Home adaptations and occupational therapist assessments

This information applies to England and Wales.

Your occupational therapist (OT) wants to find out what you need to support you in your home.

The OT will also look at your home. They write a report about you and what changes to your housing could make your life easier.

Finding the right equipment and assistive technology

If you do not own your home, you will need permission from your landlord to make any changes to physical features.

Most people are assessed by their local authority, but some care teams also include an OT. Getting an assessment and adaptations can take time. You could also get a private assessment.

Talking to your landlord

You will need to get your landlord’s permission to change any physical features. This could be a private landlord, housing association or your local authority.

If you count as disabled under the Equality Act, you have the right to reasonable adjustments. This means adjustments that do not mean making a physical or structural change to your home.

Definition of disability under the Equality Act 2010 (GOV.UK)

Landlords, disabled tenants and adaptations

Getting an assessment

Most people get an assessment by asking their local authority’s adult social care team. There may be a waiting list.

If your care team includes an OT, the OT might be able to assess you. Ask them how you could get an assessment.

Getting home adaptations

Contacting your local authority

Some home adaptation information can be hard to find. Look for a section of your local authority’s website that talks about ‘housing’ or ‘disabled people’. Some pages might be called 'help to stay in the home' or ‘care assessments and housing adaptation’.

Sometimes it’s not clear who you should contact. If you’re not sure, contact your local authority’s general number or email address. They can tell you who to contact or refer you to the correct department. It can help to ask for the Community Occupational Therapy office.

Find your local council (GOV.UK)

Private assessments

If you are planning to pay for your own adaptations, you could pay an OT to assess you. This OT would not be working for your local authority or the NHS.

Paying to be assessed could be faster than waiting for your local authority to assess you. Your local authority or Home Improvement Agency may be able to recommend an OT service.

If you do not own your own home, you will still need permission from your landlord to make changes to physical features.

If you decide to have an OT report from another service or the NHS, check your housing provider will accept this.

Search for a registered Occupational Therapist (Health and Care Professions Council)

Find an Occupational Therapist (Royal College)

Before your assessment

Say if you need support in the assessment. For example, if you want:

  • someone else there to support you, like a family member, friend or independent advocate
  • to see the OT alone, without your parent or carer
  • to meet at a particular time of day because of your condition

Getting support and knowing your rights to adaptations can be difficult. An advocate or social worker may be able to help support you with your social care assessment.

Advocates for social care assessments

Advocacy and links to organisations (Disability Rights UK)

Make a list of:

  • anything you find difficult to do at home and want them to pay attention to
  • what’s important for you to do at home and why
  • equipment and adaptations you’ve already tried and reasons why they did or did not work

For example, if you’ve used a shower in a wet room when you’ve not been able to bathe at home.

What happens in an assessment

The OT will visit you at home to see how things are set up there. They want to know:

  • what you can do around the home
  • what you find difficult to do
  • what you need to do things safely

They will ask you questions about:

  • how things can be made easier
  • what equipment you’ve already tried

They might ask you to show them how you do things. You can say if you do not want to and they will find another way to find out what adaptations might help.

You can ask for a specific adaptation, but the OT will need to understand why you need it.

For example:

“My condition means that I can’t stand safely in my shower or get in and out of my bath. And sitting on a bath board is painful for me.

I’ve tried a shower chair but it doesn’t fit in my shower. Would a wet room with a chair be the best way for me to clean myself?”

The OT will think about what equipment will help you

They will start by thinking about the smallest change that could make the biggest difference. This could be a bath board, bath rails and then maybe a wet room.

If your condition means that you need support with personal care, they may ask you some personal questions.

For example, the OT could ask how you wash.

If a carer helps you to wash, they will ask you how your carer supports you. For example:

  • physical help with large or small movements
  • getting in and out of the shower or bath
  • moving around
  • being reminded what you need to do next, verbally or by using pictures

After the assessment

The OT will write a report to show you how they plan to adapt your home.

They may talk to you again about what adaptations they’re going to recommend and why. You can also say why it might or might not work.

They will send this to you and anyone else involved. If you’re a tenant, this might be your:

  • private landlord
  • housing association
  • council housing office

If you have an OT report from another service or the NHS, check with your housing provider if they will accept this. Some housing associations and private landlords, for example, will not accept an NHS report for an adaptations application.

Permission from your landlord

If you do not own your home, you will need permission from your landlord to make changes to the features and structure.

The OT will talk with the person who manages your housing to see how the adaptations could work in your home.

If there’s an adaptation that you need that cannot be made in your home, they might recommend that you move.

Temporary housing during home adaptations

Getting a second opinion

If you do not agree with your local authority’s OT report, you can challenge it.

Challenging recommendations about NHS disability equipment

You could get a private OT assessment for a second opinion. But this can be expensive and there’s no guarantee that the private report will help support your dispute.

Last reviewed by Scope on: 26/02/2024

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