What Is Module 1: High Intensity Daily Personal Activities?

Registration group 0104, High Intensity Daily Personal Activities, is audited against Module 1 of the NDIS Practice Standards. Registered providers can only deliver the specific high intensity supports listed on their certificate of registration, not every support by default.

What are the skills descriptors?

The high intensity support skills descriptors are supplementary guidance from the NDIS Commission setting out the skills and knowledge a worker needs to safely deliver each high intensity support. Auditors use them to assess whether a provider has met the Module 1 Practice Standards, and providers and workers use them to understand what’s expected and to select or design suitable training.

The support categories

Module 1 covers eight distinct support categories, each with its own outcome and indicators that registered providers must meet under the NDIS Practice Standards.

1. Complex bowel care. For participants at risk of severe constipation or faecal incontinence whose support plan involves non-routine treatment, such as PRN use of laxatives, enemas or suppositories.
2. Enteral feeding and management. For participants who depend on tube feeding, including nasogastric, gastrostomy or jejunostomy feeding, and any medication delivered through a feeding tube.
3. Severe dysphagia management. For participants assessed as having swallowing, biting or chewing difficulties that risk choking, aspiration, malnutrition or dehydration.
4. Tracheostomy management. For participants who use a fenestrated or non-fenestrated tracheostomy and related equipment, including stoma care.
5. Ventilator management. For participants who use a ventilator or related equipment, such as BiPAP or CPAP machines, humidifiers and manual ventilation devices.
6. Urinary catheter management. Covers in-dwelling, in-out and suprapubic catheters. Insertion of in-dwelling and suprapubic catheters is not in scope for support workers and must be done by a health practitioner.
7. Subcutaneous injections. Covers a range of medications, with additional guidance for workers supporting a participant’s diabetes management.
8. Complex wound management. For participants at high risk of pressure injuries, covering both prevention and treatment.

Workers don’t need to be nurses to deliver these supports

Support workers can deliver high intensity supports, and it’s not a requirement for these supports to be delivered by a nurse or any other health or allied health practitioner. The skills descriptors are written specifically for the skills and knowledge expected of a worker who isn’t a qualified health or allied health practitioner, once that worker has been trained and assessed against the relevant support.

The health practitioner’s role includes developing and overseeing each participant’s support plan, reviewing their health status at regular intervals, and providing, or verifying, the training a worker needs before delivering the support.

There are two exceptions where the task itself must be done by a health practitioner. Insertion of in-dwelling and suprapubic urinary catheters must be done by a health practitioner, even though ongoing catheter care can sit with a trained support worker. Training for severe dysphagia management must also come specifically from a health practitioner with expertise in that area, rather than the practitioner-or-trained-worker pathway available for other categories.

What’s required if you’re registered

Providers audited against Module 1 need appropriate policies and procedures in place for each category they deliver, including a training plan for workers. Each participant needs an individual support plan for the relevant support, developed with the participant and overseen by a relevant health practitioner. Workers need to understand each participant’s specific, not just have general knowledge of how to deliver the support.

Providers are responsible for documenting training and reviewing it regularly. The skills descriptors recommend annual competency reviews, and reassessment with refresher training where a worker hasn’t delivered a particular support for more than three months, or where a participant’s needs or support plan have changed.

Epilepsy and seizure support isn’t included in Module 1

Epilepsy and seizure support has its own skills descriptor, but it isn’t formally linked to the Module 1 practice standards the way the eight categories above are. It sits under additional support activities that may co-occur with the core eight, not as a standalone high intensity category.

Do you need to be registered to deliver these supports?

Not at this time, as High Intensity Daily Personal Activities isn’t on the NDIS Commission’s list of supports that require registration.

An unregistered provider can deliver Module 1 supports to a self-managed or plan-managed participant. Registration adds access to NDIA-managed participants, along with the standing that comes with an independent audit against a practice standard built specifically for high-risk supports.