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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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