Victorian Senior Practitioner

Physical restraint: what is it and what do we have to do?Plain English

Physical restraint: what is it and what do we have to do? 1

Front cover: detail from painting by Joanne Page.

To receive this publication in an accessible format phone 9096 8427, using the National Relay Service 13 36 77 if required, or email the Victorian Senior Practitioner <victorianseniorpractitioner@dhhs.vic.gov.au>.

Authorised and published by the Victorian Government, 1 Treasury Place, Melbourne.

© State of Victoria, Department of Health and Human Services, September 2019

ISBN 978-1-76069-007-6 (pdf/online/MS word)

Available at the Victorian Senior Practitioner website <https://www.dhhs.vic.gov.au/victorian-senior-practitioner>.

(1909507)

2 Physical restraint: what is it and what do we have to do?

Contents

What is this report about?.........................................................4

What is physical restraint?........................................................5Helping touch................................................................................5

Physical restraint...........................................................................6

Stopping physical restraint........................................................7Rule 1............................................................................................7

Rule 2............................................................................................7

When can disability services use physical restraint?.............8Emergencies.................................................................................8

When there is permission.............................................................8

What happens every time physical restraint is used?..........10

How can I find out more about physical restraint and what services must do?...........................................................11

Physical restraint: what is it and what do we have to do? 3

What is this report about?

This report is about physical restraint. We will tell you what physical restraint means. The report is about physical restraint and people with disabilities living in Victoria. It is about what every disability service has to do if they use physical restraint.

The Senior Practitioner has written this report because he looks at all restraint used with people with disabilities in Victoria. The Senior Practitioner has a special job to do under the law. All disability services have to follow the law. The Senior Practitioner wants to stop all types of restraint.

4 Physical restraint: what is it and what do we have to do?

What is physical restraint?

Disability support workers sometimes touch people with disabilities. There are lots of different types of touch. Some types of touch are physical restraint, and some are not.

Helping touchOne type of touch is helping touch. This is touch used to help a person do something that they are happy to do. We call this physical assistance or physical guidance. It is not physical restraint. Helping touch can include:

Touch to help with dressing, cleaning or eating (e.g., helping someone to shave)

Touch to help someone learn (e.g., teaching someone to cut fruit)

Touch for therapy (e.g., helping someone in a swimming pool or stretching)

Touch for safety (e.g., stopping someone from running onto the road)

Touch for duty of care (e.g., stopping someone from hurting themselves).

Physical restraint: what is it and what do we have to do?

Physical restraintAnother type of touch is restraint touch. This is touch to stop a person from doing something. It can involve strong or hard touch that a person with a disability is not happy with. We call this physical restraint. Physical restraint can include:

Holding somebody’s hands behind their back so they can’t reach out

Holding somebody on the floor so they can’t get up Holding somebody in a headlock so they can’t move.

Using physical restraint can hurt people. It can hurt their body making bruises, sore bodies, and sometimes physical restraint has broken bones. Physical restraint can hurt a person’s emotions: they can feel scared or feel more angry.

Physical restraint can hurt disability support workers too.

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Stopping physical restraint

The Office of the Senior Practitioner wants to stop physical restraint happening to people with disabilities in a way that is safe for everyone. This is going to take some time.

We have written some rules for all disability services. The rules will:

Let us know how much physical restraint is being used in disability services

Give services new ideas so they don’t have to use physical restraint anymore

Make sure that if physical restraint does happen it is as safe as possible for everyone.

Rule 1Disability services are never allowed to use some types of physical restraint. They have to stop using them by 2012.

These types include:

Forcing people to lie on their tummy Forcing people to lie on their back Holding people in a bear hug to stop them moving Making people fall on the ground Squashing a person’s breathing or stomach Stretching a person’s body so it hurts.

Rule 2 Disability services are only allowed to use physical restraint if

the Senior Practitioner says yes. They have to ask for permission.

Physical restraint: what is it and what do we have to do?

When can disability services use physical restraint?

There are only two times when disability services can use physical restraint. These times are:

In a serious emergency to keep a person safe, or When the service has permission from the Senior

Practitioner.

EmergenciesEmergencies are when people might get seriously hurt if somebody doesn’t stop the person.

Some emergencies are surprises – the person might do something dangerous that they have never done before.

Some emergencies are a little bit expected. The person with a disability might have done the dangerous thing a few times before. The disability service might have thought about the best way to respond. They might have written a planned emergency response.

When there is permissionPhysical restraint may be used if the Senior Practitioner has said it is okay. The Senior Practitioner can only say okay to planned emergency responses.

All disability services have to ask for special permission for every person that is going to be physically restrained. Permission only lasts for one year, then services have to ask for new permission.

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The Senior Practitioner will only say physical restraint is okay if:

Services have talked to the person’s doctor and other health professionals – they have thought about how to use restraint as safely as possible

Services show that they have thought about and tried other safer ways to respond to behaviour

Services have done a full assessment of the person and their behaviour

Services have been following a Behaviour Support Plan for some time

The person still has behaviours of concern, even though a Behaviour Support Plan is used

Services have thought about how to keep somebody safe while they are restrained and after they are restrained

Services have clear rules about finishing restraint (e.g., they will stop restraint if the person has trouble breathing).

All services need to think about how they are going to stop using restraint in the future.

Physical restraint: what is it and what do we have to do?

What happens every time physical restraint is used?

Services need to write down every time they use physical restraint. Services should look at the number of times they use restraint. They need to ask, “can we do something different so we don’t need to use physical restraint?”

Disability services need to let the Senior Practitioner know every time they use physical restraint. They must start doing this in 2011.

In 2012, services need to fill out forms for asking permission to use physical restraint.

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How can I find out more about physical restraint and what services must do?

There is more information about Physical Restraint in the full report: Physical Restraint Direction Paper.

If you have any questions you can talk to people at the Office of the Victorian Senior Practitioner on 9096 8427.

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