Disclosure Log - FOI 24/25-0952

DOCUMENT 3

Understand supports for participants who can move independently in shared living arrangements

SGP KP Publishing

Exported on 2025-02-21 03:21:36

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Disclosure Log - FOI 24/25-0952

SGP KP Publishing – Understand supports for participants who can move independently in shared living arrangements

1 Recent updates …………………………………………………………………………………………………….. 4

2 Before you start …………………………………………………………………………………………………….. 5

3 Shared supports ……………………………………………………………………………………………………. 6

4 Individual supports in a shared arrangement …………………………………………………………. 7 4.1 Things to consider for individual supports in shared living …………………………………………. 7

5 Level of support ……………………………………………………………………………………………………. 8 5.1 No additional support needed ……………………………………………………………………………….. 8 5.2 Minimal level of support needed …………………………………………………………………………….. 8 5.3 Partial level of support needed ………………………………………………………………………………. 8 5.4 Full level of support needed ………………………………………………………………………………….. 8 5.5 Complex level of support needed …………………………………………………………………………… 8

6 Personal care tasks ……………………………………………………………………………………. 10 6.1 Showering, bathing, dressing and personal hygiene …………………………………………. 10 6.2 Skin integrity care ………………………………………………………………………………………………. 11 6.3 Toileting ……………………………………………………………………………………………………………. 11 6.4 Changing or using continence products ……………………………………………………….. 12 6.5 Eat, drink and manage a mealtime plan ……………………………………………………….. 13

7 Behaviours of concern and behaviour support (capacity building) ……………………….. 15

8 Assessments or reports to support decision-making …………………………………………. 16 8.1 Provider reports …………………………………………………………………………………………………. 16

9 Next steps ………………………………………………………………………………………………….. 17

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This article provides guidance for a home and living delegate, planner delegate, review officer and planner (non-partnered area) to understand:

shared supports
individual supports in a shared arrangement
level of support
personal care tasks
behaviours of concern and behaviour support (capacity building)
assessments or reports to support decision-making.

Note: This article helps you identify supports for participants who live in a shared living arrangement and don’t need support to move around. For example, when the participant doesn’t need assistive technology to transfer in and out of furniture, like a ceiling hoist, or use a wheelchair or four-wheel walker to move around their home.

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1 Recent updates

4 November 2024
Guidance updated to include link to new article Understand supports for participants who need help to move around in shared living arrangements.

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2 Before you start

You have read and understood:

Our Guideline – Reasonable and Necessary Supports (external)
Our Guideline – Supported Independent Living (external)
Our Guideline – Creating your plan (external)
Our Guideline – Your plan (external)
Requesting home and living supports (external)
Personal care supports (external)
article Understand disability-related health supports – core supports
article Understand supports for participants who need help to move around in shared living arrangements
article Apply the home and living decision in PACE
article Add supported independent living (SIL) funding.

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3 Shared supports

Sharing supports in a living arrangement helps to meet the needs of each individual participant in a flexible and responsive way over a 24 hour period. A support worker can help one participant for a short period and also continue to support others in the home. For example, a participant sharing their supports with others might only need individual support to complete a specific task. This might be to encourage them with their personal hygiene routine or help to prepare a simple meal.

In a shared living arrangement, there are tasks shared by all participants in the home. A support worker can help more than one participant at a time to prompt, guide or set up tasks related to:

General household chores and cleaning. This may include setting up equipment like a vacuum, dishwasher and washing machine. Or hanging out clothes, folding and putting away laundry and gardening.
More involved thinking tasks like meal preparation and managing finances. This may include set up for meal planning and grocery shopping, daily meal preparation and engaging participants in household finances like paying bills. Or organising a barbeque with friends and family and planning shared social or leisure activities.

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4 Individual supports in a shared arrangement

Individual supports in a shared living arrangement are activities the participant needs a support worker’s help to complete. The level of support provided will depend on the participant’s functional capacity. When we say functional capacity, we mean things the participant can or can’t do for themselves. The support could be showing the participant the steps, helping them do it or doing the task for them.

For some tasks, the participant may need individual support that isn’t possible when sharing supports.

4.1 Things to consider for individual supports in shared living

To determine the time needed for an individual support, think about how long the task usually takes, the participant’s disability-related support needs and the support level. Look at any assessments or reports that explain the level of support the participant needs. This information is usually found in allied health practitioner (AHP) reports. When considering if these supports are suitable for the participant, you’ll need to make sure they meet the NDIS funding criteria (external). Think about:

the participant’s capacity to complete a task. Does their disability affect their range of movement? Will it limit their ability to complete a task?
the participant’s cognitive capacity to complete a task. Does their disability impact their ability to understand how to complete a task and why it’s important?
how the participant’s sensory, self-regulation or behaviour support needs may impact their ability to complete a task.

Go to section Assessments or reports to support decision-making in this article to learn more about information AHPs can provide.

If you don’t have enough information, discuss next steps with your team leader.

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5 Level of support

Use the information below to help you understand the level of support the participant may need. Think about whether capacity building supports would help to develop the participant’s skills and decrease the level of support needed. Look at the participant’s circumstances, including their level of engagement and ability to complete the task.

5.1 No additional support needed

The participant can independently complete the task and no additional hours of individual support are needed.

In a shared living arrangement, there is support available over a 24 hour period.

5.2 Minimal level of support needed

This involves verbal prompts or gestures like reminding the participant to brush their hair or teeth during their daily grooming routine.

Think about the level of support already in the participant’s plan at the shared ratio. This allows support workers to be available and provide flexible support when needed.

5.3 Partial level of support needed

This means active support provided by a support worker, like helping the participant turn on the water tap. It can also include help with part of a task like washing the participant’s legs while showering.

Think about the level of support already in the participant’s plan at the shared ratio. This allows support workers to be available and provide flexible support when needed.

5.4 Full level of support needed

This means a support worker will complete all parts of the task. The support worker might get some help from the participant like raising their arms while showering.

Think about the participant’s capacity to complete or engage in any part of the task and how this may change the time needed to complete the task. If the participant can’t help or has limited capacity, individual support may be needed.

5.5 Complex level of support needed

This level of support is for when a participant can’t complete any part of the task independently. This may be due to behaviours of concern or personal factors that affect the time or support needed to complete tasks. They may need more time and help to adapt or transition to the task, or they might resist starting, continuing or stopping the task. They may also need to do the task more often to maintain their health and hygiene.

When the AHP report says the participant needs this, think about including individual support.

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After speaking with your team leader if you’re still unsure about the level of support, request advice from the Technical Advice and Practice Improvement Branch (TAPIB). To learn how, go to article Create a technical advice case.

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6 Personal care tasks

Note: Funding for personal care tasks in shared living arrangements is included in the Home and Living support category.

To help determine the time needed for these supported activities, think about:

If the participant can complete any personal care activities by themselves.
What the support worker can do to support the participant’s personal care routine. For example, could they use verbal prompts or set up what the participant needs, instead of providing direct, hands-on assistance?
If the participant could complete these tasks with funding for the right assistive technology or home modifications. This could increase the participant’s independence and decrease their need for individual support.
If the participant’s height and weight could affect the level of active individual support needed to complete a task.
If the participant’s disability-related health supports might affect their ability to independently complete their personal care routines.
How long it takes the participant to complete their self-care routines with support, or how long it would take without any support.
If there are behaviours of concern regarding the participant’s personal hygiene, bathing, showering or dressing routines. If there are, can positive behaviour support strategies be implemented to help the participant manage these?

6.1 Showering, bathing, dressing and personal hygiene

Level	Support Type	Description
No additional support needed	Shared	The participant can independently complete all tasks related to showering, bathing, dressing and personal hygiene.
Minimal level of support needed	Shared	The participant may need a reminder to shower in the morning and occasional prompts while showering to use soap and shampoo. They may need a reminder to brush their teeth, wash their hands, apply deodorant and turn off water taps. This might involve regularly checking in or some level of supervision. They may need a prompt to choose weather-appropriate clothing and some supervision dressing themselves.
Partial level of support needed	Shared	The participant may need a support worker to set the water temperature or help to wash a body part that is hard to reach. They may need a support worker to help them prepare for personal hygiene routines, like applying toothpaste to their toothbrush and using the tap. They may need some help with doing up buttons or tying shoelaces.

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Level	Support Type	Description
Full level of support needed	Shared or individual support for up to 120 minutes per day, depending on the participant’s needs and functional capacity	The participant may need active support to get into the shower or bath, to apply soap and hygiene products and to dry themselves. They may need active support to use their toothbrush, help to concentrate while shaving or to apply deodorant. Or they may need short instructions or prompts to complete each task correctly. The participant may need help to pull a jumper over their head and put their arms in sleeves, help to sit down to put their legs into pants or help to remove clothing.
Complex level of support needed	Individual support based on AHP reports and assessments	The participant has faecal incontinence and needs to bathe and change their clothes more than once a day. The participant needs active, individual support for all tasks related to showering, bathing and dressing. This may include transfer to and from a shower chair, operating the shower, applying soap and hygiene products, and drying themselves. They need active support to dress and undress themselves, and to select weather-appropriate clothing and tie shoelaces.

6.2 Skin integrity care

Level	Support Type	Description
No additional support needed	Shared	The participant can independently complete all tasks related to maintaining skin integrity. Or they have no skin integrity concerns.
Minimal level of support needed	Shared	The participant may need to be reminded to apply a skin cream or care product to an affected area. They may need to be supervised when completing these tasks.
Partial level of support needed	Shared	The participant may need help to identify the right amount of a skin care product or help to apply the product to the affected area.
Full level of support needed	Shared or individual support for up to 15 to 30 minutes per day, depending on the participant’s needs and functional capacity	They may need help to identify when a skin care product is needed and to apply the product to the right area. For example, noticing if the participant has a cut and applying an adhesive bandage to the cut.
Complex level of support needed	Individual support based on AHP reports and assessments	The participant may have complex skin picking or biting behaviours and remove their bandages often.

6.3 Toileting

To help determine the time needed to support the participant with toileting, think about:

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What level of support does the participant need to use the toilet? Does the participant need active individual support, or can they call on a support worker as needed?
Could the participant complete these tasks with funding for the right home modifications or assistive technology? This could increase the participant’s independence and decrease their need for individual support.
Are there any behaviours of concern or does the participant experience distress related to their toileting needs? If so, can positive behaviour support strategies be implemented to help support workers respond to the participant’s needs?

Level	Support Type	Description
No additional support needed	Shared	The participant can independently use the toilet and maintain their toilet hygiene.
Minimal level of support needed	Shared	The participant may need a reminder to use the toilet, flush afterwards, wash their hands, wipe after using the toilet. They may need some supervision while completing these tasks.
Partial level of support needed	Shared	The participant may need a support worker to help them check they have completed their toilet hygiene routines after toileting. This includes flushing, wiping and washing their hands.
Full level of support needed	Shared or individual support for up to 15 to 30 minutes per day, depending on the participant’s needs and functional capacity	The participant may need active support to take off or put on clothing for toileting, to sit down or stand up when using the toilet, or to help with wiping or washing hands after using the toilet. Or they may need short instructions or prompts to complete each task correctly.
Complex level of support needed	Individual support based on AHP reports and assessments	If the participant has behaviours of concern, they might need constant redirection and positive behaviour support strategies to complete their toileting routine.

6.4 Changing or using continence products

To help determine the time needed to support this, think about:

Does the participant have continence products or continence care needs they need support to change or maintain? For example, a catheter or stoma if they have a colostomy, ileostomy or urostomy. For more information, go to Our Guideline – Continence Supports (external) or article Understand disability-related health supports – core supports.

Level	Support Type	Description
No additional support needed	Shared	The participant can independently maintain their continence needs. Or, they don’t have any continence-related needs.

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Level	Support Type	Description
Minimal level of support needed	Shared	The participant may need a reminder to change or check a pull-up pad. They may need some supervision while completing these tasks.
Partial level of support needed	Shared	The participant may need a support worker to help them regularly check or change pull-up pads or a catheter.
Full level of support needed	Shared or individual support for up to 15 to 30 minutes per day, depending on the participant’s needs and functional capacity	The participant may need a support worker to change a pull-up pad or to empty a catheter or stoma bag. Or they may need to have their stoma bag changed for them.
Complex level of support needed	Individual support based on AHP reports and assessments	For example, if the participant has an indwelling or suprapubic catheter or an ileostomy as well as behaviours of concern. This might involve picking at their catheter or stoma, or not being aware of when to change or how to manage their continence products.

6.5 Eat, drink and manage a mealtime plan

To help determine the time needed to support this, you can think about:

Could the participant complete these tasks with funding for the right home modifications or assistive technology, like modified cutlery? This could increase the participant’s independence and decrease their need for individual support.
Does the participant require Home Enteral Nutrition (HEN) or Percutaneous Endoscopic Gastrostomy (PEG) feeding with help from a support worker? For more information, go to article Understand disability-related health supports – core supports and Our Guideline - Nutrition supports including meal preparation (external).
Does the participant have any dysphagia-related support needs? What level of support does the participant need to help manage their dysphagia? Is a support worker needed to help the participant eat or drink safely? For more information, go to Our Guideline – Dysphagia supports (external).

Note: If the participant has a mealtime management plan they might need more support and time with this task. For example, when they are unable to chew or eat solid foods and need support with swallowing. A mealtime management plan will give you information about how long each day the participant needs support for this activity. For more information, go to Our Guideline – Dysphagia supports (external).

Level	Support Type	Description
No additional support needed	Shared	The participant can independently eat and drink.
Minimal level of support needed	Shared	The participant may need a reminder to eat at mealtimes and to drink enough fluids. They may need a prompt to cut food into small pieces before eating. When completing these tasks, the participant may need some supervision

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Level	Support Type	Description
Partial level of support needed	Shared	or reminders to slow down or take smaller bites to minimise risk. The participant may need some help with cutting up food into small pieces.
Full level of support needed	Shared or individual support for up to 30 minutes per day, depending on the participant’s needs and functional capacity	The participant needs active, individual support to follow their mealtime management plan and eat their meals safely. They need to have their food cut up into small pieces, be fed with cutlery and help to make sure they properly swallow their food. The participant may need their food cut up into small pieces and supervision to make sure they properly swallow their food.
Complex level of support needed	Individual support based on AHP reports and assessments	The participant may have behaviours of concern and need positive behaviour support strategies in place during mealtimes. For example, the participant needs longer breaks between mouthfuls to minimise risk. Or they need support to maintain meal hygiene.

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7 Behaviours of concern and behaviour support (capacity building)

If the participant has behaviours of concern, you may need to think about extra supports.

To fund any additional supports, we need evidence from a suitably qualified AHP to show the support meets the NDIS funding criteria (external). You can also request advice from the Technical Advice and Practice Improvement Branch. To support this request, you’ll need the current behaviour support plan from a behaviour support practitioner.

To understand behaviours of concern and their impact on supporting the participant, go to articles Guide - Behaviour support and Understand behaviours of concern and restrictive practices in a technical advice case.

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8 Assessments or reports to support decision-making

Participants may need various assessments to determine their functional abilities and support needs. Think about including capacity building funding for the participant to get an assessment from a suitably qualified assessor (external). To learn more about the different types of AHPs and information they can provide, go to article Guide – Identify home and living solutions Appendix B – Allied health practitioners.

8.1 Provider reports

Look at reports from the participant’s providers to find information about the participant’s support needs. This may include:

tasks completed by support workers in the home
incident reports. To learn more about incidents in a shared living arrangement, go to section Behaviour support in supported independent living in article Guide – Behaviour support
information on the participant’s capacity to complete different tasks
a roster of care to help understand the participant’s day-to-day disability-related support needs. For more information, go to How do we decide how much supported independent living support you get? (external)
activities the participant does outside the home
employment-related supports the participant may have.

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9 Next steps

To learn more about support needs for participants who need help to move around, go to article, Understand supports for participants who need help to move around in shared living arrangements.
For a:
- Plan Approval case, you’ll need to use the home and living calculator to determine the home and living amount. This is entered in the plan conversation support tool to develop the draft budget. To add or update this support in a draft budget, go to article Change the draft budget.
- Plan Change or Participant Budget Update case, go to article Action a budget update.

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