A missed opportunity to improve practice around the use of restraints and consent in residential aged care: limitations of the Quality of Care Amendment (Minimising the Use of Restraints) Principles 2019

Objective: To explore the meaning and potential role of new Quality of Care Amendment (Minimising the Use of Restraints) Principles 2019, (Principles) which amend Quality of Care Principles 2014 in improving practice around physical and chemical restraint.

Methods: We examined both Principles and accompanying Explanatory Statement in light of best practices around consent and use of chemical and physical restraint.

Results: The chemical restraint definition is problematic by exclusion of medications for treating mental disorders, physical illness or physical conditions, which is not considered restraint. Inexplicably, physical restraint requirements are more rigorous than chemical restraint requirements, where assessment is optional, and consent sometimes obtained, after use, and from the person's "representative," rather than the person first, followed by their proxy decision-maker.

Conclusion: Although a start in promoting best practice around physical restraint, the Principles do not address the status quo of poor practice around chemical restraint and may instead codify it.