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Bundaberg/Bargara
Supported Respite Care
24th-27th February 2023

All clients and staff must return a negative RAT 72 hours before attending

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* 1. This service agreement is for this participant in the National Disability
Insurance Scheme to participate in Sunshine Home
Support February group supported respite care STA - Dates 24th - 27th February 2023.

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* 2. Pick up and drop off address:

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* 3. Payments
After providing supports, Sunshine Home Support will issue an invoice. We process invoices and payments weekly on a Monday. After invoices have been received it is expected to be paid within 7 Business days. If payment has not been received by NDIS you will be personally responsible for all payments.

Cancellation
You must provide us with at least 15 days notice if you wish to cancel your STA booking. If you fail to provide us with the 15 days notice of cancellation, and we are therefore unable to provide the scheduled supports or part thereof, we will need to charge you a cancellation fee equal to 100% of the price of the cancelled supports. Should no notice of cancellation be received and the provider arrives at the participant’s home (or other agreed location) to collect participant, if the participant is not be present and does not respond to phone calls or text messages within 15 minutes of agreed support start time, the provider will attempt to contact the participant’s emergency contact person – if this person is unreachable the provider will contact police to request a welfare check on the participant and will continue on the STA without the participant.

Please sign below to agree with the cancellation terms and conditions:

I agree that if I fail to provide 15 days notice of cancellation, I will be charge the cancellation fee equal to 100% of the price of cancelled supports.

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* 4. Feedback, Complaints and Disputes
If you wish to give us feedback, you can talk to:
1. Your support worker on shift
2. Sunshine Home Support Office 0478 365 098
3. Your Support coordinator or Local Area Coordinator
4. National Disability Insurance Agency by 1800 800 110
5. Commonwealth Ombudsman 1300 362 072

Our Responsibilities
1. Provide you with a safe environment to stay and all your personal care needs are met
2. Treat you with courtesy, respect and listen to your needs
3. Consult you on decisions about how supports are provided
4. Give you information about managing any complaints or disagreements, and details of our cancellation policy
5. Listen to your feedback and resolve problems quickly
6. Give you a minimum of 24 hours notice if we have to change a scheduled appointment provide supports
7. Protect your privacy and confidential information
8. Provide supports in a manner consistent with all relevant laws, including the National Disability Insurance Scheme Act 2013 and rules, and the Australian Consumer Law
9. To provide you with copies of all relevant policies procedures and contracts

You agree to
1. Inform us about how you wish the supports to be delivered to meet your needs
2. Ensure that Sunshine Home Support staff are treated with courtesy and respect at all times.
Any verbal, physical or emotional abuse to support staff. All staff have right to leave and we can
cancel all supports with no notice if courtesy and respect not up held.
3. Talk to us if You have any concerns about the supports being provided
4. Let us know immediately if your NDIS plan is suspended or replaced by a new NDIS plan or
the NDIS coverage is terminated.
5. No illegal drugs will be used or kept on you while on the STA and support staff are assisting
you.

Goods and Services Tax (GST)
For the purposes of GST legislation, you and we confirm that: a supply of supports under this
Service Agreement is a supply of one or more of the reasonable and necessary supports
specified in the statement included, under subsection 33(2) of the National Disability Insurance
Scheme Act 2013 (NDIS Act), in Participant’s NDIS plan currently in effect under section 37 of
the NDIS Act; Participant’s NDIS plan is expected to remain in effect during the period the
supports are provided; and You will immediately notify us if Participant’s NDIS Plan is replaced
by a new plan or Participant stops being a participant in the NDIS.

Whats included
1. Pick up and drop off from your location and all other travel
2. Accommodation
3. All meals, snacks and drinks
4. All activities and entertainment
5. Support staff

What To Bring
Please don’t bring anything valuable as we do not take any responsibility for anything that gets
lost stolen or broken.
1. All medication and PRN’s, including any medical devices such as cPap.
2. Enough clothes for the length of your stay
3. Swimmers, beach towel, thongs, rash shirt
4. Toiletries including toothpaste, toothbrush, shampoo and conditioner, sunscreen, soap for
showering, bath towel, hairbrush, lip gloss/moisteriser etc...
5. Good enclosed walking shoes (needed for some activities)
6. Back pack
7. Water bottle
8. Hat
9. Companion card (if you have one)
10. Phone, camera and chargers
11. Small amount of spending money for any souvenirs you want (not required)

What you're not allowed to bring
Candles, illegal drugs, weapons, fireworks and flammable liquids. Sporting goods, kitchen utensils, tools, and other items with sharp edges or points capable of injuring a person. Sharp items that are not weapons but are capable (with or without modification) of causing harm by penetration. Alcohol if you're under th

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* 5. Accommodation
We will be accommodated in an Airbnb in Bargara which is a small suburb on the beach near Bundaberg. The house is equiped with free WIFI, washing machine, dryer and full kitchen facilities.



Luggage
To help you plan, you must limit your luggage to a maximum of 1 large suitcase and one small bag/small suitcase per person. Please try to keep the baggage weight to under 20kgs for the safety of staff.

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* 6. Medication
Do you need any medication assistance?

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* 7. If yes, please provide details:

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* 8. Does it need to be kept in the fridge:

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* 9. Food & Dietary Requirements
Breakfast will be at the respite house each morning which may include a selections of cereals, toast, fresh fruit, pancakes, bacon, eggs, spaghetti, juice, milo, tea and coffee.
Morning tea and afternoon tea we will have tea, coffee, milo, soft drinks and a range of snacks and fruit available at all times.
Lunch and Dinner will be a range of eating out at restaurants and at different venues, eating at the respite house or meals we have cooked.
If you have any dietary requirement please let us know so we can accommodate you including allergies, gluten free, Dairy Free, Sugar Free, vegan, vegetarian, Maoi Diet ect.

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* 10. Please indicate which STA you would like to go on

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* 11. Support Category and Ratio

Please tick what support level you require this is for the safety for yourself and others this will include 3 nights and 4 days.

Minimal or no support to eat, drink, walk, communicate, swim, shower, groom this is in a group setting where you will share a support worker with others. Must be able to administer own medications without any assistance from support staff. You are not guaranteed to have your own room and may be sharing with either a support worker or another participant of the same gender. Will be extra for any hire equipment that you require.

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* 12. Medium level of support or supervision is required to eat, drink, walk, communicate, swim, shower, groom, you will share a support worker with one other participant. Must be able to administer own medications with minimal assistance from support staff. You are not guaranteed to have your own room and may be sharing with either a support worker or another participant of the same gender. Will be extra for any hire equipment that you require.

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* 13. High level support required unable to eat, drink, walk, communicate, swim, shower or groom independently. Needs support staff to help with administering all medications. You will have a support worker available to you 24/7, you  are guaranteed your own private room, with the option to have a support worker in your room with you or to be in a separate room. We will pay for any equipment hire that you may need.

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* 14. Have you attend a group supported respite/STA with Sunshine Home Support before

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* 15. Do we need to hire you any of the following equipment

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* 16. Do you agree to completing a RAT before attending the STA - we can provide this to you

Please note - you do not need to be vaccinated to attend this group STA

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* 17. Activities Request
Please tick what activities you would like to attend. Activities can change due to weather and other unforeseen circumstances. There will always be staff left at the respite house if you wish to stay home and relax you can do so.



Bundaberg STA/Supported Respite Care

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* 18. Support Options
Please tick what support is best for you, please be advised this may change your support ratio

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* 19. Photography Options

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* 20. Covid 19
Please be advised if for any reason Covid 19 affects the STA from operating, you will not be charged for the cancellation. If Covid 19 affects you personally  you have contracted the virus and need to self isolate - there will be a fee payable, for example - if we can not get funds back from accommodation already booked and paid for, etc.

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* 21. Have you check with your Support Coordinator about having the availability and the funds to go on this STA?

Date

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* 22. No
Please do not sign and return this form until this has been completed

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* 23. Upon returning this form - please also make contact with SHS Management in regards to-
  • Any further details in relation to dietary requirements
  • Any further details in relation to medication requirements
  • Any queries, questions or concerns

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* 24. Agreement Signatures –

We agree to the terms and conditions of this Service Agreement
(And/Or)

0 of 24 answered
 

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