Restrictive Practices in Aged Care: Compliance Guide

Restrictive practices affect a person's rights, freedom and safety. In residential aged care, their use is subject to specific safeguards, clinical assessment, consent and behaviour support requirements. A completed register entry does not make a practice lawful.

This guide separates residential requirements from the home and community SIRS reporting exception. It is a starting point for reviewing your procedures with the responsible clinical and governance leads, using the Aged Care Rules 2025 and the law of your state or territory.

Rule 17-5 defines five types. Classification depends on the purpose and circumstances, not just the device or medicine involved.

• Chemical restraint: medication or a chemical substance used primarily to influence behaviour. The definition excludes medication prescribed to treat, or enable treatment of, a diagnosed mental disorder, physical illness or physical condition, and medication prescribed for end-of-life care.
• Environmental restraint: restricting access to the person's environment, including items or activities, primarily to influence behaviour.
• Mechanical restraint: using a device to prevent, restrict or subdue movement primarily to influence behaviour. Devices used for therapeutic or non-behavioural purposes are excluded.
• Physical restraint: physical force used to prevent, restrict or subdue bodily movement primarily to influence behaviour. The Rules exclude a reasonable, reflexive hands-on action to guide someone away from potential harm.
• Seclusion: keeping a person alone in a room or physical space primarily to influence behaviour, when voluntary exit is prevented, not facilitated, or understood to be prohibited. A locked door is not the only way seclusion can occur.

Rules 162-15 to 162-25 set out the residential requirements, with specific emergency exceptions discussed below. The usual requirements include last-resort use to prevent harm, consideration of the likely impact, alternative strategies and documentation, proportionality, the least restrictive form and the shortest necessary duration. Use must also meet the relevant consent, behaviour support plan, rights, quality, conduct and state or territory requirements.

For a practice other than chemical restraint, an approved health practitioner with day-to-day knowledge of the person must assess the risk of harm and necessity. For chemical restraint, the provider must be satisfied that a medical practitioner or nurse practitioner has made the required assessments, prescribed the medication for that purpose and obtained the required informed consent. A medication entry alone is not evidence that these steps occurred.

The person gives informed consent if they have capacity for the decision. If they lack that capacity, identify the restrictive practices substitute decision-maker authorised for the proposed practice. A family relationship, general contact role or software permission does not by itself establish that authority.

Rule 6-20 gives priority to the applicable state or territory appointment. Its Commonwealth hierarchy applies only in the specified circumstances: no relevant appointee and either no clear appointment mechanism or a significant delay in deciding an application. Record the basis of authority and the required written agreements.

Consent must cover the proposed use, including duration, frequency and intended outcome. A general statement that restraint is in someone's best interests does not replace consent. The Department's consent frequently asked questions explains why blanket consent is inadequate and why refusal cannot be bypassed by approaching someone lower in the hierarchy.

The Rules contain specified exceptions while an emergency makes use necessary. They do not suspend every safeguard or authorise ongoing use after the emergency ends. Proportionality, the least restrictive form and shortest necessary time, monitoring, and the applicable state or territory requirements still matter.

Under rule 162-35, as soon as practicable after use starts, inform the restrictive practices substitute decision-maker if the person lacked capacity and document the required circumstances, alternatives, reasons, care and assessments in the behaviour support plan. Chemical restraint has additional practitioner and prescription requirements. Record what happened promptly, then complete the required follow-up; do not turn an incomplete emergency record into an approval for future use.

A behaviour support plan should explain the person, their preferences and needs, behaviours of concern, relevant assessments, possible triggers, alternatives considered or used, and the results of those strategies. Rules 162-45 to 162-75 specify the required content, consultation and review.

Where restrictive practice is assessed as necessary or used, document the additional assessments, decisions, consent and use details required for that situation. Monitor distress, adverse effects, wellbeing and function, as well as whether the practice remains necessary and effective.

Review and revise the plan regularly and as soon as practicable after a change in the person's circumstances. Rule 162-70 does not prescribe a universal quarterly review interval. Set a review approach that responds to the person's needs and the applicable clinical requirements.

Assess suspected inappropriate use through your incident management process. For residential services, check the restrictive-practice safeguards and applicable reportable-incident rules rather than assuming that a signed plan or consent form settles reportability.

For home or community services, rule 16-15 provides a specific reporting exception. Before use, the care and services plan must set out the relevant circumstances and the manner of use, including duration, frequency and intended outcome. Actual use must follow those provisions, and its details must be documented as soon as practicable afterwards. This reporting exception is not a general legal authorisation to restrain someone.

For a reportable incident, assess the priority criteria. Priority 1 requires notification within 24 hours of provider awareness; Priority 2 within 30 days. An allegation of inappropriate restraint does not by itself determine the priority. Harm requiring medical or psychological treatment, reasonable grounds for police reporting and any other applicable Priority 1 category must be considered. See the SIRS reporting guide.

Your team should be able to locate the assessment, authority and consent basis, plan version, alternatives, circumstances and timing of use, people involved, monitoring, outcomes and follow-up decisions. Keep incident reporting decisions and any external notification acknowledgement with the relevant evidence.

Use review meetings to identify missing records, overdue actions and opportunities to reduce restrictive practice. A populated register supports this work; it does not independently demonstrate that care was appropriate or that every obligation was met.

Statura provides a restrictive-practices register, consent and decision-maker fields, behaviour support plan links and review records. The recording workflow includes an emergency-use route so staff can capture the event and identify outstanding governance follow-up. Recording use is distinct from authorising it.

Behaviour support plans include behaviour descriptions, triggers, prevention and response strategies, de-escalation strategies, whether the person or representative was consulted, and review dates. Your team remains responsible for clinical assessment, lawful consent, reportability decisions and external notification.

In a demonstration, ask to follow a synthetic example from the initial record through consent evidence, the linked plan and a subsequent review. Check how incomplete emergency records are distinguished from authorised ongoing use and how an incident reporting decision is documented. Explore the incident and compliance workflows.