Complex care, without losing the person in the process

The first thing I tell a new participant's family is that the clinical skills are the baseline, not the point. Anyone on our high intensity roster has been trained and assessed as competent in the specific care that participant needs — that part isn't negotiable.

What actually earns trust is everything around it: explaining each step before doing it, keeping routines consistent so a non-verbal participant isn't surprised by their own care, and working properly alongside the nurses and allied health team instead of around them.

One of my longest participants has complex respiratory needs and has been nonverbal since birth. His mum says the biggest difference between services isn't competence — everyone claims competence — it's whether the worker still talks to him, not just about him, while they work.

That's really what high intensity support is meant to be: the same dignity and choice as every other service we offer, it just happens to come with enteral feeds and seizure plans attached.