Who approves the use of restrictive practices?

The approval process depends on the type of restrictive practice and the situation. Read the Restrictive practice requirements published by the Department of Families, Seniors, Disability Services and Child Safety to find out who can approve/consent to different types of restrictive practices.

What are restrictive practices?

A restrictive practice is any intervention that restricts the rights or freedom of movement of a person with disability.

These include:

• Containment: preventing a person from leaving a premises
• Seclusion: confining a person alone in a space they cannot leave
• Chemical restraint: using medication to control behaviour
• Mechanical restraint: using devices to restrict movement
• Physical restraint: using physical force to control behaviour
• Restricted access to objects: limiting access to certain items.

How do short-term containment and/or seclusion approvals work?

When do you need short-term approval?

Disability service providers who want to use containment and/or seclusion (plus any other restrictive practices) for a short time for an adult with an intellectual or cognitive impairment, must obtain approval from us.

Why is short-term approval needed?

Short-term approval allows:

• The chief executive to complete a multidisciplinary assessment for the person
• The chief executive to develop a Positive behaviour support plan (PBSP) based on the assessment in consultation with the provider
• A joint application between the chief executive and the service provider to be made to QCAT for ongoing approval.

We’ll only consider your application if you’ve arranged for the person to undergo a functional behaviour assessment.

How long does short-term approval last?

The duration of short-term approvals for containment and/or seclusion is determined on a case-by-case basis. Typically, we grant approvals for a brief period and may extend up to six months. It’s rare for us to grant more than one short-term approval per person. This usually only occurs if there is a change in service provider.

How do ongoing approvals work?

Disability service providers who want to use containment and/or seclusion (plus any other restrictive practices) on an ongoing basis, must make contact with the chief executive who will work with the disability provider to make a joint application to QCAT for approval.

How do respite/community-access approvals work?

Disability service providers seeking to use containment, seclusion or other restrictive practices while a person is in respite care or participating in community activities, must obtain a decision from the person’s relevant decision maker.

This decision is made via a respite/community-access plan (R/CAP).

What if we are the guardian?

If QCAT appoints us to provide decision making services to a person for restrictive practices (respite) matters, we can only approve their containment or seclusion in respite care or community settings.

How long does respite approval last?

We can approve restrictive practices in respite or community settings for up to 12 months, provided they’re documented in a respite/community-access plan.

You must include the person’s views and wishes in your application. You can either include these details within the plan or as an attachment or provide details about why their views could not be obtained.

How do approvals for chemical, mechanical and/or physical restraints, and/or restricted access to objects work?

Short-term approval

For short-term use of these practices, disability service providers must get approval from the Chief Executive, Disability Services.

For more information, visit Disability services' positive behaviour support and restrictive practices.

General approval

For ongoing use, you must obtain approval from the person’s guardian for restrictive practices (general) through an approved PBSP, provided QCAT appointed the guardian to make restrictive practices decisions for the person.

If the person doesn’t have a guardian, their informal decision-maker can approve restricted access to objects through an approved PBSP.

Respite/community-access approval

For use during respite or community activities, approval must come from the person’s guardian or informal decision-maker (if no guardian is appointed). Consent is provided via an approved R/CAP.

If the person is receiving respite services only, their informal decision-maker can approve chemical restraint (fixed/daily dose only) without a respite/community-access plan.

What if we're the guardian?

If QCAT appoints us as a person’s guardian, we can approve the use of restraints and/or restricted access to objects only if QCAT authorises us to make restrictive practices (general) or restrictive practices (respite) decisions.

How long do general or respite approvals last

If the proposed restraints and/or restricted access to objects are outlined in a PBSP or a R/CAP, we can approve their use for up to 12 months.

The person’s views and wishes about the proposed restrictive practices must be included in the application for approval. This information can be provided within the PBSP or R/CAP, or as an attachment to these plans.

What needs to happen before restrictive practices can be used?

Before using restrictive practices, the person must be assessed by an appropriately qualified person (unless the practice is approved for short-term use while awaiting an assessment).

The assessment helps:

• Understand the nature, intensity, frequency, and duration of the person’s harmful behaviour
• Identify factors contributing to the behaviour (e.g., biological, psychological, social, medical)
• Develop strategies to:
  • Meet the person’s needs and improve their quality of life
  • Reduce harmful behaviour
  • Manage behaviour to minimise harm.

What is a Positive behaviour support plan (PBSP)?

Once the person exhibiting harmful behaviours has been assessed, a PBSP must be created for them.

The PBSP outlines strategies to:

• Address the person’s needs
• Support the development of their skills
• Maximise opportunities to enhance their quality of life
• Reduce the intensity, frequency and duration of harmful behaviours.

The PBSP must include, at a minimum:

• A description of the person’s past harmful behaviours, including triggers and consequences
• Positive strategies that must be tried before using a restrictive practice
• The specific circumstances in which the proposed restrictive practice will be used
• Evidence demonstrating that the restrictive practice is the least restrictive option to ensure the safety of the person and others
• Procedures for implementing the restrictive practice, including monitoring and ensuring the person’s proper care and treatment
• Anticipated positive and negative effects of the restrictive practice on the person
• The frequency of reviews to evaluate the use of the restrictive practice
• The duration and frequency of the proposed restrictive practices
• Details of any chemical restraints, including the dose, route and frequency of administration

If a service provider wants to change an approved restrictive practice, you must submit an updated PBSP to us.

What is a respite/community-access plan (R/CAP)?

If you want to use restrictive practices during respite or community activities, you must develop a plan that includes:

• The behaviour causing harm and the restrictive practice to be used
• Why the practice is the least restrictive way to ensure safety
• Positive strategies to try before using the restrictive practice.

If you want to change an approved restrictive practice, you must submit an updated plan to us.

More information

• Education and resources
• Restrictive practices decisions