High intensity supports in the Redlands, on the mainland and the bay islands, for NDIS participants who need complex care at home. MediHealth Connect provides tracheostomy and ventilator care, PEG feeding, complex bowel care, catheter and stoma care, seizure management and injections, with registered nurses leading every care plan.
The NDIS separates ordinary personal care from care that involves a clinical procedure with the potential to cause serious harm. The second kind is called high intensity daily personal activities, or HIDPA, and a provider must be registered for it specifically. The NDIS Practice Standards set out High Intensity Support Skills Descriptors that describe, procedure by procedure, what a worker must know and be able to do.
The descriptors currently cover complex bowel care, enteral feeding, severe dysphagia, tracheostomy management, ventilation, urinary catheter management, subcutaneous injections, complex wound care, diabetes management and seizure management. For a participant in the Redlands, that framework is the assurance that the people performing these tasks have been trained and are supervised. MediHealth Connect is registered for both high intensity daily personal activities and community nursing, so nurses and trained support workers come from one team.
These are the procedures our Redlands team delivers at home, on the mainland and on the islands. The nurse's care plan, agreed with your specialists, governs how each one is done.
Suctioning, inner cannula and stoma care, humidification and a rehearsed emergency response for a blocked or displaced tube, which matters even more when the nearest hospital is a ferry ride away.
Support for invasive and non-invasive ventilation at home, with circuit care, settings checked against the prescription on every shift, alarm response and staff trained on your particular ventilator.
Feeds by bolus or pump, flushes, tube site care and medications through the tube, following your dietitian's regime exactly. Our PEG feeding guide covers the essentials.
Scheduled bowel programs using digital stimulation, suppositories or enemas, with monitoring for autonomic dysreflexia in participants with spinal cord injury.
Indwelling and suprapubic catheter management, catheter changes by a nurse, intermittent catheterisation support and infection surveillance. See catheter and stoma care at home.
Colostomy, ileostomy and urostomy appliance changes and peristomal skin care, coordinated with your stomal therapy nurse for supplies and product changes.
Observation, seizure first aid and rescue medication administered according to your epilepsy management plan, with each event documented for your neurologist.
Insulin, anticoagulants and other subcutaneous medications with dose verification, site rotation and blood glucose checks where relevant.
Complex care in the Redlands is delivered by registered nurses and by support workers the nurses have trained, and the division of labour is written down rather than improvised.
The registered nurse is the constant. She or he assesses you at the start, writes the plan, checks on you at agreed intervals and carries the clinical accountability throughout. Support workers take on the routine parts of the plan only after the nurse has taught them your care, watched them do it and recorded that they are competent, and they are rechecked on a set date. During shifts the nurse is a phone call away, and if anything about your condition shifts, the nurse takes the care back. Anything that must be done by a nurse, catheter changes and ventilator adjustments among them, is marked in the plan.
Most Redlands participants begin complex care after a stay at Redland Hospital in Cleveland or at a Metro South Health specialist service in Brisbane. The handover home is the riskiest step, and for island participants the logistics add another layer, so we plan it carefully.
Before discharge we obtain the care plan, prescriptions and equipment list, train our staff on your specific care with the ward team where the hospital permits, and organise consumables and equipment with island transport in mind. After discharge, your GP receives our care plan and regular updates, the hospital specialists receive the reports they ask for, and any change to your regime is communicated to every worker on your roster the same day.
We provide high intensity supports throughout Redland City, on the mainland and on the Southern Moreton Bay Islands and North Stradbroke Island, with rosters built from staff who live locally or who plan their shifts around the ferry timetable.
Cleveland and north: Cleveland, Ormiston, Wellington Point, Birkdale, Alexandra Hills
Central and south: Capalaba, Thornlands, Victoria Point, Redland Bay, Mount Cotton
Bay Islands: North Stradbroke Island (Dunwich), Coochiemudlo, Macleay, Russell
West: Sheldon, Thorneside
Related services: community nursing in the Redlands, wound care in the Redlands and medication management in the Redlands. For South East Queensland as a whole, see the high intensity supports overview.
Two budget lines are involved, both in Core. The daily support at the high intensity price limits pays for trained support workers and the supervision behind them, and the disability-related health supports line pays for the nursing. Neither appears in a plan automatically. The NDIA wants a specialist or hospital report that names the procedures, says how often they happen and explains what would go wrong if an untrained person did them.
Our nurses can prepare the clinical reports, and a Redlands support coordinator can help you take them to a plan review or request a variation if your care needs have changed part way through your plan.
The NDIS Commission publishes skills descriptors for the procedures it treats as high intensity. They fall into a few groups: airway and breathing (tracheostomy management and ventilation), nutrition (enteral feeding and severe dysphagia), elimination (complex bowel care and urinary catheter management), medicines and monitoring (subcutaneous injections, diabetes management and seizure management) and complex wound care. If your daily care includes any of these, the provider delivering it needs high intensity daily personal activities registration.
PEG feeding and day-to-day catheter care can be delegated to a support worker in the Redlands once our registered nurse has taught them your routine, watched them do it competently and agreed a supervision arrangement, and once your specialist team is happy with that. Changing a catheter is different: that stays with the nurse. The delegated and nurse-only tasks are both written into your care plan.
On the mainland, overnight and round-the-clock rosters are usually achievable when a plan funds them. On the bay islands it comes down to whether we have island-based staff or staff who can work around the ferry timetable, which changes over time. Rather than promise, we look at your location and procedures first and tell you what we can guarantee before you sign anything.
Our nurse contacts the ward as early as the hospital allows, asks for the care plan, prescription list and equipment needs, and organises our staff to learn your care alongside the ward team before you go home. For island participants we also work out how consumables and equipment will get across the water. Once you are home, the GP gets our plan, the hospital gets the reports it asks for and we check the medication chart against the discharge summary.
There are two layers. The first is general training that matches the NDIS skills descriptors for tracheostomy and ventilation. The second, and the more important, is training on you: your tube, your ventilator, your settings and your emergency plan, taught and assessed by our registered nurse, with a date set to check competence again. Our nurses are AHPRA-registered and go through the participant-specific training too.