An occupational therapy (OT) home assessment is more than a visit to someone’s home. For Support at Home providers, the assessment report is an important part of understanding a participant’s functional needs, identifying barriers within the home and determining what practical solutions may be appropriate.
A well-prepared report should give the provider a clear picture of what the participant is experiencing, why it is happening and what may help. So, what should an OT home assessment report include?
1. Participant information
The report should clearly identify the participant and provide relevant background information. This may include:
- Participant name
- Assessment date
- Property address
- Relevant referral information
- Reason for assessment
- Relevant functional or mobility information
- Existing supports or equipment
The information included will depend on the purpose and complexity of the assessment.
2. Reason for the assessment
The report should explain why the assessment was requested. For example, the participant may be:
- Experiencing difficulty moving around the home
- Having difficulty using the bathroom
- Experiencing falls or near falls
- Finding stairs increasingly difficult
- Having difficulty with transfers
- Using a new mobility aid
- Returning home after hospitalisation or rehabilitation
- Experiencing a change in functional capacity
- Considering a home modification
Understanding the reason for referral provides context for everything that follows.
3. The participant’s goals
A good assessment should not focus exclusively on hazards or equipment. It should consider what the participant wants to be able to do.
For example: “I want to continue showering independently” or “I want to be able to get into my garden again” or “I want to be able to use the front entrance without needing someone to help me.”
These goals help ensure that recommendations are connected to something meaningful to the participant.
4. Functional assessment
The OT should consider how the participant manages relevant everyday activities. Depending on the circumstances, this might include:
- Walking
- Transfers
- Sitting and standing
- Using stairs
- Getting in and out of bed
- Showering
- Toileting
- Dressing
- Meal preparation
- Moving between rooms’
- Entering and leaving the property
- Using mobility equipment
The assessment should be tailored to the participant rather than applying the same checklist to everyone.
5. Home environment assessment
The physical environment is an important part of an OT home assessment. The OT may assess areas such as:
Entrance
Steps, thresholds, pathways, handrails and access to the property.
Bathroom
Shower access, toilet access, transfers, flooring, fixtures and available support.
Bedroom
Bed access, transfers, pathways and access to the bathroom.
Kitchen
Layout, storage, work surfaces and the participant’s ability to complete relevant tasks.
Living areas
Furniture, circulation space, transfers and movement around the room.
Stairs
Handrails, lighting, step configuration and the participant’s ability to safely negotiate the stairs.
The areas assessed will depend on the participant’s individual circumstances.
6. Identified barriers and risks
The report should explain what is making an activity difficult. Rather than simply stating “Bathroom is unsafe”, a useful report should provide more context. For example “The participant has difficulty stepping into the existing shower due to reduced lower-limb strength and requires additional support when transferring over the shower threshold.’
This connects the person, the activity and the environment. This information is much more useful when determining what solution may be appropriate.
7. Recommendations
Recommendations are one of the most important parts of the report. Where appropriate, the OT may recommend:
- Grab rails
- Handrails
- Shower seating
- Bathroom modifications
- Ramps
- Changes to thresholds
- Improved access
- Mobility equipment
- Assistive technology
- Changes to furniture or layout
- Other practical interventions
The recommendation should be connected to the participant’s assessed needs.
8. Clinical rationale
A recommendation should explain why it is being made. For example, rather than simply “Install grab rail”, the report may explain that a grab rail is recommended to provide additional support during a particular transfer or activity.
This connection between the participant’s functional difficulty and the proposed solution is particularly important when a recommendation relates to a home modification. Under the current Assistive Technology and Home Modifications (AT-HM) scheme, home modifications require an OT prescription, and the prescription needs to demonstrate that the modification addresses an identified need and helps optimise function or manage disability or age-related functional decline.
9. Recommended location and installation considerations
Where a physical modification is recommended, the report should provide enough information to help the next stage of the process. Depending on the modification, this may include:
- Recommended location
- Positioning considerations
- Dimensions or measurements where appropriate
- Type of modification
- Installation considerations
- Access requirements
- Other relevant environmental considerations
The exact level of detail will depend on the complexity of the modification. For more complex projects, additional assessment, design or specialist input may be required.
10. Priority of recommendations
Not every recommendation will have the same level of importance. A report may help distinguish between:
High priority
An issue that is creating a significant safety or functional concern.
Medium priority
An issue affecting independence or making an activity unnecessarily difficult.
Lower priority
A change that may improve convenience, accessibility or future usability.
Prioritisation can help providers and participants determine where to focus first.
11. Photographs and supporting information
Where appropriate and with the necessary permissions, photographs can help document the environment and illustrate the issue being addressed. For example, photographs may help show:
- A bathroom layout
- Shower access
- Steps
- Doorways
- Thresholds
- Existing rails
- Areas requiring modification
Other supporting information may also be included where relevant.
12. Prescription Information
Where a home modification requires an OT prescription under the AT-HM scheme, the relevant prescription information should be clearly documented.
The prescription should establish the connection between:
Participant need → Functional problem → Recommended modification → Expected functional benefit
This provides a clearer basis for the provider to consider the recommendation and determine the appropriate next steps.
What a good report should ultimately answer
At the end of an OT home assessment report, the provider should be able to answer several straightforward questions:
What is the participant struggling with?
The report identifies the functional issue.
Why are they struggling?
The assessment explains the relevant interaction between the person, activity and environment.
What does the participant want to achieve?
Their goals provide context for the recommendations.
What could help?
The OT provides appropriate recommendations.
Why is that recommendation appropriate?
The report provides the clinical rationale.
What should happen next?
The report provides enough information to support the next stage of the process.
The assessment is more than the report
A high-quality OT home assessment isn’t simply about producing a document. The report is the output of a clinical assessment. The real value comes from understanding the participant in the environment where they live and translating that understanding into practical recommendations.
That’s why we don’t start with a product. we start with a person. A grab rail, ramp or bathroom modification is only useful if it addresses an actual need and helps the participant achieve something that matters to them.
From OT Home Assessment to home modification
For Support at Home providers, the OT Home Assessment can be an important early step in the home modification process.
The pathway may look like:
Participant has a difficulty → Provider identifies the need for assessment → OT home assessment → Recommendations and prescription → Provider reviews recommendations → Funding and approval considerations → Quotes / scope of works → Modification
The OT’s role is to assess and make appropriate clinical recommendations. The provider then considers those recommendations alongside the participant’s circumstances, support plan and applicable funding requirements.
How Home Access Group can help
Finding an appropriate OT and coordinating an assessment can take time. Home Access Group provides Support at Home providers with a straightforward pathway to OT home assessments.
You refer the participant → We coordinate the OT → The OT conducts the assessment → We provide the assessment and recommendations back to you
This allows your team to access the clinical assessment they need without having to manage every step of the process themselves.
One referral. One coordinated process. Clear recommendations.
A safer home starts with understanding the person
Every home is different. Every person is different. That is why the right approach starts with the individual rather than a list of products. At Home Access Group, we help coordinate OT home assessments that consider the person’s needs, goals, functional abilities and home environment.
The mission is simple: Help people stay safe, independent and at home for longer. If you or someone you care for is finding everyday activities around the home more difficult, an OT home assessment may be a useful place to start.
Your home should work for you – not the other way around. Reach out and we’ll get back to you as soon as possible.
Information about Support at Home and the Assistive Technology and Home Modifications scheme can change. Providers should refer to current Australian Government guidance when making funding and service decisions.
