them well (or if applicable, their guardian or relevant authority) to support discussion around the needs and wishes of the person with disability.

recognise the importance of identifying unmet need and understanding the nature and function of the person’s behaviour in order to minimise the use of restrictive practices, and should seek specialist guidance (for example, from a Behaviour Support Consultant) to assist in developing this understanding when necessary.

ensure Behaviour Support Plans reflect Positive Behaviour Support principles. consider putting in place Positive Behaviour Support Panels. consider developing terms of reference for such panels and consider including a

representative external to the service provider. maintain a register of all restrictive practices in place which should include progress

towards developing action plans to minimise and eliminate the use of restrictive practices.

In addition:

service providers working with people of Aboriginal or culturally and linguistically diverse backgrounds should demonstrate cultural competence and awareness in their governance, values, behaviours and practices.

awareness of relevant cultural values and behaviours is an important consideration in person-centred service delivery but does not override the paramount importance of the human rights of the person with disability.

behaviour Support Plans are key practice and accountability documents and should be in place for all people identified as experiencing challenging behaviours who are subject to restrictive practices.

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Use of restrictive practicesService providers can minimise or eliminate restrictive practices by implementing evidence-based policies and procedures. In addition, service providers should consider staff resources, quality training and supervision, and that due consideration is given for the welfare and professional development of staff.

ConsentService providers should ensure that the person provides consent in relation to all matters that affect them, including consenting to any restrictive practice that may be used on them.

When seeking consent from the person, service providers should ensure discussions are undertaken in a culturally sensitive way. For example, when working with an Aboriginal person, it may be necessary to meet with members of the person’s family and community to discuss the consent process and support their understanding of the proposed restrictive practice in relation to their cultural protocols and obligations.

Generally, consent will be valid if:

it is voluntary – the person must make the decision themselves and must not be unduly influenced by anyone else (e.g. health professionals, family, friends).

it is informed – the person must receive sufficient information about the proposed restrictive practice to enable them to make an informed decision.

it is current – the consent must at least be reviewed as part of the annual review to ensure it remains up-to-date. More frequent reviews may be necessary, especially if the person's circumstances change.

the person has capacity to understand the information provided to them to make the decision.

it covers the restrictive practice to be used – the restrictive practice must fall within the scope of consent that has been given.

service providers should use internal policy and procedures for determining a person’s capacity to give informed consent.

Service providers should use whatever strategies are necessary, taking into account the person’s cultural and communication needs and understanding, to facilitate the person’s ability to communicate their choice and decisions.

In certain circumstances there may be:

uncertainty about the person’s capacity to provide informed consent, and/or an absence of engaged family members, carers, friends or advocates to assist the

person to make decisions, and/or uncertainty about what decisions and actions are in the person’s best interests.

In these instances, the service provider should seek the advice and guidance of the Office of the Public Advocate for adults, and the Department of Communities for children under 18 years of age, as to the correct action to take.

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Service providers should ensure there are ways for individuals to withdraw their consent for a restrictive practice. When this occurs, planned use of the restrictive practice must cease and providers will need to explore short and long-term solutions with the individual to ensure effective and safe service delivery.

Behaviour Support Plans and the use of restrictive practicesRestrictive practices must not be agreed upon for organisational or staff convenience or to overcome a lack of staff, inadequate training, or a lack of staff support and/or supervision.

Service providers must recognise that restrictive practices are not effective long-term strategies to manage risks and behaviours and can result in long-term physical and psychological harm.

Service providers must reduce and eventually eliminate restrictive practices in place wherever possible. Where not possible to eliminate restrictive practices, the service provider must continue to review and document reasons for ongoing use.

The restrictive practice should be agreed upon by the service provider and relevant stakeholders (e.g. Positive Behaviour Support Panels, CEO of the service provider) as the least restrictive option to address the person’s identified needs and risks. This agreement should be based on written confirmation that:

all less restrictive practices have been carefully evaluated and cannot be applied without the restrictive practice the person is a serious risk to themselves and/or to

others there has been consideration of the impact of the restrictive practice on the rights

and wellbeing of others who share the person’s environment the restrictive practice is considered in the context of a Behaviour Support Plan and

person-centred planning.

A restrictive practice that has been agreed upon by the service provider and relevant stakeholders can only be implemented:

with the informed consent of the person involved, using the provider’s procedures for determining capacity to consent, or when the person is determined to not have the capacity to provide consent, the consent of the person with the authority to make decisions on behalf of the person, or from an appointed guardian with the relevant authority

for the shortest possible time while a more appropriate arrangement for support is developed

under the supervision of a designated, experienced staff member who is on duty at the time

as part of a Behaviour Support Plan.

Each use of a restrictive practice must be recorded by the service provider in accordance with their policies and procedures.

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Restrictive practices must be reviewed by the service provider and relevant stakeholders on a regular basis, ideally at least every six months and no less than once every year, from the date of the first approval.

A restrictive practice should only be implemented when consent has been obtained, with the exception of emergency situations (see below).

Use of restrictive practices in emergency situationsA restrictive practice for which there has been no prior consent or Behaviour Support Plan might be necessary in an emergency to save a person’s life or to prevent them from experiencing serious harm, or to prevent the person causing serious harm to another person. The use of a restrictive practice in an emergency should involve the minimum amount of restriction necessary and be applied for only so long as is necessary to manage the risk.

The Challenging Behaviour and Restrictive Practices Decision-Making Flow Chart should be used as a guide for the use of a restrictive practice in an emergency (refer to Appendix 3)

When a restrictive practice is used in an emergency situation:

the circumstances in which the restrictive practice was used must be reviewed and recorded by the service provider as soon as possible to minimise the risk of a recurrence

the person’s family or guardian must be advised as soon as possible it should be reported to the Department of Communities as a Serious Incident

Report within seven days.

Withdrawing restrictive practicesWithdrawal of a restrictive practice can occur at any time and must be considered as part of regular review processes. The service provider should be satisfied that it is safe to do so before withdrawing a restrictive practice. In determining this, the service provider should consider factors including whether:

less restrictive alternatives have been developed, trialled and demonstrated to be effective for the person concerned

staff have had the appropriate training in how to apply the new practices and have demonstrated the skills required to support the person under the new arrangements.

The service provider must engage with the person and/or any person authorised to provide consent on their behalf in determining whether to withdraw a restrictive practice.

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Issues to consider in defining a restrictive practiceUse of a therapeutic deviceThe use of any device (e.g. arm splints) for the management of behaviour is a restrictive practice and the Challenging Behaviour and Restrictive Practices Decision-making Flowchart should be applied (refer to Appendix 3).

However, the use of a therapeutic device does not constitute a restrictive practice when it is clinically prescribed for the purpose of:

improving the quality of life of a person with disability, by preventing or minimising body shape distortions and the directly-related secondary complications that result in pain, discomfort and poor health, and/or

assisting a person to participate in a desired task or activity by minimising factors that impede them and enabling their engagement in an activity which would not otherwise be possible, and/or

providing treatment where, if there were no restriction of the person, an adverse health outcome would occur.

A device may be used for these purposes if:

its use is clinically prescribed by an appropriately qualified health professional its use is formally and regularly reviewed the person (or, if that person does not have capacity, a person authorised to provide

consent on their behalf) has consented to the use of the device.

The prescribed device should be:

the minimal intervention to achieve the desired result based on evidence from current best practice.

Use of medicationThe use of psychotropic and other drugs to reduce symptoms and behaviours associated with conditions such as anxiety, depression and other mood disorders or a psychosis, does not constitute a restrictive practice when the medication is prescribed:

for a person who has a psychiatric condition diagnosed by a qualified psychiatrist and/or general practitioner, and is reviewed at least annually or

by a general practitioner who is treating the person as part of a Medicare-approved mental health plan and the medication is reviewed at least annually.

When a service provider is responsible for attending a mental health medical appointment with a person for whom they provide support, the person should be supported by someone who knows them well.

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When medication is prescribed at the appointment, the staff member should request a written statement from the doctor or psychiatrist to confirm the reason for the prescription, and the statement should be placed on the person’s medical records held by the service provider.

When a PRN medication is prescribed, each occasion it is given to the person should be authorised by the most senior service staff member on duty, who should enter onto a PRN medication register full details of the dose, time and circumstances leading to the decision to use it.

Disagreements about restrictive practice useWhen a person, guardian, or another person with authority to make decisions on behalf of the person, disagrees with any actions a service provider undertakes in relation to the recommendations of the Code, the service provider should ensure that the person is aware of all options available to assist in the resolution of the matter. This support includes:

ensuring the person (and/or their representative) understands how to access the service provider’s internal grievance procedure, and the various external agencies with a mandate to receive and respond to a grievance from a person with a disability e.g. Health and Disability Services Complaints Office (HaDSCO).

providing advice to the person of their right to external advocacy support, and assistance to make contact with an advocacy provider if they so choose.

When a service provider has concerns that an individual is at risk due to the use of restrictive practices by other parties, the provider should follow internal care and protection policies and procedures.

For further information email [email protected]

Date: February 2019

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mailto:[email protected]


Appendix 1: International, national and State obligationsThe following have informed the development of the Code:

International

Universal Declaration of Human Rights. United Nations Convention on the Rights of Persons with Disabilities, with particular

reference to:

o Article 4 1(b) To take all appropriate measures, including legislation, to modify or abolish existing laws, regulations, customs and practices that constitute discrimination against persons with disabilities.

o Article 4 1(c) To take into account the protection and promotion of the human rights of persons with disabilities in all policies and programs.

o Article 4 1(d) To refrain from engaging in any act that is inconsistent with the present Convention and to ensure that public authorities and institutions act in conformity with the present Convention.

o Article 4 1(e) To take all appropriate measures to eliminate discrimination on the basis of disability by any person, organisation or private enterprise.

o Article 14 Liberty and Security of the person.o Article 15 Freedom from torture or cruel, inhuman and degrading treatment or

punishment.

United Nations Convention on the Rights of the Child.

Commonwealth

Disability Discrimination Act 1992. National Standards for Disability Services 2013. National Framework for Reducing and Eliminating the use of Restrictive Practices in

the Disability Services Sector 2014.

State

Disability Services Act 1993. Children and Community Services Act 2004. Guardianship and Administration Act 1990. Equal Opportunity Act 1984. Carers’ Recognition Act 2004.

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Appendix 2: Definitions and key termsThere are various interpretations in the disability services sector of key terms associated with the identification, reduction and elimination of restrictive practices but the following definitions are adopted for the purpose of this Code.

Behaviour Support Consultant

Behaviour Support Consultants act as mentors and/or frontline coordinators to assist providers to implement positive behaviour support. These positions also act as a point of contact across the sector to encourage collaboration, evidence-based practice and support transparency for providers in the development of supports for people with disability who sometimes experience challenging behaviour. Behaviour Support Consultants play an active part in the ongoing development, planning for and assessing the quality of Behaviour Support Plans.

Behaviour Support Plan

A Behaviour Support Plan is a plan developed for a person with disability which specifies a range of strategies to be used in supporting the person’s behaviour, including proactive strategies to build on the person’s strengths and increase their life skills (source: http://www.dss.gov.au/our-responsibilities/disability-and-carers/publications-articles/policy-research/national-framework-for-reducing-and-eliminating-the-use-of-restrictive-practices-in-the-disability-service-sector).

Capacity

The extent to which a person is capable of making reasoned judgements about their personal welfare and treatment (source: http://www.publicadvocate.wa.gov.au/_files/epg_guide.pdf).

Challenging behaviour

Culturally abnormal behaviour(s) of such intensity, frequency or duration that the physical safety of the person or others is placed in serious jeopardy, or behaviour which is likely to seriously limit the use of, or result in the person being denied access to, ordinary community facilities (source: Emerson, E. (1995) Challenging Behaviour. Analysis and Intervention in People with Learning Difficulties. Cambridge: Cambridge University Press.)

Cultural competence and awareness

A set of behaviours, attitudes, knowledge, skills, practices and processes which enable effective work in cross-cultural settings. It means that individuals and providers are proactive, rather than responsive, regarding cultural diversity to ensure effective and relevant service delivery or supports (source: https://www.dss.gov.au/sites/default/files/documents/06_2015/nsds_full_version.pdf).

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https://www.dss.gov.au/sites/default/files/documents/06_2015/nsds_full_version.pdf

http://www.publicadvocate.wa.gov.au/_files/epg_guide.pdf

http://www.dss.gov.au/our-responsibilities/disability-and-carers/publications-articles/policy-research/national-framework-for-reducing-and-eliminating-the-use-of-restrictive-practices-in-the-disability-service-sector




Health professional

A person registered under the Health Practitioner Regulation National Law (WA) Act 2010.

Human Rights

Human rights are rights inherent to all human beings, whatever our nationality, place of residence, sex, national or ethnic origin, colour, religion, language, or any other status (source: http://www.ohchr.org/en/issues/pages/whatarehumanrights.aspx).

Person-centred planning

A process of individual discovery and action that assist the person to live the life they want to live and find their place in the community (source: http://www.ideaswa.net/upload/editor/files/downloads/HeatherSimmons.pdf).

Positive Behaviour Support

Positive Behaviour Support is a set of research-based strategies used to increase quality of life and decrease challenging behaviour by teaching new skills and making changes in a person’s environment. Positive Behaviour Support strategies are considered effective when intervention results in increases in a person’s success and personal satisfaction, and the enhancement of positive social interactions across work, academic, recreational and community settings. Valued outcomes include improved quality of life, as defined by the person’s unique preferences and needs, and positive lifestyle changes that increase the person’s social belonging (source: http://www.apbs.org/).

Positive Behaviour Support Panel

A Positive Behaviour Support Panel can be established to guide the development and delivery of services that are respectful of the human rights of people with disability, in accordance with the Department of Communities’ Code of Practice for the Elimination of Restrictive Practices. The Positive Behaviour Support Panel can be responsible for monitoring the use of restrictive practices and reaching agreement (including interim agreement) or non-agreement of a restrictive practice to be used to support individuals accessing services.

PRN medication

Most medications are prescribed with instructions that the medication should be taken at regular times during the day. The term ‘PRN’ is a shortened form of a Latin phrase, which translates roughly as “as the thing is needed”. PRN, therefore, means a medication that is not to be taken at regular times but only at times when it is necessary for symptoms to be relieved.

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http://www.apbs.org/

http://www.ideaswa.net/upload/editor/files/downloads/HeatherSimmons.pdf

http://www.ohchr.org/en/issues/pages/whatarehumanrights.aspx


Restrictive practice

The definitions for the terms ‘restrictive practice’, ‘seclusion’, ‘chemical restraint’, ‘mechanical restraint’, ‘physical restraint’, and ‘environmental restraint’ are from the National Framework for Reducing and Eliminating the Use of Restrictive Practices (2014).

A ‘restrictive practice’ is defined as any practice or intervention that has the effect of restricting the rights or freedom of movement of a person with disability, with the primary purpose of protecting the person or others from harm.

Note: a ‘psychosocial restraint’ will not be a regulated restrictive practice under the NDIS Quality and Safeguarding Framework and is not considered an appropriate response to challenging behaviours. On this basis, the Code no longer recognises this form of restrictive practice.

Seclusion

‘Seclusion’ means the sole confinement of a person with disability in a room or physical space at any hour of the day or night where voluntary exit is prevented, implied, or not facilitated.

Chemical restraint

A ‘chemical restraint’ means the use of medication or chemical substance for the primary purpose of influencing a person’s behaviour or movement. It does not include the use of medication prescribed by a medical practitioner for the treatment, or to enable treatment, of a diagnosed mental disorder, a physical illness or physical condition.

Mechanical restraint

A ‘mechanical restraint’ means the use of a device (which may include any mechanical material, appliance or equipment) to prevent, restrict or subdue a person’s movement for the primary purpose of influencing a person’s behaviour but does not include the use of devices for therapeutic or non-behavioural purposes. For example, purposes may include the use of a device to assist a person with functional activities, as part of occupational therapy, or to allow for safe transportation.

Physical restraint

A ‘physical restraint’ means the sustained or prolonged use or action of physical force (for example, a physical force or action lasting longer than approximately 30 seconds, that is not a reflexive manual restraint) to prevent, restrict or subdue movement of a person’s body, or part of their body, for the primary purpose of influencing a person’s behaviour. Physical restraint is distinct from the use of a hands-on technique in a reflexive way (for example, momentary contact to guide or redirect a person, lasting for no more than approximately 30 seconds) to guide or redirect a person away from potential harm/injury, consistent with what could reasonably be considered the exercise of care towards a person.

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Environmental restraint

An ‘environmental restraint’ means the restriction of a person’s free access to all parts of their environment. Examples include, but are not limited to:

o barriers that prevent access to a kitchen, locked refrigerators and restriction of access to personal items such as a TV in a person’s bedroom

o locks that are designed and placed so a person has difficulty in accessing or operating them

o restrictions to the person’s capacity to engage in social activities by not providing the necessary supports they require to do so.

Substantive equality

Substantive equality means achieving equitable outcomes as well as equal opportunity, and the need to sometimes treat people differently to achieve equal results. It takes into account the effects of past discrimination, and recognises that rights, entitlements, opportunities and access are not equally distributed throughout society. It is achieved by addressing and preventing systemic discrimination by adjusting policies, procedures and practices to meet the specific needs of certain groups in the community (source: http://www.eoc.wa.gov.au/substantive-equality).

Therapeutic device

A therapeutic device is primarily used to improve function (motor and bodily) and to prevent or reduce the risk of body shape distortion and their/its subsequent secondary complications. Therapeutic devices employ a variety of methods used for the purpose of restricting the movement of the person due to high or low muscle tone and/or postural deformity. They may also be used for short periods of time to allow for wound healing/tissue repair.

The use of a therapeutic device aims to minimise the person’s risk of developing physical deformity/injury that leads to the development of pressure on the soft tissues, pain or a reduction in functional capabilities.

Examples of therapeutic devices include but are not limited to:

postural supports such as inserts splints to minimise contractures shoulder, chest and pelvic straps for optimal postural support helmets seatbelt modifications for safe transport night-time positioning equipment.

Treatment

In the Guardianship and Administration Act 1990 (WA), the term ‘treatment’ refers to any medical or surgical treatment (including life sustaining measures and palliative care) or dental treatment or other health care.

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http://www.eoc.wa.gov.au/substantive-equality


Appendix 3: Challenging Behaviour and Restrictive Practices Decision-making Flow Chart

Note: Outside of an emergency situation, with any BSP, the aim is not to have a restrictive practice in place.

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Appendix 4: Resources Positive Stories: An Exploratory Analysis of the Implementation of Positive

Behaviour Support in the Western Australian Disability Sector

o This resource shows the importance of whole of organisational buy-in and cultural change in the elimination of restrictive practices.

Positive Behaviour Framework Effective Service Design

o This resource sets out the essential elements of service design that contribute to better outcomes for people with disability who may experience challenging behaviour were identified through consultation with the disability sector.

Positive Behaviour Support Information for Disability Sector Organisations

o This resource is a plain English guide to Positive Behaviour Support.

Towards Responsive Services for All!

o This resource is a National Disability Services report on the disability sector which became the reform blueprint for the Positive Behaviour Framework.

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Notes

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Department of Communities, Disability Services Street address: 146-160 Colin Street, West Perth, WA 6005

Postal address: PO Box 441, West Perth, WA 6872

Phone: (08) 9426 9200

Free call (country): 1800 998 214

TTY: 9426 9315

Fax: 9226 2306

Email: [email protected]

Website: https://www.communities.wa.gov.au/services/disability-services

© Copyright Department of Communities. February 2019.

This publication is available in alternate formats on request.

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https://www.communities.wa.gov.au/services/disability-services

mailto:[email protected]

Documents

Code of Practice - A guide for the elimination of … · Web viewThere are various interpretations in the disability services sector of key terms associated with the identification,