New restrictive practices rules mean aged care providers must be prepared to have behaviour support plans in place by September for residents exhibiting dementia-related behaviours, the Aged Care Quality and Safety Commissioner has warned.
The new laws, which commence on 1 September, aim to minimise the use of restrictive practices and eliminate inappropriate use of physical and chemical restraint.
The legislation requires aged care providers to have a behaviour support plan in place for every resident displaying behaviours of concern or changed behaviours, or where restrictive practices are being considered, applied or used as part of their care under the Quality of Care Principles.
The resident’s behaviour support plan must include information about any behaviours of concern, behavioural assessments, previous incidents including triggers, alternative strategies known to be successful or unsuccessful and the provider’s consultations on alternative strategies.
Aged Care Quality and Safety Commissioner Janet Anderson said there was no grace period for providers to implement behaviour support plans.
“The legislation… comes into effect on 1 September… and there is no getting around that,” Ms Anderson told a webinar on the use of restrictive practices and behaviour support planning on Monday.
“If you have been concentrating on supporting and assisting in the management of behaviours of concern, you would already have at least a substantial portion of a plan already in place, if not every aspect of it,” Ms Anderson said.
The 1 September change follows additional provider responsibilities added two months ago for using any restrictive practice for permanent and short-term restorative care residents.
These responsibilities documenting alternatives to restrictive practices that were considered or used, and why any were unsuccessful.
“That additional time was built into the legal platform in order to give providers additional time to acquaint themselves with the requirements in relation to behaviour support planning and to ensure that you were to grips with what was necessary, and indeed addressing that for yourselves,” Ms Anderson said.
Monitoring and reviewing is key
Dementia Australia CEO Maree McCabe said it was important providers monitored residents for adverse events and regularly reviewed their behaviour support plans.
“If PRN medication is given, for example, please check that it’s working. And please check for side effects, it’s really important that those things are picked up,” Ms McCabe told the webinar.
Ms Anderson said all behaviour support plan must be reviewed based on an individual’s changing needs.
“Regular doesn’t have a particular period attached to it. It must be based on the presenting issues of the individual, the consumer, and whether the plan is effective in the moment or whether it needs revision because it’s no longer effective in addressing the behaviours of concern,” Ms Anderson said.
Aged Care Quality and Safety Commission chief clinical advisor Dr Melanie Wroth said consent also needs ongoing review.
“You don’t consent once to a restrictive practice that’s then continued for years without any sort of review,” Dr Wroth told the webinar.
“If restrictive practices are needing to escalate or alternative strategies are stabilised and they’ve been found to work and they de-escalate, just because someone’s consented to it doesn’t mean you go on using [restrictive practices],” she said.
The Aged Care Quality and Safety Commission’s Restrictive practices – behaviour support planning webinar took place on 23 August.