How do I capture consent, authorisation and reporting for restrictive practices in the home?

• Restrictive practices are chemical restraint, environmental restraint, mechanical restraint, physical restraint and seclusion (Aged Care Rules 2025 s 17-5).
• In a home or community setting, any use of a restrictive practice is a reportable incident unless the conditions in Rules 16-15 are met: the circumstances (including behaviours of concern) and manner (duration, frequency and intended outcome) were set out in the care and services plan beforehand, it was used as the plan says, and the use was documented as soon as practicable.
• Document risks, alternatives considered and the clinical reasons for the care approach. In residential care, the section 162 condition specifically requires documented alternatives and behaviour-support safeguards; in-home teams must check the rules relevant to their services.
• Keep relevant home-care plans and clinical records available when assessing any restrictive-practice concern. Apply the current SIRS definitions and exclusions to the circumstances rather than using residential-only conditions as an in-home exemption.
• Monitor the person’s wellbeing and any adverse effects. Review the care plan when needs, risks or incidents change and follow the applicable clinical and consent requirements.
• Reporting to the ACQSC is required in specified circumstances, including where the practice is used inappropriately or triggers a SIRS reportable incident.

Reference: Aged Care Act 2024 s 162 (restrictive practices) and Chapter 3, Part 4 (Provider conditions); Aged Care Rules 2025 (restrictive practices provisions); ACQSC published guidance on restrictive practices; behaviour support plan guidance from the Department of Health. (Historical: Quality of Care Principles 2014 was the pre-1 November 2025 framework.)

• Consent captured once and never refreshed. Consent for restrictive practice is not 'set and forget' — it needs to be reviewed as the participant's condition changes and as the least-restrictive alternatives are reconsidered.
• Carers don't recognise environmental or chemical restraint when they see it. A participant with a key on the outside of their bedroom door, or PRN medication used to manage behaviour, is restrictive practice whether or not anyone labels it as such.
• Applicable consent or decision-making authority under state or territory law is not checked or recorded. A registered supporter is not automatically a substitute decision-maker; unresolved authority requires appropriate clinical and legal review.
• No link between the restrictive practice and the care and services plan it's intended to manage. The practice exists in isolation, with no clinical reasoning on file.
• Least-restrictive alternatives 'considered' as a checkbox but not genuinely assessed — the assessment is a sentence, the decision is a conclusion, and no alternatives are documented.
• Ongoing monitoring treated as administrative rather than clinical — the frequency is logged but there's no review of whether the practice is still necessary or whether it's producing adverse effects.

• Restrictive practice register per participant, with each practice categorised (physical, environmental, chemical, mechanical, seclusion) and linked to the authorising document (consent, applicable decision-making authority, care and services plan).
• Consent and authorisation capture workflow with document attachment, effective dates, and refresh prompts before consent expires or is due for review.
• Least-restrictive alternatives assessment workflow — operators document the alternatives considered, the clinical reasoning for rejecting them, and the multidisciplinary input that informed the decision.
• Care and services plan linkage — the restrictive-practice register links the plan and documentation so use can be reviewed against the recorded circumstances and manner.
• Monitoring schedule with clinical review prompts at the frequency specified by the care and services plan or clinical lead.
• ACQSC notification preparation for incidents involving inappropriate use of a restrictive practice — the notification is pre-populated from the register entry and the incident record.
• Chemical restraint cross-reference with the medication record — PRN psychotropic medication prescribed to manage behaviour is flagged against the restrictive practice register so the review can consider dose, frequency, and clinical outcome.

Use these records to structure your evidence review. In your demonstration, check their history, attribution and export options against your organisation's requirements:

• Restrictive practice register per participant — practice type, start date, authorising document, clinical rationale, and link to care and services plan.
• Consent history with the document captured, the person who provided the consent or authorisation, the relationship to the participant if SDM, and effective and review dates.
• Least-restrictive alternatives assessments showing the alternatives considered, the rejection rationale, and the multidisciplinary contributors.
• Monitoring log — frequency of use, observed effects, clinical review notes, and the decision to continue, modify or cease the practice.
• Review history showing every formal review, the participants of the review, and the outcome.
• ACQSC notification log where a notification was triggered, with the submitted content and acknowledgement.