Working with others
Collaborating and working with others is a core skill for an APO.
APOs play a central role in balancing and connecting the needs of:
- people with disability,
- Behaviour Support Practitioners,
- the Victorian Senior Practitioner,
- the APO’s organisation, and
- other implementing providers (and their APOs).
Clear communication and knowledge of how to engage others in change underpin successful work as an APO.
Engaging others in change
In many cases, people will have established ways they do things to best manage safety for the person with disability and the people around them due to any behaviours of concern.
APOs need to understand these people’s perspectives, their concerns and their needs. APOs may also work with the Behaviour Support Practitioner to suggest strategies that address these concerns.
Changing the way people do things requires them to be engaged in the change process and motivated to change.
They must also feel supported, especially around any fears they may have.
To engage others in change, the APO or Behaviour Support Practitioner might try:
- spending additional time with people to explain the potential benefits of the proposed changes for the person with the behaviour support plan.
- clear back-up plans and contingencies to ensure the people feel supported in trying new strategies and making changes.
- clear plans for managing if things don’t always go according to plan.
- working together to agree when you will decide as a team whether a change has or hasn’t worked, making the change ‘a trial’ rather than ‘forever’, which can ease people into new behaviours and practices.
Watch a video about engaging others in change in behaviour support.
Find out more about fade-out plans.
Working with Behaviour Support Practitioners
Behaviour Support Practitioners are one of an APO’s most important partners in the authorisation process.
APOs and Behaviour Support Practitioners need to work together to find the best use of proposed restrictive practice(s) in the behaviour support plan for the person with disability.
Behaviour Support Practitioners assess the person with disability’s behaviour, develop behaviour support plans, train carers and staff to enact a behaviour support plan, and monitor progress toward the person’s goals to improve a person’s quality of life through positive behaviour support.
Behaviour Support Practitioners are responsible for contacting all people with roles in the behaviour support plan to:
- communicate their roles,
- ensure they have the skills to safely support the plan, and
- connect them with any training, as required.
Ongoing communication
The APO and Behaviour Support Practitioner need to establish a collaborative process regarding proposed regulated restrictive practice from early in the process to ensure an appropriate plan is developed and maintained outside of the formal touchpoints of the authorisation process.
In addition to checking in with the people involved with the behaviour support plan informally once the plan is enacted (to understand issues and celebrate successes), the Behaviour Support Practitioner should continue to communicate with the APO throughout the behaviour support planning lifecycle, whenever restrictive practice(s) is proposed or used.
This communication underpins and informs any revisions the behaviour support plan may need, if required.
APOs may need to be proactive in establishing and maintaining this relationship with the Behaviour Support Practitioner.
This is likely to smooth the authorisation process by reducing the chance of disagreements on how restrictive practice(s) will best meet the needs of the person with the behaviour support plan. It also ensures best practice because these key professionals are sharing knowledge, which also enables risks to be identified and overcome early.
‘Grey areas’ will occur sometimes and working together is the best way to establish how to navigate these complexities.
Collaborating to identify any uncertain areas and asking questions of the Victorian Senior Practitioner’s Office where needed will ensure the person with the proposed restrictive practice(s) has the best outcome for their plan.
APOs will also benefit from communicating their needs and timelines as Behaviour Support Practitioners may not be aware of the APOs requirements and the depth of the APO role.
Helping Behaviour Support Practitioners
APOs may also find that Behaviour Support Practitioners turn to them with questions about various aspects of a person’s behaviour support planning.
While this is not an official part of the APO role, it’s an excellent way to form trust and both establish and maintain the essential relationship with the Behaviour Support Practitioner.
It is important to note that an APO is not expected to undertake behaviour support planning – this is the role of the Behaviour Support Practitioner.
However, being open to working collaboratively with the Behaviour Support Practitioner within the scope of restrictive practice(s) outside of official touch points can produce benefits for the APO, the Behaviour Support Practitioner and – importantly – the person with the behaviour support plan.
Working with support networks, families & carers
Working with support networks, including families and carers, can be a rewarding and important part of the APO role.
A person’s support network may not be blood relatives – it is possible a person with disability may have few direct family members (or close friends in lieu of family). Different cultures also consider ‘family’ more broadly than simply ‘blood relative’.
As an APO, understanding who is in the person’s support network and Circle of Support is essential.
The people who are closest to the person – which may be families and carers – can be a rich source of information about the person with the behaviour support plan, including:
- their history,
- their communication style,
- potential triggers,
- their preferences, and
- what a ‘good life’ looks like for the person.
Behaviour Support Practitioners and APOs need to carefully consider replicating any restrictive practices and strategies that are used in the home by families to ensure they meet all governing legislation, policies and rules if used as part of a person’s behaviour support plan.
APOs and their organisations are ultimately responsible for any restrictive practice that they authorise and implement. Even if a family member consents to or endorses the use of a restrictive practice, that practice must still meet the legislative requirements for authorisation under the Disability Act 2006.
APOs may need to provide families with information about risks, human and legal rights, and alternatives to established restrictive practices in ways that are meaningful to their situation and easy for them to understand.
APOs must also consider that support networks, families and carers are also people who may have been affected by many years of working with behaviours that have risked the safety of their family member with disability and/or those around them.
This can cause trauma for these people and they will need respect and understanding. APOs can find out more about engaging support networks in change on The Right Direction website.
Families and carers are likely to have developed coping strategies and ways of managing the behaviours of concern that do not align with the behaviour support plan, or future planning.
It is natural they may have fears of their own relating to these behaviours and any changes. Some families or carers will feel anxious about making changes to strategies that have worked and will need to be supported through changes.
Finding a plan that the family and or carer feels comfortable enacting can therefore be a one of the main aspects of reducing or progressing toward eliminating restrictive practice(s) in the person’s behaviour support plan.
Working with children & young people
Schools
As schools are not subject to the Disability Act 2006, they do not require authorisation to use restrictive practice(s).
However, the NDIS Commission may require Behaviour Support Practitioners to include the use of restrictive practices by any implementers within the behaviour support plan.
Find out more information about use of restraint and seclusion as restrictive practices in schools on the Victorian Department of Education’s Policy and Advisory Library.
Child protection & out-of-home care
Children who are supported by Child Protection under the Department of Families, Fairness and Housing are not usually overseen by the NDIS Quality and Safeguards Commission or the Victorian Senior Practitioner from a regulatory perspective.
In this case, there is usually no requirement for authorisation or reporting of restrictive practices through APOs.
Instead, the regulatory oversight of the young person’s care sits with the Department of Families, Fairness and Housing Secretary and can be checked via the service agreement in place with your organisation.
Find out more about restrictive practice for children with disability or complex medical needs in Child Protection.
However, in some cases restrictive-practice regulatory oversight, authorisation and reporting may sit under the Victorian Senior Practitioner, with the support of APOs.
- This depends on:
whether the young person lives with disability, - the funding stream for delivering the supports, and
- the registration status of the provider funded to deliver the supports.
Under the Disability Act 2006, if the young person lives with disability, restrictive practices used in behaviour support through:
- NDIS-registered providers funded by the NDIS require APO authorisation (and reporting in the NDIS-based provider portal), and
- State-registered disability support providers require APO authorisation (and reporting in the State-based Restrictive Intervention Data System (RIDS)) portal, but
- Child, Youth and Families-registered and funded providers do not require authorisation under the Disability Act 2006.
If the young person does not live with disability, regulatory oversight of restrictive practices for behaviour support sits under other frameworks and legislation. Contact the Victorian Senior Practitioner via RIquestions@dffh.vic.gov.au to discuss individual circumstances.
Child safety practices
A common question APOs face is how best to distinguish between chid safety/required injury-prevention practices (sometimes called ‘child proofing’) and regulated restrictive practice(s).
Age-appropriate child safety practices are not typically considered regulated restrictive practices, particularly when used with younger children.
Determining if a strategy/intervention would be considered a restrictive practice, consider what is age appropriate for the child. If it is a typical age-appropriate child safety practice – it is likely not a restrictive practice.
However, if the practice is used beyond what would generally be considered typical for the child’s age, it could be a restrictive practice.
Part of behaviour support planning with younger people with disability is considering how to build skills to prepare the child/young person for age-appropriate access and reducing these measures naturally, in line with the child’s age and development stage.
Find out more about restrictive practices for children and young people (opens PDF doc).
Working with psychosocial disability
The Victorian Senior Practitioner oversees and approves any restrictive practice authorised as part of behaviour support for a person with psychosocial disability.
To ensure this Direction is followed (opens PDF doc), any person diagnosed with psychosocial disability must be recorded as such in the State-based Restrictive Intervention Data System (RIDS)) portal.
To support the person appropriately, check they are connected with appropriate mental-health services as part of their behaviour support plan. The person’s mental health management plan should also inform strategies included in their behaviour support plan.
Care for NDIS participants should also be guided by the Psychosocial Disability Recovery-Oriented Framework. This framework sets out six key principles to guide understanding of, and improved responses for, people living with psychosocial disability.
Working in aged-care settings
For APOs, aged care work relates only to NDIS participants. Restrictive practice used outside of NDIS-registered providers falls outside of the APO remit as it is governed under the Aged Care Act (2024).
For NDIS participants who live in aged-care facilities, the same regulatory requirements apply under the Disability Act (2006). However, there are additional regulatory requirements under the Aged Care Act (2024).
The service provider must comply with both legislations in relation to the use of restrictive practices and APOs need to be aware of both legislative contexts when working with people in this setting.
Find out more from the Aged Care Commission.
The registered nurse at the facility can assist with identifying restrictive practices and seeking information from prescribers.
Working with allied-health professionals
Appropriate allied-health professionals must be involved when considering the safe and effective use of restrictive practices.
For example, where devices are proposed for use with people, it is vital for relevant professionals (eg: occupational therapists) assess and clarify:
- the purpose of any device,
- how devices should be used, under what circumstances and for how long,
- what training staff require to implement any device,
- how and when devices will be reviewed, and
- how the goals of any device(s) will be evaluated.
This will APOs to determine if the device is considered a mechanical restraint or if it is instead therapeutic (or used for non-behavioural purposes).
There may be circumstances where a device is used for dual purposes (both therapeutic and behavioural). In these cases, clear documentation from the prescribing professional will support APOs’ decision making.
APOs should be alert for cases where reviewing devices used for therapeutic purposes may need regular review from the prescribing professional to prevent the device from being used outside its intended purpose(s) (eg: mistakenly used as a mechanical restraint).
Useful resources:
- NDIS Commission Safe transportation guide (opens PDF doc), and
- Recognising and reducing mechanical restraint practice guide (downloads Word doc).
Working with medical doctors/general practitioners (GPs)
Doctors, or General Practitioners – often referred to as ‘GPs’ – are skilled professionals who are often best placed for a holistic view of a patient’s care, due to their general knowledge of the medical field and their position as the primary point of care for most people.
It is therefore essential for an Authorised Program Officer (APO) to establish good rapport with the person’s regular treating GP to ensure holistic treatment and good outcomes for the person, who is likely to have many specialists involved in the care of their health and disability.
GPs are often particularly relevant in cases where medication is prescribed and APOs may need to contact prescribing doctors to clarify the intent of medications to correctly identify possible chemical restraints, to maintain an up-to-date medication list, to schedule medication reviews and to assess polypharmacy.
Working with GPs can be important for understanding potential and actual side effects of medication, as well as monitoring them over time.
Doctors are the clinical decision makers regarding the appropriate use of all medications and – if permission is granted under the information sharing clause in your service provider agreement – are only required to provide information related to medication use, such as reason for use and potential benefits and risks.
APOs must therefore check whether permission has been granted for this information to be requested under the information sharing clause in the service provider agreement before requesting this information from the GP.
It is also important to clarify any monitoring needs of the person in relation to the restrictive practice from the treating doctor, such as need for regular blood tests, weight, appetite etc.
Likewise, APOs must communicate all relevant information or monitoring data to the doctor regularly to inform the GP’s decisions and care for the person. This is vital for the person with disability’s quality of life and quality of care.
Requesting information
An APO can request information from a person’s treating doctor via a Medication Purpose Form (opens PDF doc) or via a treatment sheet/letter.
A treatment sheet is a document used to record the prescription, dosage, frequency and method for administering medication to a patient. It may also include the purpose/indication of the medication.
Under the Disability Act 2006, APOs are responsible for identifying and authorising the use of chemical restraints (as per definition from the NDIS (Restrictive Practices and Behaviour Support) Rules 2018) – this is not the GP’s responsibility.
Therefore, APOs must determine which medications are considered chemical restraint (and authorise them accordingly), after confirming the intent from the treating doctor.
GPs have many administrative tasks and may feel overwhelmed and frustrated by additional paperwork when resources stretched.
It is useful to explain the purpose of any administrative forms and any legal requirements for record keeping.
APOs can consider pre-filling the form where possible to support the GP in completing the task quickly.
In cases where there is no change to the person’s medication, APOs do not need to request repeat information from prescribers.
Working with the justice system
There are times when an Authorised Program Officer (APO) may work with people at risk of – or currently – in contact with the criminal justice system, subject to lawful orders.
Restrictive practice(s) that relate to lawful orders such as supervised treatment orders (STOs) need to be considered based on their context.
The Victorian Senior Practitioner’s Office provides e-Learning modules for APOs working with the justice system, which can support APOs who find themselves in this environment.
Learn more about the foundations of disability support for people at risk of contact with the justice system.
Find out who to contact with questions.
Lawful orders
A ‘lawful order’ refers to any formal order or condition placed on a person by a court of law, or a tribunal. Such orders can place restrictions on a person’s freedoms and rights, and may require a person to meet specific obligations or conditions under the lawful order.
APOs may not necessarily be aware that the person with the behaviour support plan is subject to an order. Whether this information is shared with the APO depends on:
- your need to know about the lawful orders to enable you to support the person, and
- the person (or legal decision maker) consenting to sharing the information.
The obligations, conditions or restrictions placed on a person by a lawful order are not considered regulated restrictive practices under the NDIS (Restrictive Practices and Behaviour Support) Rules 2018 (and are not under the jurisdiction of the Disability Act 2006).
As such, the provider’s role is not to make the person comply with the lawful order, but instead to support the person.
This means helping them understand the nature and obligations of the lawful order. This also means understanding the implications of not complying with the conditions of a lawful order.
A service provider might also deliver supports to assist the person to comply with the lawful order (this may include skill-development strategies in their behaviour support plan, for example).
If a service provider uses regulated restrictive practices that relate to the lawful order, those practices must also meet all governing legislation, policies and rules, including being included in the person’s behaviour support plan.
For example, if a person has a condition to remain at their residence after a certain time at night:
- it is the responsibility of the person to meet this condition (not the staff).
- staff may work with the person to encourage them to understand and follow their conditions. This is not considered restrictive practice.
- if staff lock doors at night to prevent the person from leaving (and therefore prevent the person from breaching their conditions), this is considered restrictive practice. It is therefore governed by the Disability Act 2006 and must be included in the behaviour support plan and authorised by the APO.
The person may also have a range of forensic/justice specific professionals and agencies who are involved in their support who APOs need to consult with and work collaboratively with, including:
- Forensic Psychologists or Psychiatrists (professionals who focus on offence-specific behaviours,
- Disability Justice Support Coordinators,
- Legal Aid Solicitors, and/or
- Community Corrections Services staff (eg: the person’s Community Corrections Officer or Parole Officer).
When a lawful order is amended or revoked, the behaviour support plan must be reviewed immediately.
Read more about the justice system and lawful orders (opens PDF document) in relation to NDIS participants.
Find out who to contact with questions.