NDIS Restrictive Practices: Documentation and Authorisation Requirements

What constitutes a regulated restrictive practice

The National Disability Insurance Scheme Act 2013 (Cth) and the National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018 define "regulated restrictive practice" and establish the obligations that attach to its use. There are five categories of regulated restrictive practice under the NDIS framework. Each is defined by its mechanism — what it does to restrict the participant — not by its intent or the name given to it by the provider or worker.

Physical restraint is the use of physical force to prevent, restrict, or subdue a participant's movement of their body or part of their body. This includes holds and physical blocking. The definition is function-based: a practice that uses physical force to restrict movement is physical restraint regardless of whether it is described as a "calming hold", "therapeutic hold", or other euphemism. The Commission expects records to use the regulatory classification.

Chemical restraint is the use of medication or a chemical substance for the primary purpose of influencing a participant's behaviour. The definition is intent-based and is distinct from medication prescribed for a medical condition. A sedative prescribed by a psychiatrist to manage an anxiety disorder is not a chemical restraint. The same medication, or a different one, administered primarily to manage behavioural presentation rather than to treat a medical condition, is a chemical restraint. This distinction is one of the most contested areas in restrictive practices practice and requires careful documentation of the purpose for which each medication is administered.

Mechanical restraint is the use of a device to prevent, restrict, or subdue a participant's movement. This includes straps, harnesses, and other physical devices. Mechanical restraint is distinct from physical restraint in that it relies on a device rather than direct physical force.

Environmental restraint is restricting a participant's free access to all parts of their environment, including items or activities. Locking a door to prevent a participant from leaving a room, restricting access to food or personal belongings, or preventing access to outdoor spaces are examples. Environmental restraint is sometimes overlooked because it does not involve physical contact, but it is a fully regulated category with identical documentation and authorisation requirements.

Seclusion is the sole confinement of a participant in a room or physical space at any point in time. It requires that the participant be alone in the confined space. Seclusion is the most restrictive of the five categories and carries the most serious documentation and authorisation obligations.

These five categories are "regulated" because their use is subject to specific authorisation requirements under the NDIS framework and must be reported to the Commission. The use of any regulated restrictive practice without the required authorisation is a Priority 1 reportable incident under the NDIS (Incident Management and Reportable Incidents) Rules 2018. Providers should work with an NDIS-registered Specialist Behaviour Support Practitioner to determine whether a particular practice in their service meets the definition of a regulated restrictive practice — the definitions are functional, not nominal, and some practices that are described informally as safety measures may meet the regulatory definition.

Authorisation requirements

No regulated restrictive practice may be used unless it has been authorised through the relevant state or territory authorisation process. The authorisation pathway differs by jurisdiction: some states have established specific NDIS-aligned authorisation processes; others rely on existing guardianship or mental health legislation. Providers operating across multiple jurisdictions must maintain separate authorisation records for each jurisdiction's requirements. The Commission's expectation is that providers understand and comply with the applicable jurisdictional requirements — a failure to obtain the correct authorisation in the correct jurisdiction is not mitigated by having obtained authorisation elsewhere.

In addition to jurisdictional authorisation, every regulated restrictive practice must be documented in a Behaviour Support Plan (BSP) prepared by an NDIS-registered Specialist Behaviour Support Practitioner. The BSP must describe the specific practice, the circumstances in which it may be used, the less restrictive strategies that must be attempted first, the monitoring arrangements, and the reduction goals — the plan for reducing and ultimately eliminating the practice over time. A practice that is documented in the BSP but not yet authorised under the applicable jurisdictional process may not be used. Both conditions must be satisfied before use.

Where a BSP is being developed — for example, for a new participant — an interim restrictive practice arrangement may be put in place, subject to state or territory requirements. This interim arrangement must itself be documented, must specify which practice is authorised on an interim basis, and must record the interim nature of the arrangement clearly. An interim arrangement is not a licence for indefinite use pending a BSP — it has a defined period and must be followed up with the full BSP process.

Workers who deliver supports involving a regulated restrictive practice must be trained in the specific practice and its safe use. Training must be role-specific and practice-specific — generic behaviour support training does not satisfy the requirement for a worker who is implementing physical restraint under a BSP. Training records must document what training was provided, when, by whom, and in relation to which specific practice.

A provider cannot lawfully use a regulated restrictive practice unless all four conditions are simultaneously met: state or territory authorisation is in place; the practice is documented in a current BSP; the relevant workers are trained in the specific practice; and the practice is being used only in accordance with the BSP and the authorisation. Each of these conditions must be evidenced in the record. A provider that can demonstrate only two or three of the four conditions is not in compliance.

Contemporaneous documentation requirements

Every use of a regulated restrictive practice must be documented at the time of use, or as close to immediately after as is practicable given the circumstances. The contemporaneous record serves three functions: it evidences that the use was consistent with the BSP and the authorisation; it provides the factual foundation for the Commission's monthly reporting requirement; and it constitutes the primary evidentiary record if the use is subsequently investigated as a reportable incident.

The record must be specific in its identification of the practice type. Describing the practice as a "hold", a "redirect", a "safe space", or any other non-regulatory label does not satisfy the requirement. The Commission expects the record to use the regulatory classification — physical restraint, chemical restraint, mechanical restraint, environmental restraint, or seclusion — so that the reporting obligation can be properly assessed and the practice can be matched to the BSP.

Duration is a material element of every restrictive practice record. Without a documented start and end time, the Commission cannot assess proportionality — whether the practice was used for longer than the BSP contemplates or longer than the circumstances warranted. Duration also matters for monitoring: if a practice is being used for increasing periods over time, that trend should appear in the record and should trigger BSP review. A record that says a physical restraint was used but omits the duration of that restraint is incomplete.

NDIS Commission notification requirements

Registered providers who use regulated restrictive practices have an ongoing reporting obligation to the NDIS Quality and Safeguards Commission, separate from and in addition to any reportable incident obligations that may apply.

Providers must report the use of regulated restrictive practices to the Commission through the Provider Reporting Portal on a monthly basis, or as otherwise required by the Commission. The monthly report must document each use of a regulated restrictive practice during the reporting period — including the practice type, the participant, the date, and the duration. This reporting obligation requires that contemporaneous shift-level records are maintained with sufficient specificity to populate the monthly report accurately. A provider that cannot produce shift-level records to support its monthly report has a documentation failure at two levels: the underlying record and the regulatory return.

If the use of a regulated restrictive practice constitutes a Priority 1 reportable incident — specifically, if the practice was used without the required authorisation — the 24-hour notification obligation under the Incident Management Rules also applies, in addition to the monthly reporting obligation. These are parallel obligations, not alternatives. An unauthorised use must be notified within 24 hours and must also appear in the monthly restrictive practice report for the relevant period.

The Commission uses the monthly reports to monitor patterns of restrictive practice use across registered providers. A provider whose reports show increasing frequency or duration of use, or use that does not correspond to BSP parameters, can expect regulatory scrutiny and may be required to demonstrate that reduction goals in the BSP are being actively pursued. The monthly reports are also used to identify whether a provider's records are internally consistent — if the same participant appears in monthly RP reports but the participant's BSP does not document that practice, the Commission will investigate.

Documentation failure modes specific to restrictive practices

The NDIS Commission's audit and investigation experience identifies a set of recurring documentation failures in restrictive practices records that are distinct from general incident documentation failures. These failures are treated seriously because every regulatory failure in this area either constitutes or is adjacent to a Priority 1 reportable incident.

Using a regulated practice without BSP documentation. A practice that meets the regulatory definition of a regulated restrictive practice but is not documented in the participant's BSP is an unauthorised use — a Priority 1 reportable incident — regardless of whether the provider believed the practice was appropriate or safe. The BSP is not a formality; it is the legal instrument that authorises the practice.

Using non-regulatory labels in records. Describing a physical restraint as a "therapeutic hold" or an environmental restraint as "supervised time in the garden room" does not change the regulatory classification of the practice. The Commission expects records to use the regulatory terminology. Records that use euphemisms are treated as incomplete and, where the practice is not documented in the BSP, may constitute evidence of an attempt to conceal unauthorised use.

Omitting duration from the record. Duration is material to proportionality assessment and to the monthly reporting requirement. A record that documents that a physical restraint occurred but does not record how long it lasted cannot be used to populate the monthly report accurately and cannot support any assessment of whether the use was proportionate to the circumstances.

No documentation of the preceding behaviour or less restrictive strategies attempted. BSPs require that less restrictive strategies be attempted before a regulated practice is implemented. Without a record of the behaviour or circumstances that led to the use of the practice, and without a record of what alternatives were attempted, the Commission cannot assess whether the practice was used within the parameters the BSP sets. A bare record of use — without context — does not satisfy the requirement.

Chemical restraint recorded as medication administration. A medication administered for the primary purpose of influencing behaviour, where that purpose is not reflected in the record, creates a documentation failure that is also potentially a fraudulent record — because the record asserts the medication was given for a clinical purpose when it was not. This failure is common where a registered nurse or worker administers a medication that is technically prescribed for a medical condition but is being used as a behavioural strategy. The distinction must be documented, the BSP must address it, and the practice must be authorised as a chemical restraint.

No follow-up record showing BSP practitioner notification. Where a use of a regulated practice occurs — particularly one that involves escalation, is outside the normal parameters, or involves a new triggering behaviour — the BSP practitioner must be notified. This notification and any response must be documented in the record. The absence of a follow-up record showing practitioner engagement suggests the monitoring obligations of the BSP are not being met.