Behaviour support (NDIS Providers)
Behaviour support is about individualised strategies for people with disability that are responsive to the person’s needs, in a way that reduces the occurrence and impact of challenging behaviour, and minimises the use of restrictive practices.
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.
These arrangements will include undertaking a functional behavioural assessment, then developing an NDIS behaviour support plan containing evidence-based, proactive strategies that meet the needs of the participant.
The new behaviour support and restrictive practices arrangements will involve significant change for providers.
The NDIS Commission have put in place provisions for providers in New South Wales and South Australia to give them time to meet the new behaviour support and restrictive practices requirements from 1 July 2018.
These transitional arrangements extend the timeframes for existing providers transferring to the NDIS Commission to comply with the new requirements, depending, for example, on whether the person with disability has a behaviour support plan in place, and whether the restrictive practice being used has been authorised in line with the relevant state requirements.
What is a restrictive practice?
Restrictive practices include seclusion, and chemical, mechanical, physical, and environmental restraints. In the past, restrictive practices were often used as a first response to behaviours that caused significant harm to the person or others. It is now recognised that restrictive practices can represent serious human rights infringements.
In 2014, state and territory governments endorsed the National Framework for Reducing and Eliminating the Use of Restrictive Practices in the Disability Service Sector.
Registered providers delivering behaviour support will be required to abide by 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 part of the new arrangements, 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.
Where an NDIS participant’s behaviours of concern place themselves or others at risk of harm, and regulated restrictive practice is required, a registered provider will need to develop a behaviour support plan. The NDIS Commission Rules outline the requirements for registration and monitoring of restrictive practices used in behaviour support plans for NDIS participants.
What is a behaviour support plan?
An NDIS behaviour support plan is a document developed for a person with disability by an NDIS behaviour support practitioner.
It 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, and increase their opportunities to participate in community activities and develop new skills. It also includes any restrictive practices that may be required, subject to conditions.
Behaviour support plans are 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.
Using restrictive practices as part of a behaviour support plan
If the plan contains a restrictive practice, the use of that practice must meet NDIS Commission conditions, and might require authorisation or consent under the relevant jurisdiction’s legislative and policy frameworks.
The registered specialist behaviour support provider must ensure that:
- a behaviour support practitioner will work with the participant, informal supports, and implementing provider to develop a behaviour support plan that is based on a functional behaviour assessment
- a statement of intent to use a restrictive practice is given to the participant and their supports in an accessible format
- the behaviour support plan contains strategies that are outcomes focused, person centred, and proactive, and that address the participant’s needs and the functions of the behaviour
- the behaviour support plan contains strategies to reduce or eliminate the use of restrictive practices with the participant over time
- the behaviour support plan is registered with the NDIS Commission to enable monitoring of regulated restrictive practices.
All providers using restrictive practices when delivering NDIS supports need to meet conditions of registration. These include the following:
- 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 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.
- If the state or territory requires authorisation for the use of a restrictive practice, the implementing provider must obtain it.
- The provider must register the behaviour support plan and the regulated restrictive practice with the NDIS Commission, and comply with monthly reporting requirements.
Who will oversee behaviour support?
The Senior Practitioner will lead the NDIS Commission’s behaviour support function, and will:
- oversee behaviour support practitioners and providers who use behaviour support strategies and restrictive practices
- provide best-practice advice 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.
Changes for providers
Providers must meet certain obligations in delivering behaviour support that includes restrictive practices.
The new requirements include the following:
- Providers who deliver specialist behaviour support—including undertaking functional behavioural assessments and developing behaviour support plans—and who use restrictive practices must be registered.
- These providers must engage a specialist behaviour support practitioner, qualified to do behaviour support assessments and develop behaviour support plans.
- NDIS participants who may be subject to restrictive practices must have a behaviour support plan developed and lodged with the NDIS Commission.
- The use of restrictive practices will be subject to conditions, including that the person must have a behaviour support plan in place, specifying 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.
- Providers who use restrictive practices must provide monthly reports to the NDIS Commission.
- Providers must understand how NDIS policies and procedures support participants with behaviour support needs.
- Providers must help staff, participants, families, and decision-makers understand the NDIS Commission’s behaviour support function.
- Providers implementing behaviour support plans must work closely with the NDIS behaviour support practitioner, the participant, and their family and carers on the development of the NDIS behaviour support plan.
- Providers must ensure that any staff involved in implementing positive behaviour strategies or restrictive practices have received appropriate training.
- Providers must report the unplanned or unapproved use of a restrictive practice to the NDIS Commission as a reportable incident.
The Senior Practitioner’s team is available for advice and guidance during the development and implementation of the NDIS behaviour support plan. This support is available to anyone—behaviour support practitioners, providers using the plan, participants, family members, carers, and advocates.