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Behaviour Support

June 4, 2019

 

There is significant change involved for providers to transition to the new behaviour support and restrictive practices arrangements as part of the NDIS Quality and Safeguarding Commission.

 

As the NDIS Commission begins operation progressively across Australia, transitional provisions give providers time to meet the new requirements. In this blog we update you on the new requirements for providers.

 

The new arrangements for behaviour support under the NDIS Commission focus on person-centred interventions to address the underlying causes of behaviours of concern or challenging behaviours, while safeguarding the dignity and quality of life of people with disability who require specialist behaviour support.

 

What is Behaviour Support

Behaviour support is about creating individualised strategies for people with disability that are responsive to the person’s needs, in a way that reduces the occurrence and impact of behaviours of concern and minimises the use of restrictive practices. This approach includes undertaking a functional behavioural assessment, then developing an NDIS behaviour support plan containing evidence-based, proactive strategies that meet the specific needs of the participant.

 

The role of the Senior Practitioner

The Senior Practitioner leads the NDIS Commission’s behaviour support function. It is the role and responsibility of the Senior Practitioner to:

 

  • oversee behaviour support practitioners and implementing providers who use behaviour support strategies and restrictive practices

  • provide best-practice advice to practitioners, providers, participants, families, and carers

  • receive and review provider reports on the use of restrictive practices

  • follow up on reportable incidents that suggest there are unmet behaviour support needs.

 

The role implementing providers

An implementing provider is any NDIS service provider that uses a regulated restrictive practice in the course of delivering NDIS supports to a participant. For example, support workers restricting a participant’s free access to the community due to behaviours of concern are implementing a regulated restrictive practice. Implementing providers use who regulated restrictive practices must report monthly on this use to the NDIS Commission.

 

The role of behaviour support practitioners

Under the NDIS Commission, a registered provider of specialist behaviour support services must use a behaviour support practitioner whom the NDIS Quality and Safeguards Commissioner considers suitable to undertake behaviour support assessments and develop behaviour support plans that may contain the use of restrictive practices. To be considered suitable, the registered specialist behaviour support provider must provide details of their behaviour support practitioners to the NDIS Commission.

 

Development of the Behaviour Support Capability Framework

The development of a strengthened Behaviour Support Capability Framework is currently underway. The framework will focus on the knowledge and skills that underpin contemporary evidence-based practice and standards. The intention is for the framework to reflect the diversity and variation of the sector’s capability in delivering behaviour support. Through the capability framework the NDIS Commission aims to raise the bar with a view to strengthen the safeguards for the person receiving behaviour support. 

 

Understanding restrictive practice

Restrictive practice means any practice or intervention that has the effect of restricting the rights or freedom of movement of a person with disability. Under the Rules, certain restrictive practices are subject to regulation. These include seclusion, chemical restraint, mechanical restraint, physical restraint and environmental restraint.

 

In the past, restrictive practices were often a first response to behaviours that caused significant harm to the person or others. It is now recognised that restrictive practices can present serious human rights infringements. In 2014, state and territory governments responded to this by endorsing the National Framework for Reducing and Eliminating the Use of Restrictive Practices in the Disability Service Sector.

 

Under the NDIS Commission, registered providers who deliver behaviour support are required to comply with the NDIS Quality and Safeguarding Framework, which is underpinned by the same high-level guiding principles, including human rights and a person-centred approach as the national framework. Within the new arrangements, the states and territories continue to be responsible for the legislative and/or policy arrangements for authorisation and consent to the use of a regulated restrictive practice.

 

Behaviour support plans

An NDIS behaviour support plan is a document developed for a person with disability by an NDIS behaviour support practitioner. It is developed in consultation with the participant, their family, carers, guardian, and other relevant people, as well as the service providers who will be implementing the plan. A behaviour support plan specifies a range of evidence-based and person-centred, proactive strategies that focus on the individual needs of the participant. This includes positive behaviour support to:

 

  • build on the person’s strengths

  • increase their opportunities to participate in community activities, and

  • increase their life skills.

 

It also includes any regulated restrictive practices that may be required.

 

Using restrictive practices as part of a behaviour support plan

For plans that contain a regulated restrictive practice, the use of that practice must meet NDIS Commission conditions and may also require authorisation or consent under the relevant state or territory legislative and policy frameworks. As a registered specialist behaviour support provider, you must ensure that:

 

  • a behaviour support practitioner completes a functional behaviour assessment and develops the behaviour support plan in consultation with the participant, their family, carers, guardian, and other relevant people, as well as the service providers who will be implementing the plan.

  • a statement of intent to include a restrictive practice in the behaviour support plan is given to the participant and their family, carers, guardian, and other relevant people in an accessible format and the behaviour support plan must contain:

    • strategies that are outcomes focused, person-centred and proactive

    • strategies that address the participant’s individual needs and the functions of the behaviour of concern

    • strategies to reduce or eliminate the use of restrictive practices with the participant over time

 

All providers using restrictive practices when delivering NDIS supports need to meet conditions of registration. These include:

 

  • A restrictive practice can only be used when it is part of a behaviour support plan developed by a specialist behaviour support practitioner.

  • If a restrictive practice is used, it must, among other things:
     

    • be the least restrictive response possible in the circumstances

    • reduce the risk of harm to the person or others, and

    • be used for the shortest possible time to ensure the safety of the person or others.
       

  • Where required, the implementing provider must obtain authorisation for the use of a restrictive practice from the state or territory.

  • The implementing provider must comply with monthly reporting requirements.

 

Provider obligations

Specialist behaviour support providers have certain obligations to deliver behaviour support under the NDIS. These requirements apply regardless of whether regulated restrictive practices are included in a behaviour support plan. Implementing providers who use regulated restrictive practices also have additional obligations which are detailed below. Specialist behaviour support providers must:

 

  • Be registered for behaviour support with the NDIS Commission

  • Use behaviour support practitioners considered suitable by the NDIS Commission

  • Specify in the NDIS participant’s behaviour support plan that person-centred strategies must be applied first, with restrictive practices used as a last resort, in response to a risk of harm to the person or others, and in line with any state or territory authorisation and consent requirements

  • Lodge behaviour support plans that contain regulated restrictive practices with the NDIS Commission

  • Understand how NDIS policies and procedures support participants with behaviour support needs

  • Help your staff, NDIS participants, their families, and other decision-makers to understand the NDIS Commission’s behaviour support function

 

Implementing providers must:

  • Be registered with the NDIS Commission for the type of support they are providing

  • Submit monthly reports to the NDIS Commission on the use of restrictive practices. The NDIS Commission will notify you of your reporting requirements and procedures

  • Ensure staff are appropriately trained to implement positive behaviour strategies or use restrictive practices

  • Notify the NDIS Commission in the event of any unplanned or unapproved use of a restrictive practice through the reportable incident process

  • Understand how NDIS policies and procedures support participants with behaviour support needs

  • Help your staff, NDIS participants, their families, and other decision-makers to understand the NDIS Commission’s behaviour support function

 

To find more information on the NDIS Quality and Safeguards Commission visit the site here

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