High Intensity Supports Procedure

Participant Support Procedures > High Intensity Supports Procedure

Authorised by Chief Executive Officer

Revised Date: 15 May 2023

Statement

The high intensity support procedure guides Kyeema on the training and record keeping required to deliver the High Intensity Daily Personal Activities Module. The skills and knowledge required are documented in the participants Health Support Plan and the NDIS Practice Standards: High Intensity Support Skill Descriptors

These supports present some of the highest risks for participants, such as complex bowel care, enteral feeding support, dysphagia support, ventilator support, tracheostomy support, urinary catheter support, subcutaneous injections, complex wound care, and epilepsy and seizure support.

This procedure supports Kyeema to apply the NDIS practice standards Module 1 – High Intensity Daily Personal Activities Module

Scope

This procedure applies to relevant managers, participants and the workers who support participants with high intensity daily personal activities.

Relevant legislation

NDIS Practice Standards

NDIS Practice Standards: High Intensity Support Skill Descriptors current version.

Definitions

An appropriate medical or health professional is a person with a qualification in a defined area of medical or health practice, such as a medical specialist, physiotherapist, speech pathologist or dietitian. Such a person may train workers in procedures that relate specifically to their area of expertise.

Procedure

Before supporting a participant with high intensity needs, the worker is required to:

• agree to and sign their own Individual Training Plan (ITP)

• attend all training requirements as per their ITP

• read and understand the participants Health Support Plan

• sign and date the accompanying signing sheet kept in the participants locked file

Annual Skills Review – the workers competency is reviewed annually and training gaps are identified. Workers, team leaders and the training officer

• High Intensity Supports Skills review – Bowel & Catheter CCF-37

• High Intensity Supports Skills review – Severe Dysphagia CCF-54

• High Intensity Supports Skills review – Enteral CCF-55

High Intensity Supports that Kyeema is registered to provide:

• Complex Bowel Care

• Enteral Feeding and Management

• Dysphagia Support

• Urinary Catheter

Additional Support Activities

• Epilepsy & Seizure Support

Consent

The participant must provide their express consent or agreement to any activity not considered part of the everyday or ordinary routine. Express consent is required for procedures such as administering enemas or tube feeding. This must occur prior to the specific procedure being performed for the participant.

A participant's consent is not required in emergency situations. For example, where a participant's life is at risk, medical treatment or first aid can be provided even though the participant may not have given consent. In such situations, a file note setting out the emergency circumstances and the treatment that was carried out is placed on the participant's file.

Awareness & Training

High intensity support workers will have their currency of skills and knowledge reviewed annually and training provided as required. A review may occur where there is change in participant support plans or support workers.

Workers providing high intensity support for dysphagia participants must be trained in the specific health management procedures by an appropriate medical or health professional before they can be performed. Workers who deliver complex bowel care, urinary catheter, enteral feeding and epilepsy support are to be trained by a qualified health practitioner or a person who meets the expectations of the High Intensity Support Skill Descriptors v3

In instances where no specifically trained workers are available to carry out a specific health care procedure for a participant, a manager or team leader should arrange for the participant to access a suitable community medical or nursing service i.e. the Urgent Care Department of the Hospital, District Nurse Service or phone Nurse on Call.

Where appropriate, participants should be taught to perform or to assist with tasks relating to their own health care by suitable health professionals.

The NDIS high intensity support skill descriptors emphasise the importance of having up-to-date skills and knowledge. In most areas, this involves:

• at least an annual review

• if a worker has not delivered a particular support for more than three months or if the participant’s needs have changed, NDIS recommend that the workers’ capability be reassessed and refresher training provided

• dysphagia training provided by a qualified health practitioner with expertise in severe dysphagia management

• training for the other high intensity supports to be provided by a qualified health practitioner or a person who meets the expectations of the High Intensity Support Skill Descriptors v3

• all high intensity workers have an Individual Training Plan (ITP)

Responsibilities

The manager is responsible for ensuring the workers providing the support are trained and competent to provide the relevant health support.

The training coordinator is responsible for ensuring the high intensity workers individual training plans are current and all training is recorded on Sentrient LMS.

Workers and team leaders/supports manager are responsible for completing the annual review.

Record Keeping

Kyeema maintains a data base of trained workers and the direct health supports they are trained to provide. All training is recorded on Sentrient LMS.

All training and competency reviews are properly documented and recorded on Sentrient

High intensity workers have an Individual Training Plan (ITP).

ITP’s – Sentrient Workflow (k/dve interim)

Annual skills review (CCF37, CCF-54, CCF-55) are filed electronically and locked filing cabinets. Annual review and training are recorded on Sentrient

Related Policies, Procedures and Documents:

NDIS Practice Standards

NDIS Practice Standards: High Intensity Support Skill Descriptors current version

Complex Bowel Care Procedure

Dysphagia Support Procedure

Health Support Plans

Enteral Feeding Support Procedure

Behaviour Support and Restrictive Practices Policy and Procedure

Health Support Plan – Mealtime Management or Dysphagia Support CCF-83

Health Support Plan - Bowel Care CCF-81

Health Support Plan - Catheter Care CCF-50

Health Support Plan - Epilepsy CCF-46