Restrictive Practices in Physical Disability Support: Identification, Review and Reduction
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Restrictive practices in physical disability services are often introduced with good intentions: to reduce risk, prevent incidents or manage complex needs. However, restrictions can easily become embedded into routine practice without regular review, gradually eroding independence, dignity and human rights. Commissioners and inspectors increasingly expect providers to identify restrictive practices proactively and demonstrate clear processes for review and reduction.
This article explores how physical disability services can identify, review and reduce restrictive practices in lawful, proportionate ways. It should be read alongside Restrictive Practices & Human Rights and Positive Risk-Taking & Risk Enablement.
What restrictive practice looks like in physical disability services
Restrictive practice is not limited to physical restraint. In physical disability support, it may include limits on community access, rigid routines, overuse of equipment, or staff completing tasks a person could do themselves.
These practices often develop gradually and can be overlooked.
Commissioner and inspector expectations
Two expectations are consistently applied:
Expectation 1: Identification and recording of restrictions. Inspectors expect providers to know where restrictive practices exist.
Expectation 2: Evidence of active reduction. Commissioners expect restrictions to be reviewed and reduced wherever possible.
Identifying restrictive practices in everyday support
Providers should routinely ask whether support promotes independence or restricts it. Audits, observations and supervision are key tools.
Operational example 1: Identifying routine-based restriction
An audit identified fixed meal times limiting independence. Adjusting routines increased choice without increasing risk.
Reviewing restrictions proportionately
Restrictions must be justified, time limited and reviewed. Reviews should consider alternatives and the person’s perspective.
Operational example 2: Reviewing equipment-based restrictions
A service reviewed routine hoist use and identified opportunities for assisted standing transfers, reducing restriction and improving confidence.
Reducing restrictions safely
Restriction reduction should be planned, supported and monitored, not abrupt.
Operational example 3: Phased reduction of supervision
A provider reduced supervision during community access in stages, maintaining safety while increasing independence.
Governance and assurance
Providers should evidence restrictive practice management through:
- Registers of restrictive practices
- Scheduled review dates and outcomes
- Management oversight of restriction decisions
Restriction reduction as quality improvement
In physical disability services, reducing restrictive practices is a marker of quality. Providers that actively identify and review restrictions demonstrate rights-based, inspection-ready safeguarding.
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