Support at Home documentation requirements: what providers must record

From Home Care Packages to Support at Home

The Support at Home program commenced on 1 July 2025, replacing the Home Care Packages (HCP) program and the Short-Term Restorative Care program. Existing HCP recipients transitioned to Support at Home on 1 July 2025. The Commonwealth Home Support Programme (CHSP) is expected to transition to Support at Home in a subsequent phase. The transition is the most significant structural change to home care funding since the introduction of consumer-directed care in 2015.

For providers, the shift from HCP to Support at Home changes three things that directly affect documentation obligations. First, the funding model shifts from package-level budgets to a needs-based assessment with approved budgets against specific service categories — which means documentation must demonstrate that services were delivered within the approved categories and aligned with assessed needs. Second, the care and support plan takes on greater regulatory weight, as services and documentation must be traceable to its contents. Third, the strengthened Quality Standards, which commenced on 1 November 2025, apply to Support at Home in the same way they apply to residential care — including the outcome-focused documentation requirements of Standards 5, 6, and 7.

New service categories and their documentation implications

Support at Home organises services into distinct funding categories, each with its own approved budget allocation. Documentation must link service delivery to the relevant category and demonstrate that services were delivered within the approved scope. The eight categories are: daily living assistance, nursing care, allied health and therapy, assistive technology and aids, home modifications, support coordination, carer support, and goods and equipment.

For shift notes, the daily living assistance and nursing care categories carry the most direct documentation obligations. Shift notes for daily living assistance must record what personal care or domestic assistance was delivered, how it aligned with the care and support plan, and how the person responded. Nursing care shift notes must meet the clinical documentation requirements of Standard 5 — recording specific clinical observations, the person's response, and any deviations from the care plan. Where nutrition and hydration is part of the service, Standard 6 documentation requirements apply.

Care and support plan alignment

Support at Home introduces a stronger link between the approved care and support plan and the documentation of services delivered. Providers must be able to demonstrate, from the shift note record, that services delivered matched the plan's approved categories and met the assessed needs of the person. This makes care plan alignment — one of the seven documentation failure modes the Commission identifies — particularly important for Support at Home providers. Notes that describe activities without referencing the plan cannot demonstrate this alignment.

What Support at Home shift notes must contain

The documentation standard for Support at Home shift notes is the same as for residential aged care — outcome-focused, person-centred, and specific. The following elements are required by the combination of the Aged Care Act 2024, the strengthened Quality Standards, and the Support at Home program rules.

Services delivered and plan alignment

The note must record what was delivered during the visit, which approved service category it falls under, and how it aligned with the care and support plan. A note that says "personal care provided" without establishing what was done, in what category, and how it related to the plan's requirements does not satisfy the documentation standard.

Person's response and observations

Consistent with the strengthened Standards, notes must record the person's response to care — not just the care delivered. For Support at Home, this means recording how the person was at the start of the visit, how they responded to services, and their condition at the end of the visit. Any changes from the previous visit should be noted specifically.

Concerns, changes in condition, and incidents

Where a worker observes a change in the person's condition, a concern, or a potential incident, the note must record the specific observation, the time, what action was taken, and who was notified. SIRS applies to Support at Home providers with the same reporting timeframes as residential care — 24 hours for Priority 1 incidents, 30 days for Priority 2.