Support at Home

What we provide: wound care, medication management, continence assessment and support, chronic disease monitoring, post-operative care, and palliative and end-of-life support. Nursing is the most-used clinical care service in the program.

What to expect at your first visit. Your nurse will take a clinical history, review your medications and your existing care arrangements, and assess whatever brought us out to you: a wound, your continence, your skin, or a chronic condition that needs monitoring. Wounds are measured and photographed with your consent so that healing can be tracked rather than guessed at.

You will finish the visit with a written plan: what the dressing or care regimen is, how often we will come, what your family or support workers should watch for, and what would make us escalate to your GP. We report back to your GP and to your provider or care partner after every visit, which is how the rest of your care team stays informed.

There is no client contribution for nursing under Support at Home. Nursing sits entirely within clinical care, and clinical care is fully government funded regardless of your income or assets.

What we provide: mobility, strength and balance, falls prevention programs, rehabilitation after a hospital stay or a fall, and mobility aid assessment. Falls prevention is the service with the clearest evidence behind it, and it needs a sustained program rather than a few visits.

What to expect at your first visit. A falls risk assessment is completed at every initial physiotherapy appointment under Support at Home, whether or not falls are the reason you were referred. That is deliberate. Most older people who are at risk of falling have not fallen yet, and the assessment is how we find that out before it happens rather than afterwards.

The falls assessment covers your balance and strength, how you rise from a chair and turn, your walking pattern, your footwear, any dizziness or blood pressure drop on standing, your medications where they affect balance, your vision, and the hazards in your home, including rugs, lighting, steps and bathroom access. Your physiotherapist will also ask directly about any falls or near-falls in the past year, because near-misses predict falls just as well as falls do.

Alongside that, we assess whatever else you were referred for: pain, joint range, endurance, transfers and your mobility aid, including whether it is the right one and set to the right height.

You will finish with a home exercise program written at a level you can actually do, a clear statement of your falls risk and what is driving it, any equipment or referral recommendations, and an agreed visit frequency. Strength and balance work needs to run over months rather than weeks to make a difference, and we will be honest with you about that at the outset.

What we provide: daily living tasks, showering and dressing, equipment prescription, home modification assessment, seating and pressure care, and home safety. Occupational therapy is also the service that prescribes anything complex funded through the AT-HM scheme.

What to expect at your first visit. Your occupational therapist will ask you to show them rather than tell them. Getting out of your chair, walking to the bathroom, stepping into the shower, reaching the kettle. Difficulty tends to show up in the doing, and describing a task from an armchair rarely captures what actually goes wrong.

They will assess your daily living tasks, your transfers and seating, pressure risk if you spend long periods sitting or lying, fatigue and how you pace your day, and the layout, access and hazards of your home. Where a family member or support worker helps you, the therapist will watch that too, because the technique being used matters as much as the equipment.

You will finish with recommendations that fall into two buckets: things that cost nothing, such as changing how a task is done or rearranging a room, and things that need equipment or building work. For the second, your therapist will tell you which AT-HM tier the item is likely to sit in and prepare the prescription, so that the request going to your provider is properly evidenced the first time.

What we provide: general foot and nail care, high-risk foot assessment, diabetes foot checks, callus and corn management, footwear advice and orthoses. Frequently the service that keeps someone walking safely.

What to expect at your first visit. Your podiatrist will assess the skin and nails, check circulation and sensation, particularly if you have diabetes or neuropathy, look at how your feet are loading when you walk, and inspect your footwear, which is often where the problem sits. Painful nails, corns and calluses are usually treated in the same visit.

If you have diabetes, the first appointment includes a full high-risk foot assessment with a risk category, which then sets how often you need to be seen. You will finish with your feet attended to, a recurring visit schedule at the interval your risk warrants, footwear advice, and a plan for anything that needs watching between visits.

What we provide: unintentional weight loss, malnutrition, poor appetite, nutrition alongside chronic conditions, and nutritional adequacy on texture-modified diets.

What to expect at your first visit. Your dietitian will go through your medical history, your medications where they affect appetite or taste, your weight history, and what you actually eat and drink across a normal day. They will ask who shops and who cooks, whether you eat alone, whether chewing or swallowing is difficult, and what has changed recently. Malnutrition in older people is commonly missed because weight loss is put down to age rather than to something addressable.

A validated malnutrition screen is completed at the first visit where it is relevant. You will finish with a practical plan built around food you already eat and can get hold of, rather than a theoretical diet, plus supplement advice where it is genuinely needed and a review to check whether it is working.

What we provide: communication support, and swallowing assessment and mealtime management, including safe textures and fluids, which matters more than most families realise.

What to expect at your first visit. Where swallowing is the concern, your speech pathologist will take a history of what happens when you eat and drink, including coughing, throat clearing, a wet voice, food sticking, or chest infections, then examine the movement and strength of your lips, tongue and jaw, and observe you eating and drinking the textures you normally have.

Where communication is the concern, they will assess understanding, speaking, reading and writing, and how you manage in real conversations rather than only with them.

You will finish with a mealtime management plan setting out safe textures and fluid levels using the IDDSI framework, positioning and pacing advice, and training for whoever assists you at meals, or a communication plan and strategies for the people who talk with you daily. Where swallowing and nutrition are both affected, we work alongside the dietitian rather than in parallel with them.