Behaviour Support and Restrictive Practices: What the Rules Require

Behaviour support and restrictive practices: what the rules actually require

If a provider locks the kitchen because someone with a brain injury eats compulsively, that is a restrictive practice. It is regulated. It requires a behaviour support plan written by a registered practitioner, it requires authorisation under state law, it has to be reported to the NDIS Commission monthly, and it must have a plan to eliminate it.

A great many providers do not know this. Some that do know it do it anyway and do not report.

This guide sets out what the rules actually require, because families supporting someone with a brain injury are often the only people in the room who will check — and because behaviour support done properly is one of the more effective interventions available, while behaviour support done badly is a plan in a drawer and a locked door.

The clinical side — why behaviour changes after a brain injury and what reduces it — is covered in insight and behaviour after brain injury.

The five regulated restrictive practices

Under the NDIS rules, a restrictive practice is any practice or intervention that has the effect of restricting the rights or freedom of movement of a person with disability. Five categories are regulated, which triggers the whole compliance framework. From the NDIS Commission’s behaviour support guidance:

Seclusion — confining a person alone in a room or space where they cannot, or believe they cannot, leave voluntarily. Note the second limb: a door that is not locked but that the person believes they may not open is still seclusion.

Chemical restraint — using medication or another substance for the primary purpose of influencing behaviour. Medication prescribed to treat a diagnosed condition, including a diagnosed mental health condition, is excluded. The distinction turns on purpose, not on the drug.

Mechanical restraint — a device used to restrict movement for the primary purpose of influencing behaviour. Devices used for therapeutic or non-behavioural purposes, such as postural supports or a seatbelt used for safety as intended, are excluded.

Physical restraint — using physical force to restrict movement of all or part of the body, for the primary purpose of influencing behaviour. Brief hands-on guidance away from immediate danger is excluded.

Environmental restraint — restricting a person’s free access to parts of their environment, including items or activities.

Environmental restraint is the one providers most often use without recognising it. Locked kitchens, locked fridges, locked cupboards, locked gardens, a phone kept at the office, car keys held, cigarettes rationed, a TV remote controlled by staff, internet restricted. All of it is regulated restrictive practice if it is being done to influence behaviour.

That does not mean any of it is forbidden. It means it is regulated, and the difference matters: a locked kitchen with a plan, authorisation, reporting and a reduction strategy is lawful. The same locked kitchen without those things is not.

When a restrictive practice is permitted

A regulated restrictive practice may only be used where it:

• Reduces the risk of harm to the person or others
• Is the least restrictive option that would be effective
• Is used as a last resort, after other strategies have been tried
• Is proportionate to the potential negative consequence or risk
• Is used for the shortest possible time
• Is set out in a behaviour support plan lodged with the Commission
• Is authorised in accordance with the relevant state or territory requirements

All seven, not a selection.

Who can write a behaviour support plan

This trips up families and providers alike.

A behaviour support plan containing a regulated restrictive practice must be written by an NDIS behaviour support practitioner — someone the Commissioner considers suitable to conduct behaviour support assessments and develop such plans. Suitability involves a self-assessment against the Positive Behaviour Support Capability Framework, then an application to the Commission.

The practitioner must be engaged by a specialist behaviour support provider registered for registration group 110. A provider can only write plans itself if it is an NDIS behaviour support practitioner.

So: your regular support provider generally cannot write the plan. A separate, specifically registered provider does that, and your support provider is the implementing provider who delivers it.

This is worth checking rather than assuming. Ask to see the practitioner’s status and the provider’s registration group.

What the plan must contain

A behaviour support plan is built on a behaviour support assessment, which for a comprehensive plan includes a functional behaviour assessment — work to understand what the behaviour achieves for the person, because behaviour almost always has a function.

The plan must:

• Identify each restrictive practice in detail, and set out how it will be reduced and eventually eliminated
• Include monitoring and review arrangements
• Use evidence-based, person-centred, proactive strategies addressing the person’s needs and the function of the behaviour
• Be developed in consultation with the participant, their family and carers, the implementing provider, and any guardian or support person

That first point deserves emphasis. The purpose of the framework is reduction and elimination, not indefinite authorisation. A plan that has contained the same locked door for four years with no reduction strategy is not complying with the framework, whatever has been lodged.

The consultation requirement also matters. Families are entitled to be involved in developing the plan, and a plan produced without consulting the person and the people who know them is both poor practice and non-compliant.

The timeframes

Specific, and worth knowing because they are commonly missed:

Providers using routine chemical, environmental or mechanical restraint may be able to report weekly rather than per incident.

Authorisation: the state layer

A point of confusion worth clearing up.

The NDIS Commission does not authorise restrictive practices. Each state and territory does, through its own authorisation process, and those processes differ considerably. Implementing providers must obtain authorisation under the relevant local requirements and lodge evidence of it with the Commission.

Where a state or territory has no authorisation process, the practice still must be included in the behaviour support plan and the plan still must be lodged.

So there are two separate obligations — state authorisation, and lodgement with the Commission — and satisfying one does not satisfy the other.

Unauthorised use is a reportable incident

This is the part that gives the framework teeth.

Using a regulated restrictive practice without authorisation, or without a behaviour support plan in place, is a reportable incident under the Reportable Incidents Rules. It must be notified to the NDIS Commission within 5 business days.

Implementing providers must be registered for the supports they deliver, though they do not need registration group 110 themselves. They must also take all reasonable steps to assist in the development of a behaviour support plan.

What this means in practice for a family: if a provider is locking a door, holding medication to settle someone, or restricting access to food or possessions, and there is no behaviour support plan, that is not a grey area. It is a reportable incident, and the provider has an obligation to report it against themselves.

What families should actually ask

A checklist, in the order worth asking.

Is any restrictive practice being used? Ask it directly and broadly — locked doors or cupboards, restricted access to food, drink, the garden, a phone, cigarettes, money or possessions; any medication given to manage behaviour; any physical holding; any room the person is kept in.

Is there a behaviour support plan, and may we see it? You are entitled to it.

Who wrote it, and are they a registered NDIS behaviour support practitioner with a provider registered in group 110?

Is it an interim plan or a comprehensive one, and when is the comprehensive plan due?

Has the practice been authorised under state requirements, and may we see the authorisation?

What is the reduction and elimination strategy, and what is the timeline? This is the question that most often produces a silence.

When was the plan last reviewed? It must be at least annually.

How are staff trained in it, and how do you know they are following it? A plan nobody has read is not a plan.

What proactive strategies does it contain? If the document is mostly about what to do during an incident and contains little about preventing one, it is not a positive behaviour support plan.

Were we consulted? If not, that is a compliance failure as well as a courtesy failure.

If the answers do not satisfy you, the regulator to contact is the NDIS Quality and Safeguards Commission, on 1800 035 544. A complaint can come from anybody at all, and it can be made without giving your name.

What good looks like for a brain injury

Behaviour support frameworks were largely developed for intellectual disability and autism, and ABI has features that need accounting for. A good plan for someone with a brain injury will:

Address fatigue explicitly, since it is the dominant trigger, and build the day around the person’s capacity rather than the roster’s convenience.

Account for memory impairment. Strategies that rely on the person recalling an agreement will fail. Prompts, written cues and environmental structure work; consequence-based approaches generally do not.

Account for impaired insight, rather than being built on the person’s agreement with the plan.

Specify consistency between workers in concrete terms — the same order, the same words, the same response — because inconsistency is itself a trigger.

Include a medical exclusion step: check pain, constipation, infection, sleep and medication before treating escalating behaviour as behavioural.

Preserve dignity of risk. The framework exists to reduce restriction, not to produce a maximally controlled life. A plan that has eliminated all risk has usually eliminated most of the person’s autonomy with it.

Name the triggers specifically, from actual incident records rather than generic categories.

And one thing that is not in the rules and matters anyway: a behaviour support plan for someone with an ABI should be written in the knowledge that this person had a different life until recently, and that a great deal of what presents as behaviour is grief, frustration and loss of control expressing itself through a damaged regulatory system.

If a provider says they cannot support someone

A situation families with brain injury encounter more than most, and worth knowing how to handle.

Providers do withdraw. Sometimes legitimately — a service genuinely cannot manage a risk, or the arrangement is unsafe for other residents or for workers. Sometimes not: a provider has not trained its staff, has no behaviour support plan, and has decided the person is too difficult.

The obligations are not nothing. A registered provider must:

Give reasonable notice and not leave a person without support. Service agreements generally specify notice periods, and abrupt withdrawal that leaves someone unsupported may be a reportable matter.

Cooperate with transition to another provider, including handing over information.

Take all reasonable steps to assist in developing a behaviour support plan — which means a provider cannot rely on the absence of a plan it did nothing to obtain.

Not use unauthorised restrictive practices as an alternative to supporting someone properly.

What to do:

Ask why, in writing, and ask specifically what training staff received, whether a behaviour support practitioner was engaged, and what strategies were tried.

Contact your support coordinator immediately, and the NDIA if there is a risk of being left without support.

Request an urgent plan reassessment if the funded supports do not match the actual need — a frequent underlying cause, where a plan funds generic support work for someone who needs specialist ABI support and behaviour support.

Complain where it is warranted. Complaints about a registered provider go to the Commission on 1800 035 544.

And the uncomfortable truth worth stating: people with brain injury and behaviours of concern are among the hardest to place in Australian disability services, and a plan that funds ordinary support work at ordinary rates will not attract a provider capable of doing it well. Getting the funding right is often the real solution to a placement problem.

A note on what this framework is for

It is easy to read the compliance requirements as bureaucracy, and worth remembering why they exist.

Before the NDIS Quality and Safeguards Commission, restrictive practices in Australian disability services were largely invisible. People were locked in, sedated, restrained and secluded, for years, with no plan, no authorisation, no reporting and no requirement that anybody ever try to stop. The Disability Royal Commission documented a great deal of it.

The framework is designed to make three things true: that restriction is visible, that it is temporary, and that somebody is accountable for reducing it.

Which means the most important element is not the paperwork. It is the reduction and elimination strategy — the requirement that every restrictive practice has a documented plan to end it, and that progress is reviewed at least annually.

For a family, that reframes the conversation. The question is not “has the provider filled in the form.” It is “what is being done so that this door does not need to be locked in twelve months’ time, and what has changed since last year.” A provider that can answer that is doing behaviour support. A provider that cannot is doing containment with a lodged document.

And for anybody supporting a person with a brain injury, there is a particular reason to hold that line. Restriction is unusually easy to justify here: impaired insight means the person cannot consent meaningfully, impaired memory means they will not remember objecting, and genuine risk means there is always a reason. Those three things together make it very easy for a restricted life to become permanent by default. The framework exists precisely to prevent that, and it only works if somebody is asking the questions.