Understanding NDIS High Intensity Supports: A Complete Guide

All support under NDIS is targeted towards ensuring the well-being, independence and safety of the participants. But some support requires more attention owing to its complex nature.

High Intensity Supports under NDIS refer to support needs that require specialised attention. Managing high-intensity supports involves a combined effort of healthcare professionals and support workers.

In providing these supports, the participant's comfort and dignity must be prioritised. Participants should be able to receive excellent care without compromise to their independence at home.

What are High Intensity Supports?

High Intensity Supports refer to daily personal care activities that involve higher health risks and the safety of the participant. As such, there is a need for higher care and support by both health professionals and support workers.

These supports are not just about routine assistance; they are provided with individual health needs in mind. Due to the nature of the care required, there's also emphasis on the dignity and independence of the care receiver.

Types of Tasks Considered NDIS High Intensity Supports 

The following are tasks considered as high-intensity supports under NDIS: 

• Complex bowel care
• Tracheostomy care
• Enteral feeding (PEG or nasogastric tubes)
• Urinary catheter care
• Subcutaneous injections
• Wound care
• Dysphagia support 
• Ventilation support

There is a level of health risk involved with these tasks which requires workers to possess specific skills and training in order to perform them safely.

Who Requires these Supports?

High-level support is meant for people who live with complex or chronic health conditions and physical disabilities. NDIS participants under high-intensity support receive medical support as part of their daily care routine. Such people may include:

• Individuals with spinal cord injuries
• People with progressive neurological conditions(MND or MS)
• Persons living with epilepsy
• Persons suffering from diabetes
• Persons requiring respiratory support

NDIS High Intensity Supports Requirements

The NDIS Commission outlines strict requirements for service providers delivering these specialised supports. The requirements include:

• Use appropriately trained and competent staff
• Follow participant-specific care plans  
• Ensure quality and safety through clinical supervision 
• Compliance with the NDIS Practice Standards and High Intensity Skills Descriptors

Who can Provide High-Intensity Support?

Two groups are involved in high-intensity support. These are the health professionals and the trained support workers. The health team may comprise registered nurses, GPs and allied health professionals.

Support workers, on the other hand, are individuals trained on how to provide high-intensity support. They form the greater part of the support team and work under the supervision of the health team.

Roles of the Support Worker in High Intensity Care

Support workers work extensively in delivering high-intensity care. They offer participants with complex health needs respectful and safe care directed to their specific needs.

It is not just the provision of physical tasks but also upholding the dignity and independence of the individual as well. The following are the core responsibilities and expectations of support workers in high-intensity supports:

• Provide assistance with complex personal care tasks
• Monitor changes in the participant’s condition 
• Report any changes, especially in behaviour 
• Keep records of daily activities 
• Use appropriate infection control and manual handling techniques
• Follow organisational policies and NDIS Practice Standards

In discharging these duties, there's a need for a strong relationship with health professionals. As much as a support worker may be experienced in caring for the participant, the role of health professionals cannot be overlooked, especially when it concerns diagnosis and identification of potential issues. 

Hence, the support worker should at all times:

• Seek clarification from supervising clinicians when needed
• Participate in training and assessments to stay competent
• Communicate observations in time and in clear language 
• Know when to seek help 

The Importance of Following Individualised Care Plans

High intensity supports like standard support require individualised care plans. However, it's more pertinent that in high-level supports, both support workers and health professionals adopt an effective way of getting the work done in addition to focusing on the individual's needs. 

With a well-curated plan, the specific tasks and risks associated with the support are outlined. Support workers are subsequently expected to follow these routines to perform their duties diligently and mitigate the risks involved.

The Boundaries of a Support Worker

High intensity support comprises physical support practices and the health support aspect. Although both are targeted towards the same outcome, they differ in their manner of provision. Understanding that the support work has limits to its services is important in preventing certain risks.

As such, there are certain roles that the support worker must not take on, regardless of their experience. Such tasks include:

• Diagnosis of a participant
• Alterations in treatment plans
• Administration of unauthorised medication
• Performing clinical procedures that they are not trained or certified in

The support worker undertakes the duty of reporting the health condition of the participant. Unless you are a trained health professional, you must not take any clinical actions on your own without supervision.

This is to ensure the safety of the participant as well as yours. It is also in adherence to the quality standards of care within the NDIS framework.

Skills and Training Requirements

High-intensity supports require a higher level of training and adherence to rules than standard support. That's why support workers under high-intensity supports must possess specific skills, acquired through formal training.

The aim of this training is to provide support workers with the needed skills for carrying out complex support tasks in a safe manner and within the NDIS framework.

High-intensity care support workers must be proficient in the individual tasks they are to perform, e.g., PEG feeding or catheter management. These competencies are assessed against nationally recognised standards and should include:

• Practical skills in performing the task correctly
• Use of personal protective equipment (PPE)
• Understanding of health risks and appropriate risk mitigation strategies
• Accurate documentation and reporting practices
• Adherence to infection control protocols

How to Qualify as a High-Intensity Support Worker under NDIS

Before you can be certified as a high-intensity support worker under NDIS, you must complete certain training. These trainings and assessments are to determine your level of competency in providing the needed support and your ability to manage the risks involved. 

To make this easy, NDIA put in place the High Intensity Support Skills Descriptors. It contains all the guidance and assessment needed to perform high-intensity support tasks. The commission takes great priority in the adherence to these guidelines for every support worker who wishes to undertake high-intensity support roles.

How Do I Access High-Intensity Support Training?

For the most part, the training is delivered by NDIS-registered providers. However, unregistered providers may also offer training following the guidelines as outlined by NDIA. 

Registered providers such as Support Network offer quality training and assessments under clinical supervision. The workers undergo a series of training to provide them with the needed skills and resolve for the job.

Risk Management and Incident Prevention

In high-intensity support, even minor errors can lead to serious consequences. Good risk management skills should be applied to ensure the participant and the support worker are protected. It begins with recognising the potential risk of every task and seeking a productive method towards safety.

Support workers need to be able to identify potential hazards in the discharge of their duties. This includes:

• Reviewing individualised care plans for identified risks
• Performing a quick risk assessment before every high-intensity activity
• Ensuring all required equipment is clean and functional
• Verifying that infection control procedures are implemented

With the risks identified, the support worker must follow established protocols in reducing the chances of any harm occurring. This includes using personal protective equipment (PPE) and adhering to task-specific procedures.

Common Risk Scenarios

High intensity supports are often associated with complex medical conditions, so the following risks are commonly encountered:

• Aspiration: This could occur during PEG feeding or oral hygiene tasks
• Pressure injuries: Resulting from being in one position for a long time
• Infections: Poor wound management can cause this. It could also arise from poor catheter care.
• Seizure-related injuries: This might happen if appropriate support strategies aren’t followed
• Hypoglycaemia: This could arise during diabetes care.

The risk factors associated with each of these cases give you a hint as to what might come next. That way, you can seek help in time.

The Role of Reporting and Documentation

Accurate and timely documentation is a key factor in high-intensity care. Support workers must record all tasks completed and any deviations from the care plan. You need to record observations about the well-being of the participant. This encourages continuity of care and early detection of any emerging health problems.

Incident reporting is also important. Even if nobody is injured, near misses should be reported so that the team can learn and prevent them from occurring again in the future. Reports should include:

• What happened
• When it happened 
• What actions were taken
• Who was informed
• The outcome or follow-up required

Consistent documentation also protects workers by providing a clear record of actions taken following the care plan. In the case of a legal action, you can always defend yourself with evidence from your documentation and reports.

Responding to Incidents and Emergencies Effectively

As a support worker under high-intensity support, you ought to have an emergency response strategy. That is your gateway to ensuring the safety of your care receiver during incidents. Actions to take should include:

• Following the participant’s emergency response plan
• Calling for medical assistance if needed
• Administering first aid within the scope of training
• Informing the health team leader
• Properly documenting incidents 

Training in emergency procedures helps to enable support workers to feel secure in how to respond to unexpected incidents. With the right knowledge, support workers can easily reduce incidents and provide better care in a safer manner.

Compliance with NDIS Practice Standards

Delivering High-Intensity Supports under the NDIS framework has strict compliance requirements. The NDIS Practice Standards have been created to ensure participants are receiving high-quality and safe care that respects their dignity and rights with minimal risk. These standards must be followed by support workers and providers alike.

NDIS Practice Standards for High Intensity Daily Personal Activities

High Intensity Supports fall under the module for High Intensity Daily Personal Activities in the NDIS Practice Standards. These standards require providers to:

• Deliver high-intensity tasks following individualised plans
• Ensure workers have the right skills for carrying out specific supports safely
• Provide adequate clinical monitoring for safety 
• Allow participants to make decisions of their own 
• Use appropriate equipment 
• Implement infection control measures to protect health and safety

The standards are designed to align service delivery with personalised principles and clinical best practices. This is to ensure a continuous improvement in care quality.
To ensure this compliance, NDIS-registered providers delivering high-intensity support are subject to independent audits and compliance checks. To prepare for these, providers must demonstrate:

• That staff have completed all necessary training and competency assessments
• That risks are actively managed, reviewed, and documented
• That care delivery reflects current plans approved by clinical supervisors or allied health professionals
• That systems are in place for reporting incidents and improvements.

Supporting Participants and Families 

In high-intensity care, relationships are just as important as routines. Support workers as well as health professionals must go beyond performing daily tasks to developing good relationships with participants and their families.

Wherever possible, participants must be actively engaged in understanding and managing their own care. This might include:

• Explaining the purpose of high-intensity tasks in simple, respectful language
• Demonstrating how equipment works or what signs to watch for
• Involving them in daily routines

You can build more confidence and reduce anxiety in participants by giving them a clear understanding of their support needs. This, in turn, fosters a stronger sense of independence even in the presence of complex care needs.

Building Trust with Families and Guardians

Families play a significant role in providing for the needs of participants under higher intensity support. This is especially important for participants with limited communication abilities or at a higher health risk. Building trust with the families of participants involves

• Communicating freely and respectfully
• Providing regular updates about health and care changes
• Responding to concerns and feedback
• Respecting cultural practices as well as family values
• Maintaining strong professional boundaries but being empathetic at the same time.

Strong relationships with families improve continuity of care and help create a support environment that feels secure and respectful for the participant.

Supporting Transitions

Managing transitions in care and environment is a significant part of specialised supports. When a participant moves from a nursing home back to their home or into palliative care, they face physical and emotional challenges. The support worker can help them adjust easily by:

• Cooperating with health professionals to ensure a swift transition 
• Helping families understand new care requirements or risks
• Reassuring the participant and creating stability during periods of change
• Remaining calm to reduce stress

Proper support is needed during transitions to promote the well-being of participants and prevent any regressions.

Challenges in High-Intensity Support Work

Working in high-intensity support can be demanding. Support workers are often faced with complex responsibilities where physical tasks are closely tied to emotional support. Some of the challenges that come with high-intensity support include:

• Stress and fatigue

Managing the complex health needs of participants under high-intensity support can be stressful. Undertaking repetitive routines and dealing with medical risks is not easy. It is even more exhausting on the emotions if it involves end-of-life care.

Burnout not only affects the well-being of the worker but also the quality of care being offered. Taking scheduled breaks and using available leaves is necessary.

• Navigating complex care needs 

Participants receiving high-intensity support often have individualised plans involving complex health support needs. As a result, support workers might need to manage ambiguous instructions within care plans as well as conflicting procedures from different members of the health team.

Where such cases arise, clarification is the best course of action. It would be dangerous to attempt new procedures without supervision or the right instructions. Open documentation and good communication can help guarantee that confusion is avoided and safer outcomes are promoted.

• Managing aggressive behaviours

There have been cases where support workers sustained serious injuries from physical assault inflicted by participants. This could happen if the care receiver has mental impairments.

When faced with this situation, it is important that the support worker has an exit plan. When you're in a safe place, you can then raise an alarm for help. Do well to record and report the incident immediately for early intervention.

Frequently Asked Questions ( FAQs)

1. Who is eligible for High Intensity Support?

You need to have complex care needs identified in your NDIS plan. Funding is included under "Assistance with Daily Life."

Support Network can help you navigate the process and connect you with trained workers.

2. What services are provided under High Intensity Support?

Tasks include personal care, medication management and mobility support. Basically, anything related to the disability needs of the participant.

3. Who can become a High Intensity Support Worker?

Anyone who completes the required NDIS training, competency assessments, and works under clinical guidance can deliver high-intensity support.

Conclusion

High intensity support represents a critical part of the NDIS effort to provide efficient care to all its participants, regardless of their needs. As such, how this support is provided must be special. That involves the use of well-trained workers who understand the nature of the job and what it entails. It is the belief that with more attention to high-intensity support, participants with complex support needs can enjoy as many benefits as those under standard support.