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Is the use of a seat belt a Restrictive Practice?

The Aged Care Quality and Safety Commission has provided clarification on whether the use of a seat belt on a motorised wheelchair for the purpose of protecting a resident’s safety is a restrictive practice.


24 Nov 2021

The The Aged Care Quality and Safety Commission has provided the following clarification on whether the use of a seat belt on a motorised wheelchair for the purpose of protecting a resident’s safety is a restrictive practice.

The approved provider will need to determine the primary purpose and scope for the use of the seatbelt. Section 15E(4) of the Quality of Care Principles (the Principles) define mechanical restraint as a practice or intervention that is, or that involves, the use of a device to prevent, restrict or subdue a care recipient’s or movement for the primary purpose of influencing the care recipient’s behaviour, but does not include the use of a device for therapeutic or non‑behavioural purposes in relation to the care recipient.

If the use of the seatbelt is for a resident’s safety and/or is a legal requirement to operate the chair, rather than to influence their behaviour, this is not a form of restrictive practice. The practice of using the seatbelt, and the reason for doing so, should be reflected in the consumer’s care plan.

If the seatbelt is used for the primary purpose of influencing the resident’s behaviour, this is a form of restrictive practice, and all associated requirements relating to restrictive practices apply. These requirements are set out in section 15FA of the principles with section 15FA(1) noting any restrictive practices may be used only as a last resort and after consideration of the likely impact of the use of the restrictive practice on the care recipient. Further tests for the use of a restrictive practice in this section include, but are not limited to:

  • the restrictive practice is used only to the extent that it is necessary and in proportion to the risk of harm to the care recipient or other persons.

  • the restrictive practice is used in the least restrictive form, and for the shortest time, necessary to prevent harm to the care recipient or other persons.

  • if the care recipient lacks capacity to give consent, consent needs to be obtained from the restrictive practices substitute decision maker.

  • the use of the restrictive practice complies with any relevant provisions of the care and services plan for the care recipient.

These tests form part, but not all, of the requirements for the use of any restrictive practices; refer to sections 15FA, 15FB, 15FC, 15GA and 15GB of the Principles for a full listing of requirements and responsibilities in regard to the use of restrictive practices. The only exception to the requirements are in the event of an emergency, and only then if necessary and while the emergency exists (section 15FA(2-3) of the Principles).

If the restrictive practices substitute decision maker is providing informed consent to the use of restrictive practices, in this case, securing the resident to the chair for the primary purpose of influencing behaviour, care records should demonstrate relevant requirements under sections 15FA and 15FB of the Quality of Care Principles have been met. In particular, that:

  • where possible, best practice alternative strategies have been trialled
  • alternative strategies that have been considered or used have been documented.

Consent requirements are not new. Consent for restricting movement of residents prior to the Principles coming into effect should already have been recorded in the care recipient’s care and services plan. Approved providers should have processes in place to demonstrate provision and recording of informed consent. The care recipient should provide consent in the first instance and, if they lack the capacity to make the decision themselves, consent from the care recipient’s substitute decision maker should be sought and recorded.



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