24 hrs care

NDIS 24 Hour Care · Australia

24 Hour Care

Three providers can all say “24 hour care” and mean three different arrangements costing between $207,000 and $800,000 a year. This page sets out the arithmetic, the models, and which one you are actually being offered.

“24 hour care” is one of the least precise phrases in Australian disability support, and the imprecision is expensive.

It can mean a worker awake and present every hour of every day. It can mean a worker present through the day and asleep on the premises overnight, available if woken. It can mean two or three people sharing a house with workers rostered across all of them. And it can mean a worker in the building who is supporting someone else for most of the night.

Those are not variations on a theme. At current NDIS price limits the gap between the most and least intensive is more than half a million dollars a year for the same calendar coverage.

So this page does something the provider pages on this topic generally don’t: it works through the actual numbers, names the three models, and explains how to tell which one you are being offered.

A note on scope before we start, because it matters. We are a registered NDIS provider — NDIS Provider No. 4050164422 — and not an approved aged care provider. If you are looking for 24-hour care for an older parent who has never been an NDIS participant, the system that funds that is aged care, not the NDIS, and the honest starting point is My Aged Care on 1800 200 422. We have written a full section on that boundary below, because a lot of people arrive at pages like this one in the wrong system and nobody tells them.

The three models

Worth getting precise, because the phrase is used for all three.

Active 24/7 support. A worker is awake and present at all times, one-to-one. Nobody is asleep on shift. This is what most people picture, and it is the rarest arrangement in practice because of what it costs.

Active days, sleepover nights. A worker is awake and present through the day and evening, then a sleepover shift covers the night — the worker sleeps on the premises and is available if something happens. Under the 2026-27 NDIS Pricing Arrangements a sleepover is a flat $311.79 per night and includes up to two hours of active support; beyond that, additional active hours are billed on top. This is the most common genuine 24-hour arrangement for one person living alone.

Shared support in a supported home. Two to three people share a dwelling, and workers are rostered across all of them. Each resident has round-the-clock cover, and for much of the day they are sharing a worker at a 1:2 or 1:3 ratio. This is how the large majority of 24-hour arrangements in Australia are actually delivered, and it is the only one most people can afford.

A fourth thing gets called 24-hour care and isn’t: on-call support, where nobody is on the premises but someone can be reached by phone. That is a legitimate arrangement for some people and it is not 24-hour care. If a provider’s “24/7” turns out to mean a phone number, that is worth establishing early.

What it actually costs

Here is the arithmetic, worked at the 2026-27 NDIS price limits for a standard support worker in a standard (non-remote) area.

The rates, which vary by time of day and day of week:

A shift crossing two bands is split and billed at each applicable rate.

Model A — active 24/7, one-to-one

A weekday runs 14 hours at the daytime rate, 4 hours at the evening rate and 6 hours of active overnight: $1,849.82 per day. Saturday at 24 hours is $2,484.96. Sunday is $3,204.00.

That is $14,938 per week, and allowing for around eleven public holidays a year charged at the public holiday rate, roughly $799,600 a year.

Model B — active days, sleepover nights

Sixteen hours of active support to 10pm, then a sleepover: $1,504.05 on a weekday, $1,968.43 Saturday, $2,447.79 Sunday.

That is $11,936 per week, or approximately $636,400 a year.

So moving from waking nights to sleepover nights saves around $163,000 a year — which is why the clinical justification for active nights matters so much, in both directions.

Model C — shared 1:3 daytime, shared sleepover

Where daytime support is shared across three residents and the overnight sleepover covers the household, the per-person cost falls to roughly $3,979 per week, or about $206,900 a year.

What the real-world numbers say

Set those against what the NDIA actually pays.

The average committed Supported Independent Living plan budget is around $488,200. Core daily activities payments relating to SIL participants totalled $12.4 billion in the year to 30 June 2026 across roughly 36,808 participants — about $337,000 each.

Both figures sit below Model B and well above Model C. That tells you something important: almost all real 24-hour arrangements in Australia are a blend of shared ratios and sleepover nights, not continuous one-to-one active support. A provider quoting “24-hour care” within an average SIL budget is necessarily offering something closer to Model C than Model A, and that is not dishonest — it is the arithmetic. It is only dishonest if nobody says so.

In remote and very remote areas, loadings of 40% and 50% apply, which takes Model A past $1.1 million and $1.2 million respectively.

How to tell which model you are being offered

Ask these, in this order:

“Is a worker awake at all times, or is the overnight shift a sleepover?” This single question separates a $636,000 arrangement from an $800,000 one, and most quotes do not make it explicit.

“If it’s a sleepover, what happens when the worker is woken?” A sleepover includes up to two hours of active support. Someone needing attention four times a night is not in a sleepover arrangement — they are in an active night arrangement that has been costed as a sleepover, and either the funding or the roster is wrong.

“What ratio applies at each part of the day?” Not an average. Morning personal care at 1:1 and daytime at 1:3 is a reasonable arrangement; personal care at 1:3 is not.

“Is the worker supporting anyone else during my hours?” In a shared house the answer is yes for part of the day, which is fine if it is stated. It is the unstated version that causes trouble.

“Can I see the roster of care?” Not a summary — the document showing hours, ratios and times that the provider submitted and the NDIA approved. You are entitled to it.

“How many workers are in this roster?” A week has 168 hours. Covering it sustainably takes four to six workers before you account for illness, leave, turnover and public holidays. A provider delivering 24-hour support from three workers has no resilience, and the first failure will be a Sunday night.

Our high care page covers support ratios and the roster of care in more depth, and our complex care page covers the clinical competency requirements where round-the-clock support involves clinical tasks.

Where 24-hour care is delivered

In a person’s own home, with workers attending on a roster. This is what most people mean by “24 hour care at home”. It is entirely achievable and it is the most expensive model per person, because there is nobody to share with.

In a shared supported home — supported independent living. Around 36,808 participants live in SIL nationally, about 4.8% of all participants, and this is where most 24-hour arrangements actually sit.

In specialist disability accommodation, where the building itself is purpose-built. SDA funds the dwelling; the support inside it is funded separately. Our SDA page covers the design categories.

With family, alongside funded support. The most common arrangement of all, and the least discussed.

Night-time, properly considered

The overnight hours are where 24-hour arrangements are decided, and they get less attention than any other part of the day.

What a sleepover is and isn’t. The worker sleeps on the premises. They can be woken. The flat rate includes up to two hours of active support. It is appropriate where overnight needs are occasional and unpredictable — someone who might need help to the bathroom, or reassurance after a bad dream, or assistance if they fall.

When a sleepover is not adequate. Where someone needs repositioning several times a night to prevent pressure injuries. Where seizures require a timed response. Where suctioning or ventilator management is needed. Where someone wakes and becomes distressed or disoriented regularly. In those situations a worker who must be woken each time is both an inadequate clinical arrangement and an unsustainable one for the worker.

When active night support is the wrong answer. Being observed while you sleep is a genuine imposition. For an adult who has had it for years it can be distressing, and some people would rather accept a degree of risk than give up the only private hours they have. That is a legitimate position and it should be documented rather than overridden.

The thing that should be written down. Which model applies, why, and on what clinical evidence. An arrangement described only as “overnight support” is the line most likely to be cut at a plan reassessment, because nobody can say what it was for.

A practical check for families: ask what actually happened overnight last month. A provider with good records can tell you how many times a worker was woken and for what. A provider who cannot is not monitoring the thing that determines whether the arrangement is right.

The over-65 and aged care boundary

This is the section most pages like this one leave out, and it is the one a lot of readers actually need.

If you are looking for 24-hour care for an older person who has never been an NDIS participant, the NDIS is not the pathway. You cannot join the NDIS after turning 65. The system that funds aged care at home is Support at Home, which replaced Home Care Packages on 1 November 2025, and access runs through My Aged Care on 1800 200 422.

Some things worth knowing about that system, because they are genuinely different:

Support at Home is means tested. NDIS funding is not. Your income and assets affect what you contribute.

Funding is set through eight classifications based on assessed need, rather than four fixed package levels, and is paid quarterly.

Clinical care — nursing, wound care — is fully government funded regardless of income. From 1 October 2026, personal care such as showering, dressing and continence support also became fully government funded, with the co-contribution for it ending.

Genuinely continuous 24-hour care is not what Support at Home is designed to deliver. Package funding at the highest classifications does not approach the $600,000-plus that round-the-clock one-to-one support costs. Families seeking 24-hour care at home for an elderly parent through aged care funding generally find the gap is filled privately, by family, or by moving to residential aged care. That is an uncomfortable answer and it is better heard early than discovered after months of looking.

If the person was already an NDIS participant before turning 65, nothing changes automatically. The plan, the providers and the funding continue. It ends only if they move permanently into residential aged care, or start permanent home care for the first time after 65. Moving from the NDIS to aged care is generally a one-way door, so for someone already in the scheme with high support needs, staying put is usually the right call — but it is worth deciding deliberately.

We can’t help with aged care funding, and we would rather say so on the page than take an enquiry we can’t serve. If that is your situation, My Aged Care is the call to make, and a good aged care placement adviser or an independent advocate is worth talking to before committing to anything.

Dementia, and where the NDIS does apply

Because “24 hour dementia care at home” is something a great many people search for, and the answer is more specific than most pages admit.

Dementia diagnosed before the age of 65 — younger onset dementia — can be NDIS-eligible. Dementia Australia’s guidance is that a person who was under 65 when diagnosed may be eligible, and the test is age at diagnosis rather than current age. Eligibility is not automatic, and the usual access requirements still apply.

For someone in that position, an NDIS plan can fund daily living support including supported independent living, home modifications and assistive technology, behaviour support planning, carer training, allied health, and social participation.

Dementia diagnosed at 65 or over is an aged care matter, through My Aged Care.

Younger onset dementia is a particularly difficult situation — people are frequently still working, often have children at home, and fall between services designed for older people and services designed for younger people with disability. The National Dementia Helpline on 1800 100 500 is a genuinely useful first call, and Dementia Australia’s own guidance is better than anything a provider will write.

The same age-at-diagnosis logic applies to other progressive conditions: Parkinson’s disease, motor neurone disease, multiple sclerosis and Huntington’s disease are all NDIS-fundable where the person entered the scheme before 65, and all commonly progress to needing round-the-clock support. For those conditions the useful planning point is that needs change faster than plans do — a 24-hour arrangement built for today’s function will be wrong within a year, and the review should be scheduled rather than triggered by a crisis.

When a family has been doing it themselves

The most common form of 24-hour care in Australia is unpaid, and the transition to funded support deserves its own section because it is handled badly so often.

Families who have provided round-the-clock care for years develop knowledge no service has: how a transfer actually works, what the early signs of a bad day look like, which approach settles someone and which escalates. Handing that over is genuinely hard, and the instinct to keep managing from outside is understandable.

What helps:

Write it down before workers arrive. Routines, equipment, communication, early warning signs, what helps, what makes things worse. A good provider will want this document and will train from it.

Expect the first months to feel worse. Function frequently dips during a transition, and an unfamiliar worker genuinely is harder than a parent who has done it for twenty years. That is a transition effect, not proof the arrangement is wrong, and it is worth agreeing in advance how long to give it.

Be realistic about what the funding buys. If the family has been providing sixteen hours a day unpaid, a plan funding eight hours is a reduction in care, not an addition — and the gap will come back to the family. That is an argument to make at planning, with evidence, rather than a disappointment to absorb afterwards.

Protect the respite. Where short term accommodation funding exists, using it is what makes the whole arrangement sustainable. Many families at this intensity cannot find respite able to take someone with high needs, which is a capability gap worth asking about specifically.

Step back once the team is established. Workers take direction from whoever gives it. If that is always a parent, the person being supported is being trained out of authority over their own life.

What to ask a 24-hour care provider

• Is a worker awake at all times, or is the overnight shift a sleepover?
• If it’s a sleepover, how often was the worker woken last month?
• What ratio applies at each part of the day?
• Is the worker supporting anyone else during these hours?
• Can I see the roster of care, not a summary?
• How many workers are in this roster, and what happens when two are unavailable?
• What proportion of shifts are filled by agency staff?
• Who provides clinical oversight, and how is it reached at 3am on a Sunday?
• What is your turnover in this arrangement over the past twelve months?
• What have you declined to take on, and why?

Warning signs: “24/7” that turns out to mean on-call; an overnight model left unspecified; no numbers on roster depth; a quote that doesn’t distinguish sleepover from active night; and a provider who agrees before assessing the person.

Our approach

We deliver round-the-clock support across New South Wales — in supported independent living homes, SDA dwellings and people’s own homes.

We are specific about the overnight model and why it applies, because the difference between a sleepover and an active night is both a clinical judgement and $163,000 a year, and leaving it vague serves nobody.

We build roster depth rather than minimum coverage, because a roster that collapses when one worker is unwell was never a roster.

We tell you which model your funding will actually buy, including when the honest answer is that continuous one-to-one support is not within the plan and a shared arrangement is what is achievable.

And we say no when the honest answer is no — including when the right answer is aged care rather than us.