AUTHORISATION (RPA) IN NSW NDS FORUMS April/May 2019 1 Recap 2 - - PowerPoint PPT Presentation

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Family & Community Services

RESTRICTIVE PRACTICE AUTHORISATION (RPA) IN NSW

NDS FORUMS April/May 2019

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Recap

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Restrictive Practice Authorisation in NSW

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States and Territories, including NSW, are responsible for managing the authorisation of regulated restrictive practices. NSW has an interim policy for authorising regulated restrictive practices. It started on 1 July 2018 with the full-scheme NDIS. The interim policy will end on 30 June 2020. NSW Government will design how NSW will authorise regulated restrictive practices from 1 July 2020.

Regulated Restrictive Practices

In NSW, there are three requirements for the use of a regulated restrictive practice:  1. A Behaviour support plan is developed, and  2. Informed consent is obtained by the participant or their guardian, and  3. Authorisation is approved by a restrictive practice authorisation panel (RPA Panel) managed through internal policy and procedures of the registered NDIS provider. Restrictive Practices should be:  Person centred  Least restrictive response  Used for the shortest possible time  Focused on the reduction & elimination of the practice  Monitored  Reviewed regularly.

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Restrictive Practice Authorisation

Restrictive Practice Authorisation (RPA) serves to:  appraise the need, risk, applicability and outcome of a regulated restrictive practice for a person with disability with reference to the person’s needs, quality of life and living context  enable the use of regulated restrictive practices as a component of a documented behaviour support plan  ensure that people who receive a behaviour support service are protected from exploitation, abuse, neglect, and unlawful and degrading treatment  ensure that consent is in place for any recommendation for the use of a regulated restrictive practice  consider the appropriateness of a documented support plan or strategy  ensure the appropriate documentation is available and contains information that is sufficiently evidence based to justify the strategies being requested, and  ensure the timely reduction and cessation of regulated restrictive practices.

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Authorisation requirements

 Requests for RPA must be submitted via the NSW (FACS) RPA System by the NDIS Provider or Behaviour Support Practitioner  All registered NDIS Providers must have an RPA mechanism that comprises a properly constituted RPA Panel which meets membership requirements  Membership will comprise as a minimum, a senior manager of the NDIS Provider and a specialist who is independent of the service provider and the person. Additional panel members may be included according to an individual provider’s preference  The senior manager of the NDIS Provider is to be the chair of the RPA Panel. No member of the RPA Panel can also bring forward an application for the RPA Panel’s consideration  The NSW government has established a pool of Restrictive Practices Authorisation Independent Specialists to ensure that registered NDIS Providers have access to appropriately qualified behaviour support practitioners to support the operation of provider RPA Panels  The RPA Panel considers the appropriateness of a documented behaviour support plan and evaluates the recommendations in the context of the NDIS Provider’s

• perations, as well as the appropriateness of the strategy to achieve the intended

therapeutic outcomes  The RPA Panel’s decision to authorise a regulated restrictive practice is to be

• unanimous. On making its determination the RPA Panel specifies the length of time for

which the authorisation applies, not exceeding 12 months  Decisions of the RPA Panel are recorded in a formal Outcomes Summary in the NSW (FACS) RPA System.

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The good news

engagement is increasing

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Rich data -

distribution

• f

regulated restrictive practices

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About –

Planned vs Interim

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Independent Specialists

Regional Metro All Panel meetings 401 431 Panel meeting with FACS IS 129 128

401 Regional, 129 431 Metro, 128

RPA Panel Meetings

All panel meetings Panel meeting with FACS IS

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Sentiment analysis

Main Themes:

• Definitions and policy are clear
• RPA system and dashboard
• Self assessment tool and

guidance documents

• Support from the Central

Restrictive Practices Team

• Access to Independent

Specialists

• ‘Amazing panels’, ‘great

behaviour support practitioners’

• Well managed Panels

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Main Themes:

• Limited funding in NDIS plans to

create and update BSP’s, and to participate in the RPA process

• Thin behaviour support market
• Chemical restraint, specifically

PRN and its use for behaviours

• f concern/mental health
• Support planners stating that

funds can not be allocated for restrictive practice related needs

• High volume of unauthorised

restrictive practices

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themes – questions

13.6% 6.5% 5.8% 5.2% 4.5% 4.2% 3.9% 3.2% 2.6% 1.9% 1.9% 1.6% 1.6% 1.6% 1.3% 1.3% 1.3% 1.3% 1.3% Chemical Restraint System Policy Non purposeful risk Scope of requirements Transition timeframes Consent Definitions - clarity in practice Reporting requirements Definitions Policy - clarity in practice Chemical restraint - clarity in practice Environmental Restraint Mechanical Restraint Independent Specialists Interim practices Panel Reportable Incidents Resources

Enabling access to the RPA System

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Why is engagement important?

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Comply with NSW Government policy and RPA requirements.

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Submit requests for authorisation through the FACS RPA System.

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Manage information

• n RPA in one single

accessible location.

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Decisions are recorded and reduction and elimination can be evidenced.

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What FACS is doing to support the sector

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Work with the Q&S Commission on known issues Refine the FACS RPA System based on user feedback Develop key resources to support policy and improve practice Assess risks and work collaboratively with providers to address the issue/s Communicate in an open, engaging way and be responsive to questions and concerns

Clarification Points

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What is a review of a RPA

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• A review of an RPA is required when a RPA Panel decides to monitor the

progress of the implementation and/or the enacting of their

• recommendations. The review of a submission can occur at any time within

the authorisation period, once or according to a schedule of multiple

• reviews. While often requested by an RPA Panel, it can also be requested

by those implementing the practice.

• The review process ensures that the recommendations made by RPA

Panels are being progressed by NDIS Providers as a part of their commitment to the reduction and elimination of regulated restrictive

• practices. It also provides the opportunity for NDIS Providers to provide

feedback to the RPA Panel in regards to any constraints they are facing or any improvements gained by enacting these recommendations.

• It is important to remember that a review is not a re-authorisation, or

renewal of authorisation which is about to expire. As such, the date of review and the date of expiry should not be the same. These dates should also not occur within a short time frame of each other. When setting a review date, consideration to the expiry of the authorisation should be given to allow time for NDIS Providers to action recommendations and collect data, and to avoid the duplication of information when submitting for re-authorisation.

What is Re- authorisation

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• Re-authorisation is required where the person has an existing regulated

restrictive practice in place which is authorised, however it is due to expire or has expired.

• When seeking a re-authorisation for an existing regulated restrictive practice

within the NSW (FACS) RPA System, a new RPA Submission must be

• created. This ensures that information and documents supporting

submissions for re-authorisation are updated on at least an annual basis. This is in line with the NDIS Restrictive Practices and Behaviour Support Rules 2018 requirement of behaviour support plans being reviewed every 12 months.

• When a new RPA submission is created, the form will pre-populate with all

historical submissions that have been completed within the NSW (FACS) RPA System. NDIS Providers and the RPA Panel can refer to this when completing new submissions.

• If a regulated restrictive practice is being implemented where the

authorisation has expired, it is considered to be a reportable incident and providers are obliged to notify the NDIS Commission’s Reportable Incident Team.

Activity

19 Activity – Scenario (hand out 1) Consider this example within your service setting As a provider you have been supporting Jimmy to meet a few goals identified within his NDIS funded support plan. In recent weeks you have noticed Jimmy become increasingly unsettled and at times very irritated, he has recently begun mumbling under his breath and being heavy handed with things such as slamming things down on benches, slamming doors and telling staff he hates them, swearing and throwing nearby items at anyone else in the room. Last week he hit someone on the head with a coffee cup, the person required stitches. The reason for his shift in mood isn’t clear, but you know an appointment has been made with his GP. Yesterday, shortly after you arrived at work you learnt that Jimmy was prescribed Valium 5mg by his GP to be taken when he shows signs of becoming distressed or

• angry. At the end of the day Jimmy was becoming distressed and telling those around

him to leave “or else”, he was stomping and slamming doors as he moved from one room to the next. It was clear that the situation fits the description given by his GP for the administration

• f the 5 mg of Valium so your colleague gives it to him.

Jimmy currently does not have a behaviour support plan or funding for behaviour support as part of his NDIS support plan. Question: What does this situation mean for your service according to the expectations laid out by the NDIS Restrictive Practices and Behaviour Support Rules and the NSW Government RPA Policy?

More information & contact details

For more information visit: Webpage:  https://www.facs.nsw.gov.au/providers/deliver-disability- services/restrictive-practices-authorisation-portal Email:  RestrictivePracticesAuthorisation@facs.nsw.gov.au

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