A locked pantry. A bedroom door that only opens from outside. Medicine given to settle someone when they are upset.
Each of these can be a restrictive practice. Families often find out the term only when a provider, a school or a support coordinator mentions it. Then the questions come fast. What does it mean? Who decides? Will it be there forever?
This guide explains restrictive practices in the NDIS for parents, carers and support coordinators across Sydney. It covers the 5 regulated types, the rules providers must follow and how a behaviour support plan works to reduce them.
Key points
- The NDIS regulates 5 types of restrictive practice: seclusion and chemical, mechanical, physical and environmental restraint.
- A provider can only use one if it’s in a behaviour support plan and authorised where the state requires it.
- Use is reported to the NDIS Commission every month.
- Every plan must include steps to reduce the practice over time.
What is a restrictive practice in the NDIS?
A restrictive practice is any practice or intervention that restricts the rights or freedom of movement of a person with disability. Under the NDIS, the main purpose is to protect the person or others from harm. A restrictive practice must always be a last resort, written into a behaviour support plan and reduced over time.
That definition comes from the NDIS (Restrictive Practices and Behaviour Support) Rules 2018. The NDIS Quality and Safeguards Commission oversees how providers use them.
The key word is rights. A restrictive practice limits something most people take for granted. That might be walking out of a room, opening the fridge or going outside. That’s why the rules around them are strict.
Why are restrictive practices used at all?
Restrictive practices are usually brought in after something frightening has happened. A person may have run onto a busy road, hurt themselves badly or hurt a support worker. People reach for a restriction because they want everyone to be safe.
The problem is that a restriction manages the risk without changing why the behaviour happens. It can also harm the person’s dignity and their relationships with the people who support them. Positive behaviour support looks for the reason behind the behaviour so the restriction is no longer needed.
What are the 5 types of regulated restrictive practices?
The NDIS regulates 5 types of restrictive practice: seclusion, chemical restraint, mechanical restraint, physical restraint and environmental restraint. Each one has a legal definition in the NDIS Rules. Any of the 5 used by an NDIS provider must be in a behaviour support plan, and authorised where the state requires it.
Here is a short version of each, with an everyday example:
| Type | What it means | Example |
|---|---|---|
| Seclusion | Keeping a person alone in a room or space they cannot freely leave | A locked bedroom door |
| Chemical restraint | Using medicine mainly to influence behaviour, rather than to treat a diagnosed condition | Medicine given when a person becomes distressed |
| Mechanical restraint | Using a device to limit movement mainly to influence behaviour | Arm splints to stop hand biting |
| Physical restraint | Using physical force to limit movement mainly to influence behaviour | Holding a person’s arms down |
| Environmental restraint | Limiting free access to parts of the environment, items or activities | A locked pantry, fridge or gate |
Our guide to the types of restrictive practices goes deeper into each one. It also covers what does not count, such as a seatbelt used for safety in a car.
What rules must NDIS providers follow?
An NDIS provider can only use a regulated restrictive practice if it’s in a behaviour support plan and authorised where required. It must be a last resort, and its use is reported to the NDIS Commission. It must be the least restrictive option and used for the shortest time possible. Using one outside these rules is a reportable incident.
The main rules work like this:
- It must be in a plan. A registered NDIS behaviour support practitioner writes the plan. The plan names the practice, when it can be used and what must be tried first.
- It must be authorised. In NSW, authorisation goes through the NSW restrictive practices authorisation process, which is separate from the NDIS. The rules differ in each state and territory.
- It must be the least restrictive option. It should match the level of risk and last no longer than needed.
- It must be reported. Providers who use a regulated restrictive practice report its use to the NDIS Commission each month, including practices in the plan that weren’t used.
- Unauthorised use is a reportable incident. If a provider uses a restrictive practice without a plan or authorisation, it must be reported to the Commission.
The NDIS Commission’s Regulated Restrictive Practices Guide also lists practices that should never be used. These include punishment, such as withholding food or drink, and holds that put a person face down or restrict their breathing.
What timeframes apply to a behaviour support plan?
When a regulated restrictive practice is in use, the NDIS Commission sets clear timeframes. An interim behaviour support plan is due within 1 month. A comprehensive behaviour support plan is due within 6 months. The plan is then reviewed at least every 12 months, or sooner if the person’s needs change.
Our page on Reducing Restrictive Practices shows how we work through each of these steps with families and providers.
Who decides if a restrictive practice is used?
No single person decides alone. A behaviour support practitioner recommends a restrictive practice in the plan. The state authorisation process approves it where required. The provider who uses it must follow the plan exactly. The person and their family should be part of every conversation.
In practice, several people are involved:
- The person. Their views and preferences come first, in whatever way they communicate them.
- Family and guardians. They help shape the plan and can question anything in it.
- The behaviour support practitioner. They assess, write the plan and train the people who use it.
- The implementing provider. This is the service that carries out the plan day to day, such as a group home or day program.
- The authorisation panel. In NSW, a panel looks at the plan before a practice can be authorised.
If you disagree with a restrictive practice, say so. You can ask the practitioner to explain the reasons and what has been tried. You can also contact the NDIS Commission if you have a concern about how a practice is being used.
How does positive behaviour support reduce restrictive practices?
Positive behaviour support reduces restrictive practices by finding out why a behaviour happens. It then changes the environment, teaches new skills and trains the people around the person. As the risk drops, the restriction can be used less often. The goal is to remove it altogether where that’s safe.
The work usually starts with a Functional Behaviour Assessment. It looks at when, where and why a behaviour happens. If a person climbs the back fence every afternoon, the assessment might show they’re bored, overwhelmed by noise or looking for a particular person. Each answer leads to a different plan.
From there, the plan replaces the restriction step by step. A locked pantry might give way to set snack times, a visual timetable and then an open pantry for longer stretches of the day. Our guide to reducing restrictive practices walks through how that fading process works.
A good plan also looks at the setting. The Capable Environment Framework asks whether the person’s day has enough choice, activity and predictability. Small changes there can lower stress and risk for everyone.
What should families ask about a restrictive practice?
Families should ask what the practice is, why it’s needed and what was tried first. Ask how often it’s used and what the plan is to reduce it. You have the right to clear answers. A good practitioner will welcome these questions and show you the data behind their advice.
Questions worth bringing to your next meeting:
- What exact practice is in the plan, and when can it be used?
- What behaviour is it meant to keep people safe from?
- Which less restrictive strategies were tried first?
- How often has it been used in the last month?
- Is it authorised, and when does that authorisation end?
- What is the plan to reduce it, and how will we know it’s working?
Keep a copy of the plan and any reports. If a practice seems to be used more than the plan allows, write down the dates and raise it with the provider straight away.
Frequently asked questions
What happens if a restrictive practice is used without a plan?
If an NDIS provider uses a regulated restrictive practice without a behaviour support plan, or without authorisation where it’s required, that is a reportable incident. The provider must report it to the NDIS Commission. The Commission can then follow up with the provider and take action where needed.
Do restrictive practices rules apply at home with family?
The NDIS rules apply to registered NDIS providers and their workers. They don’t directly govern what family members do at home. Still, many families choose to work with a practitioner on any restriction they use. The same ideas about last resort and reduction apply, and we can help you plan for that.
Can a restrictive practice ever be removed completely?
It can be, and that’s the aim of every plan we write. How long it takes depends on the person, the level of risk and how consistently the plan is used. For some people a practice is removed. For others it’s used less often over a longer time.
Who authorises restrictive practices in NSW?
In NSW, a restrictive practice used by an NDIS provider is authorised through the state’s restrictive practices authorisation process. A panel reviews the behaviour support plan before it approves a practice. The NDIS Commission doesn’t authorise practices. It oversees how providers use and report them.
Are restrictive practices used with children?
Sometimes, and the same rules apply. The NDIS Commission has a practice guide for children and young people. It asks providers to think about the child’s age, development and rights. A practice that may be ordinary parenting for one age, like a locked gate for a toddler, can be a restrictive practice for an older child.
Talk to our team about restrictive practices
My Behaviour Support is a registered NDIS provider in Narellan, working across South West and Western Sydney. Our Director, Domenic Barca, is a Proficient Behaviour Support Practitioner with long experience in high-risk behaviours and restrictive practice requirements. Michelle Boyce works in a trauma-informed way and has strong experience reviewing restrictive practices.
If a restrictive practice is in place for someone you support, or someone has suggested one, you don’t have to work it out alone. Make a referral or call us on 0415 930 548, and we’ll talk you through the next steps.
