Mary is 35 years old and lives with quadriplegia. She lives in a residential aged care facility and wants to live with people closer to her own age.
Mary and her planner work together to understand Mary’s daily support needs. They talk about other housing options to suit Mary’s needs so she can move out of residential aged care.
A report from Mary’s therapist includes a manual handling plan that indicates two carers should assist with her transfers. It includes information about Mary’s disability support needs and the risk to her safety and safety of her carers if a second person is not available during transfers.
Mary wants to move into a home with supported independent living supports and live with two friends Jake and Sarah. Jake and Sarah are also participants who own the home and have asked Mary if she wants to rent the spare room. Jake and Sarah both use wheelchairs and they share a support worker for their daily activities. They have similar support needs to Mary but only need 1:1 support for their transfers.
Would we fund this?
Yes, we could fund supported independent living supports for Mary’s daily activities, and 2:1 ratio of supports for Mary’s transfers to:
- make sure she and her carers are safe
- support her choice to live with Jake and Sarah with supported independent living in her home
There will be times each day when Mary shares a support worker with Jake and Sarah. At other times we will fund a second worker for her transfers.
Why would we fund it?
To decide if a support is reasonable and necessary for Mary, we think about the information she has given us against the NDIS funding criteria.
For us to fund 2:1 support for Mary’s transfers and shared supports for Mary’s daily activities, we consider all of the information against the NDIS funding criteria. We look at whether the support:
- will help Mary pursue her goals to move to live with people closer to her own age
- will help Mary improve her social and work activities
- is something that could be given by Mary’s family or friends
- will be, or is likely to be effective and beneficial in helping Mary live with people closer to her own age and to build her capacity to participate in community activities.
- be value for money, which means the costs of the increased support, is reasonable when comparing the benefits it will give Mary versus the cost of alternative supports
- is something the NDIS is responsible for providing.
What else do we think about?
We think about Mary’s other support needs as well as the support needs of her housemates Jake and Sarah. Mary, Jake and Sarah all have high support needs.
Jake and Sarah need 1:1 support for their transfers and for bathing, eating and dressing. They currently share one support worker to help with their other daily activities.
Because Mary’s support needs are similar to Jake and Sarah’s during the day, Mary is able to share this support for her daily activities.
We also think about whether a ceiling hoist or similar assistive technology would mean that one support worker could assist with Mary’s transfers. We have evidence in the manual handling report that her transfers need two support workers, so we agree to fund this support.
When we create your plan we must think about your supports as a total package of supports. To help us to do this we use the principles we use to create your plan.
Leifa is 25 years old, has an intellectual disability and shares a house with participant Tony. Leifa and Tony live in a supported independent living arrangement and share a support worker at times during the day.
Leifa receives care from a support worker in her home through a provider registered with the NDIS Commission. This care includes the implementation of a behaviour support plan for the possible physical restraint of Leifa during times of high distress. Leifa and Tony share one support worker at home. The behaviour support plan shows one support worker can manage Leifa’s behaviours on their own in the home.
Leifa has a goal to improve her social skills. Her behaviour support practitioner has recommended Leifa attend a weekly community therapy group. Leifa’s previous community activities have shown benefits in her overall behaviour. Leifa’s Behaviour Support Plan includes a Community Outing Support plan. It recommends 2 support workers go with Leifa so she can participate in a community therapy group. The plan includes a functional behavioural assessment showing the possible risk of harm to Leifa and others in less predictable environments. The plan includes details of the roles for each support worker during the community outings.
We don’t fund 2:1 support for Leifa at home because she doesn’t need the support in her home environment.
However, we could fund a 2:1 support for Leifa for the community activity to help her:
- safely access the community. The support workers will make sure Leifa is safe around traffic during her outing and manage behaviours of concern that could put Leifa or others at risk.
- make improvements with her behaviours of concern
- become more involved with social activities.
To decide if a support is reasonable and necessary for Leifa, we think about the information we have against the NDIS funding criteria.
For us to fund a 2:1 support it must meet the all of the NDIS funding criteria. It must:
- help Leifa to pursue her goals
- help Leifa to improve her social and work activities
- not generally be something that could be provided by her family or friends
- be, or is likely to be effective and beneficial in helping her
- be value for money, which means that the costs of the increased support, are reasonable when comparing the benefits it will give Leifa versus the cost of alternative supports
- be something the NDIS is responsible for providing.
When we decide whether we should fund 2:1 ratio of supports for Leila’s community therapy group we think about:
- alternative supports available to help her achieve the same outcome
- the risks to Leifa and others in the community when managing her behaviours of concern
If Leifa gives us a new behaviour support plan in the future that shows her behaviours of concern are decreasing and she can monitor and manage her behaviour in the community, she might no longer need a 2:1 ratio of support.
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