High-intensity supports in SIL homes: what good complex care actually looks like

“High-intensity daily personal activities” is NDIS language for supports that carry clinical risk: enteral (PEG) feeding, complex bowel care, urinary catheter management, tracheostomy support, ventilator support and subcutaneous injections. The NDIS Practice Standards set specific skills descriptors for each — but standards on paper only matter if a provider genuinely meets them.

What to look for

• Named training, not vague assurance. Ask exactly what training workers hold for the specific support, who delivered it, and when it was refreshed.
• Clinical oversight. Who does the worker escalate to at 2am? Capable providers have registered nurses involved in care planning, delegation and competency sign-off.
• Written protocols. Each participant should have individualised health support plans — not generic templates — developed with their treating health professionals.
• Honesty about limits. The right answer to “can you support this?” is sometimes “not yet — here’s what we’d need in place first.” Providers who never say no should worry you.

How Vitality approaches it

We support participants with complex and high-intensity needs where we have the right staffing, clinical oversight and risk planning in place — including in our supported accommodation. Every high-intensity support is delivered by trained, competency-assessed staff under nurse-led protocols, with onboarding that involves the participant’s full care team.