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New rules for using restraints in aged care

Residential aged care providers need to ensure assessment by an approved person and document alternative alternative options tried before physical or chemical restraint can be used from 1 July, the government has announced.

Minister for Senior Australians and Aged Care Ken Wyatt announced the new rules for providers to use restraints last Friday and has since amended the Quality of Care Principles 2014 to reflect the incoming specific requirements.

He said the government has worked with a group of key stakeholders to inform a regulatory approach to minimise the inappropriate use of restraints, treating chemical and physical restraints as separate issues.

“Restraint must only be used as a last resort,” Mr Wyatt said.

Under the new regulations residential aged care providers will need to satisfy several conditions, Mr Wyatt said.

They include the requirement for an assessment by approved health practitioner before physical restraints are used and an assessment by the medical practitioner or nurse practitioner who prescribed the medication before the use of chemical restraint.

“The aged care home must also have the informed consent of the consumer or their representative before using physical restraint, unless restraint is necessary in an emergency.

“In all cases of restraint, the home will also be required to document the alternative options to restraint that have been used. Any use of restraint must also be regularly monitored,” Mr Wyatt said.

Mr Wyatt foreshadowed the strengthening of regulations for the use of physical and chemical restraints in residential aged care on the eve the first public hearing of the Royal Commission into Aged Care Quality and Safety following media reports showing images of residents with dementia being strapped to chairs.

The new arrangements reflect elements of the Decision-Making Tool: Supporting a Restraint Free Environment in Residential Aged Care (revised in 2012).

These new regulations support the government’s broader reform agenda to ensure aged care is delivered to a high-quality at all times and in all places, he said.

Also coming into force on 1 July 2019 are the new Aged Care Quality Standards.

Mr Wyatt said providers delivering clinical care will be required to have a clinical governance framework in place that minimises the use of all forms of restraint.

“We have equipped managers and staff in aged care facilities with tools and guidelines to achieve safe, high-quality care and practice safe management of medicines,” he said.

Providers also need to collect and report information on the use of physical restraints, as well as pressure injuries and unplanned weight loss, as part of the quality indicators program, which becomes compulsory for residential aged care providers from 1 July.

Aged Care Quality and Safety Commissioner Janet Anderson said last month it was expected that the first release of quality indicator data would be published online by the end of the year (read more here).

Mr Wyatt said he expected to sign the regulatory changes regarding restraints into law this week.

This story was updated on 3 April to reflect new information.

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2 Responses to New rules for using restraints in aged care

  1. Over PC September 20, 2019 at 1:03 am #

    This has resulted in a major increase in residents being injured, causing injury and property damage simply because facilities are now too scared to try everything else then looking at the least restrictive restraint. Management in majority of facilities even go as far as saying restraints are outlawed instead of saying “let’s look at every avenue and only then, if all options are exhausted, will we explore restraint options with the resident/representative and MO”.

    I agree 100% restraints should never be the go to option but when people are falling out of bed onto crash mats on a regular basis, it’s gets a bit much for any aged care worker to see the bruises that are piling up. Crash mats are great for feather weights, not so good for larger people. That also adds on to staff muscular and spinal injuries when transferring from floor onto bed with a full mechanical lifter. The theory of sensors to let us know if they have fallen out of bed only lets us know when, it does not prevent it and unless you plan on standing beside the bed 24/7, regular checks only work at that moment, it does not mean they won’t roll out between them.

    We have become such a “scared of our own shadow” industry, and society for that matter, that we are allowing people to harm themselves and calling it their right. I’m pretty sure not one person on this earth has injured themselves accidentally is thinking ‘THANK GOD, THOUGHT THAT WOULD NEVER HAPPEN THIS WEEK!’.

  2. Anita Player October 2, 2019 at 12:33 am #

    My Father lives in a aged care facility, at least 3-5 times a week l get a call saying he has had a fall, generally falling out of bed, but sometimes he crashes to the floor in the bathroom, ( in his dementure he forgets that he can’t walk very well and he gets out of bed- because there is nothing stopping him from doing so). He is left brused, in pain and confused, often missing long strips of skin, and, more often than not requiring medical attention.They say restraining them is abuse–THIS IS ABUSE! How does a bed rail constituency restraint/abuse, it keeps them safe. If you saw your toddler walking towards the end of a jetty, and someone went to hold them back, would you put out your arm to stop them, and say “no, leave them, it’s not right to restrain them”! !.my Father has had well over 200 falls, and do you know how upset and angry l feel because l can do nothing to stop it? I can’t help the man who stopped me from falling when l was young, and l just have to sit by and here about the details of how he ‘has a bruse on his face and he’s missing a bit of skin on his left arm, he’s a bit confused at the moment, but were keeping an eye on him in case of concussion! I bet he’s confused!, confused as to why he’s always getting hurt, and why l’m not doing something to stop it !
    And as far as mat alarms are concerned, GOD SAVE US FROM FOOLS, how the hell does that get classified as restraint? (Unless you roll them up in it and tie the cord around their neck!). Such a brilliant idea, let them fall out of bed, then let them lay there for hours because nobody is await that something has happened. BRILLIANT!, who was the dumb ass who thought that was a clever system?
    I was informed today that my Father was found cralling on all fours into other patients rooms, please, give him back his dignity, he needs gentle restraint, and to say that the staff should be responsible for manually keeping them in a safe position at all times, is down right ridiculous! have you ever watched how flat out busy they are with the work they already do? ? Mr Wyatt, if you believe that is a feasible propersition, then, l’m sorry, you just aren’t living in the real world!.
    I would even say a gentle sash around his waist, not tight, loose enough that he could turn over, sit up reach for something on his bed side cabnet, but would stop him being injured by restricting him from getting out of bed on his own, would be far kinder than the constant falls and knocks that he suffers! ! ! !Please wake up and think about what l’ve said Mr Wyatt ( and any other politician that is responsible for this calamity), this obvious example of ‘peoples rights’ gone mad has to be put right, before something horrendous happens, like a nursing home catching fire because the patients are running free with nothing to restrain them, and a lot of them suffering with dementure makes it so feasible a possibility! ? !
    Thank you for taking the time to read this message, l hope it does some good.

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