O. Reg. 78/02: GENERAL

 

ONTARIO regulation 78/02

made under the

developmental services act

Made: March 11, 2002
Filed: March 11, 2002
Printed in The Ontario Gazette: March 30, 2002

Amending Reg. 272 of R.R.O. 1990

(General)

1. Regulation 272 of the Revised Regulations of Ontario, 1990 is amended by adding the following Part:

PART VI
RULES GOVERNING PHYSICAL RESTRAINT

17. (1) In this Part,

“direct care staff member”, in relation to a facility, means,

(a) a member of the facility’s staff who provides direct care to residents of the facility, and

(b) an owner of the facility who is an individual providing direct care to residents of the facility;

“physical restraint”, in relation to a resident, means using a holding technique to restrict the resident’s ability to move freely, and “physically restrain” has a corresponding meaning.

(2) For greater certainty, physical restraint does not include,

(a) restriction of movement, physical redirection or physical prompting, if the restriction of movement, physical redirection or physical prompting is brief, gentle and part of a behaviour teaching program; or

(b) the use of helmets, protective mitts or other equipment to prevent a resident from physically injuring or further physically injuring himself or herself.

18. (1) The board, or where there is no board, the owner of every facility shall ensure that physical restraint of residents of the facility is not carried out except in accordance with the following rules:

1. Physical restraint of a resident may be carried out only for the purpose of preventing the resident from physically injuring or further physically injuring himself or herself or others.

2. Physical restraint of a resident may never be carried out for the purpose of punishing the resident.

3. Physical restraint of a resident may be carried out only if there is a clear and imminent risk that the resident will physically injure or further physically injure himself or herself or others.

4. Physical restraint of a resident may be carried out only after it is determined that less intrusive interventions are or would be ineffective in preventing the resident from physically injuring or further physically injuring himself or herself or others.

5. Physical restraint of a resident may be carried out only by the facility’s direct care staff members who have received the training and education described in section 21.

6. A particular holding technique may be used only by the facility’s direct care staff members who have received specific training in that technique in a training program approved by the Minister.

7. When physical restraint of a resident is carried out, it must be carried out using the least amount of force that is necessary to restrict the resident’s ability to move freely.

8. During physical restraint of a resident, the resident’s condition must be continually monitored and assessed.

9. Physical restraint of a resident must be stopped upon the earlier of the following:

i. When there is no longer a clear and imminent risk that the resident will physically injure himself or herself or others.

ii. When there is a risk that the physical restraint itself will endanger the health or safety of the resident.

(2) The board, or where there is no board, the owner of every facility shall establish,

(a) a written policy concerning the interventions that must be employed or considered for the purpose of preventing a resident from physically injuring or further physically injuring himself or herself or others, in order to avoid the need to physically restrain the resident; and

(b) a written policy concerning the protocols that must be followed in monitoring and assessing a resident’s condition during physical restraint.

19. Within 24 hours after physical restraint of a resident of a facility is carried out, the board, or where there is no board, the owner of the facility shall report the occurrence to,

(a) the Minister; and

(b) a parent, guardian or emergency contact of the resident.

20. The board, or where there is no board, the owner of every facility shall,

(a) ensure that after a resident is physically restrained, a debriefing process is conducted among the facility’s direct care staff members who were involved in the physical restraint;

(b) ensure that after a resident is physically restrained, a debriefing process is conducted among the facility’s direct care staff members who were involved in the physical restraint and the resident who was physically restrained, and that the process is structured to accommodate the resident’s psychological and emotional needs and cognitive capacity; and

(c) ensure,

(i) that the debriefing processes referred to in clauses (a) and (b) are conducted within 48 hours after the physical restraint is carried out, or

(ii) if circumstances do not permit a debriefing process to be conducted within the 48-hour period, that the debriefing process is conducted as soon as possible after the 48-hour period and that a record is kept of the circumstances which prevented the debriefing process from being conducted within the 48-hour period.

21. (1) The board, or where there is no board, the owner of every facility shall ensure that all of the facility’s direct care staff members successfully complete,

(a) a training program that includes training in the use of physical restraint and that is approved by the Minister; and

(b) all refresher courses required under the program.

(2) The board, or where there is no board, the owner of every facility shall ensure that,

(a) all of the facility’s direct care staff members receive education respecting,

(i) the provisions of this Regulation concerning physical restraint of residents,

(ii) the policies established by the Ministry concerning physical restraint of residents, and

(iii) the facility’s policies concerning physical restraint of its residents;

(b) the education of a current direct care staff member,

(i) in the subject-matter described in subclause (a) (i) is completed within 30 days after each new regulatory provision concerning physical restraint of residents comes into force,

(ii) in the subject-matter described in subclause (a) (ii) is completed within 30 days after each new Ministry policy concerning physical restraint of residents is received by the facility, and

(iii) in the subject-matter described in subclause (a) (iii) is completed within 30 days after each new facility policy concerning physical restraint of its residents is established;

(c) if a new direct care staff member, other than an owner of the facility, commences employment with the facility, the member’s education in the subject-matter described in clause (a) is completed within 30 days after the member commences employment with the facility;

(d) if an owner of the facility who is an individual has not provided, but subsequently begins to provide, direct care to residents of the facility, the owner’s education in the subject-matter described in clause (a) is completed within 30 days after the owner begins to provide direct care to residents of the facility; and

(e) a performance review is conducted annually for each direct care staff member, other than an owner of the facility, and that, during the performance review, the member’s understanding and application of the subject-matter described in clause (a) is assessed and recorded.

2. This Regulation comes into force on April 1, 2003.

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