For some people receiving Supported Independent Living (SIL), daily support includes managing a feeding tube, following a bowel care plan or receiving prescribed injections. These activities need careful planning around the person’s health, preferences and everyday routine.
High intensity daily personal activities in SIL rely on more than having staff available. Workers need to understand the individual support plan, have the skills to follow it and know how to respond when something changes.
This guide looks at how those arrangements work in a SIL home, from preparing workers to keeping information consistent between shifts.
How Do High Intensity Activities Fit Into a SIL Routine?
A person’s day may include assistance with dressing, household tasks and community activities alongside specific health-related supports. The timing and staffing arrangements need to reflect all these needs.
For example, someone who receives enteral feeding may also have appointments, outings and preferred rest times. Planning should account for these activities while following the instructions in their individual feeding plan.
The NDIS High Intensity Daily Personal Activities standards cover eight support areas: complex bowel care, enteral feeding, severe dysphagia, tracheostomy management, urinary catheter management, ventilation, subcutaneous injections and complex wound management.
For an overview of these activities and how they relate to other services, visit our complex care and high intensity NDIS support page.
Planning Support Before the First Shift
Before a participant moves into a SIL home or begins a new support arrangement, everyone involved should understand who is responsible for each part of their care.
A practical starting point is to review:
- The current support plans and who maintains them
- When each activity is needed, including overnight
- Which workers are prepared to provide each support
- Equipment, consumables and storage requirements
- Clinical contacts and emergency instructions
- Arrangements for staff absences and shift changes
Where several providers are involved, responsibilities should be recorded clearly. The participant should know who to contact about daily support, equipment problems or a change in their health needs.
Registered providers can deliver only the high intensity activities included on their registration certificate. Confirm that the relevant provider’s registration covers the required activities before support begins.
Are Workers Prepared for Your Individual Plan?
A worker’s experience with one participant does not automatically prepare them for another person’s equipment, routine or risks.
Ask how workers learn your support plan and demonstrate that they can follow it safely. This conversation should include the regular team and anyone who may cover leave or overnight shifts.
The NDIS Commission’s skills descriptors recommend annual competency reviews. They also recommend reassessment and refresher training when workers have not delivered the support for more than three months or when the participant’s needs have changed. Specific trainer requirements vary by activity.
In practice, a useful question is: “If my equipment or support instructions change, how will every worker be prepared before using the updated plan?”
Medication Routines and Clear Shift Handovers
Medication support in a SIL home can include reminders, assistance with pharmacy-packed medicines or prescribed administration. Routine oral medication assistance is not automatically a high intensity activity; subcutaneous injections are one of the specified support areas.
Whatever assistance a person receives, staff need clear, current instructions and a reliable way to record what happened.
After a prescription changes, the provider should have a process for updating records and informing the workers involved. Participants and families can ask how the team handles missed doses, medication refusal, unclear instructions and concerns that require clinical advice.
Shift handovers should also make outstanding actions clear. For example, if a worker is waiting for a clinician to clarify an instruction, the incoming team needs to know who was contacted and what follow-up is required.
Keeping Bowel Care Consistent and Private
For a participant who needs complex bowel care, consistency includes following the prescribed routine, documenting outcomes, and reporting changes.
The individual plan should guide workers on the required support and how to respond to concerns. Workers should not change the routine based on what worked for someone else.
Privacy and communication also deserve attention. Participants may have preferences about how workers explain each step, who is present and how intimate care fits into their day. These preferences should be discussed directly with the person and reflected in the support arrangement.
When reviewing how the routine is working, consider both health-related outcomes and the participant’s experience. A plan may need discussion with the treating practitioner if support is becoming uncomfortable, difficult to follow or disruptive to daily life.
What Happens When Support Needs Change?
A hospital admission, new piece of equipment or change in health can affect several parts of a SIL routine at once.
Before a revised arrangement begins, clarify who will update the support plan, brief the team and check whether additional training is needed. Equipment and staffing arrangements may also need review.
The participant should remain involved throughout. Where they want family members or other supporters included, agree on how information will be shared and who will coordinate communication.
Regular conversations can help identify concerns early. They also give the participant an opportunity to explain what is working well and what they would like to change.
Questions to Bring to Your SIL Planning Meeting
A planning meeting is a chance to turn general assurances into clear arrangements. Consider asking:
- Who will provide each high intensity activity during my usual week?
- What is the backup arrangement if a trained worker is unavailable?
- How will staff access the latest version of my support plans?
- Who responds to concerns during evenings and overnight?
- How will my preferences and feedback shape the routine?
- When will we review whether the arrangement is working?
Keep a written record of the agreed responsibilities and any actions that need to be completed before support starts.
Discuss Your Daily Support Arrangements With Hilda Care
If you are exploring Supported Independent Living in Melbourne, Hilda Care can discuss your daily living needs and how its services may fit alongside clinical or high intensity supports.
Bring your current support plans and questions about staffing, communication and provider responsibilities. The discussion should clarify which services Hilda Care can provide and where another provider or health professional may be involved.
Contact Hilda Care to talk through your SIL support needs.