Decision Making Tool: Supporting a Restraint-Free Environment
This document has been developed to assist staff and management working in both the residential and community aged care setting to make informed decisions in relation to the use or non use of restraint, in responding to behaviours of concern.
A restraint-free environment is seen as a basic human right for all and care recipients are entitled to respect and protection of their basic rights and freedoms, regardless of whether the care is being provided in a residential aged care setting or within the care recipients own home.
The Decision Making Tool: Responding to issues of restraint in Aged Care (2004) resource has been updated and developed into separate tool kits for the community and residential sectors.
In keeping with Ministerial endorsement of the Australian Safety and Quality Framework for Health Care in 2010, each section of the Tool Kits align with one of the three endorsed core principles, namely:
- driven by information
- organised for safety.
These Tool Kits are designed to assist in the decision making process bearing in mind that any form of restraint is only to be used as a last resort. Organisational policies and procedures need to be underpinned by a restraint-free way of thinking and developed in conjunction with relevant legislation such as the Aged Care Act 1997.
A restraint-free environment means no words, devices or actions will interfere with a person’s ability to make a decision or restrict their free movement.
A person-centred approach is a restraint free approach – a way of thinking that preserves the human rights of any person. All residents are entitled to respect and protection of their basic rights and freedoms, regardless of where they live. This entitlement includes all persons bearing a corresponding obligation to respect and protect the rights and freedoms of others.
The Aged Care Quality Standards, which come into effect on 1 July 2019, require aged care providers who deliver clinical care to have a clinical governance framework in place that includes minimising the use of restraint.
The Quality of Care Principles 2014 have been amended to reflect specific requirements in relation to the use of physical and chemical restraint. Only when providers have explored alternatives to restraint and satisfied a number of conditions, can either form of restraint be used. These requirements also come into effect on 1 July 2019.