Restraint laws restricting use “as a last resort” introduced to parliament

The first laws to implement the recommendations of Australia’s Royal Commission into Aged Care Quality and Safety have been introduced into parliament.

Welcomed by the aged care peak body, the amendments to the Aged Care Act will regulate chemical and physical restraints, introduce assurance reviews for home care services, and revise governance structures.

These changes precede a new Aged Care Act set to be introduced in 2023.

Health and Aged Care Minister Greg Hunt said Aged Care and Other Legislation Amendment (Royal Commission Response No. 1) Bill 2021 was the first step in the Australian Government’s five-year aged care reform plan.

He said increased controls on restraints were “a critical focus” to improved quality and safety across the industry.

“Addressing concerns raised by the Royal Commission and the independent review into restraint, our amendments will mean from 1 July, we will have clearly defined restrictive practices, which align with the definitions used in the disability sector,” he said in a statement.

“We are strengthening legislation to ensure that restrictive practices are only used as a last resort, the impact on the care recipient is considered, and consent arrangement is clear.”

In the coming months, the government will appoint a senior practitioner to the Aged Care Quality and Safety Commission to oversee an education campaign to minimise the use of chemical and physical restraints.

The Commission will also be tasked with running the independent review mechanism and penalties will be introduced for operators that breach the responsibilities regarding restraints.

In mid-2019, Quality of Care Principles was amended to limit the use of chemical and physical restraint to “a last resort”.

A 12-month review of the changes, released on New Year’s Eve 2020, found stakeholders “had mixed views on the extent to which the Restraints Principles have led to a reduction in physical and chemical restraint”.

“It is not possible to draw definitive conclusions about the effectiveness of the Restraints Principles at this time,” the report said.

“This is due to the limitations of the secondary data, lack of a benchmark for restraint use prior to the Restraints Principles, and the short timeframe since the Restraints Principles and related initiatives were introduced.”

It did find, however, that most providers were taking steps to reduce their use of the measures.

Under the new legal amendments introduced, there is also more oversight of home care delivery and administration.

The assurance reviews, operated through the Department of Health, will look into the use of home care subsidies and home care recipient charges, the nature of home care services, and provider dealings with home care recipients.

Operators will be required to provide information to the department when they receive “notices to give” or “notices to attend”.

“Failure to comply with these notices or provide reasonable assistance will incur civil penalties,” the bill said.

“Assurance reviews will inform the continuous improvement of home care policy and the education of approved providers in relation to home care and home care services.”

Leading Age Services Australia tweeted the implementation of the reform and the details will be important.


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