Home Safety Assessments for Older People
Usually it starts with a moment: a stumble on the back step, a night on the floor nobody talks about, a hospital letter that says “review home environment”. A home safety assessment is how that moment becomes a plan, made by an occupational therapist, in the home itself, with the person at the centre of it rather than the object of it.
Staying at home is a design problem, and design problems have answers
Most homes were set up by and for a younger version of the person living in them. The body changes; the house does not. The result is not “too frail to be at home”. It is a mismatch between a person and a building, and mismatches can be assessed, measured and fixed: with technique, with equipment, with changes to the home, and with support where support is genuinely what is needed.
That is what a home safety assessment is. An occupational therapist spends time with the person in their own home, watches how the real routines actually go, and produces a practical plan: what to change, in what order, and how each change gets funded. It is also, under the current aged care system, one of the best-funded things a family can ask for: for Support at Home participants, our assessment sits in clinical care, which is fully government funded with no participant contribution under current settings.
The signs families tell us they noticed, afterwards
None of these mean someone cannot stay at home. Each one means the home is asking for attention.
Why we watch the routine instead of inspecting the house
A checklist finds hazards. An occupational therapist finds the interaction between this person and this home, which is where falls actually come from.
This is why the assessment happens in the home, with the person doing their actual routines, and why the recommendations that come out of it get used instead of resented.
The full method behind every assessment, including our evidence standard, is public on our assessment methodology page.
What actually happens, start to finish
A conversation first, not a clipboard
What matters to the person, what a good week looks like, what they are worried about and what they are not. Assessments done to someone fail; assessments done with someone stick.
The routines, walked for real
Getting up, showering, making tea, the laundry run, the steps, the letterbox, the night route. We watch, measure and, where useful, gently test alternatives on the spot.
Family and carers heard, separately when that helps
With consent. The person’s account and the family’s account often differ, and both are real information rather than a contradiction to resolve.
A plan in plain English, sequenced by urgency
Quick wins first: rails, lighting, equipment, technique changes. Bigger items after: modifications, therapy, support. Each with its funding route named, whether that is the AT-HM scheme, a Restorative Care Pathway episode, CHSP, Medicare or private.
Follow-through until it is real
Equipment set up and practised, builder liaison for modifications through our home modification service, and a review where the changes are significant.
A daughter’s phone call, worked through
The situation
A woman in her late seventies lives alone in the Bankstown house she raised her family in. Last month her daughter found bruising on her mother’s arm and eventually heard the story: a slip in the bathroom, a twenty-minute crawl to the phone table, and a decision not to worry anyone. Her mother is adamant she is not leaving her home. Her daughter is frightened, guilty about being frightened, and googling at midnight. Neither of them knows that her mother’s new Support at Home arrangement means an OT assessment would cost nothing.
What we would do
Take the enquiry from the daughter, then talk with her mother directly, because the assessment belongs to her. Visit the home and walk the real routines: the bathroom where it happened, the night route, the back steps to the clothesline, the chairs she uses to rise. Listen to what she wants kept exactly as it is, which matters as much as what needs to change. Speak with the daughter separately, with consent.
What the report would set out
The immediate items with low-tier AT-HM evidence: bathroom rails placed for her actual transfer, non-slip treatment, a bedside lamp she can reach and sensor lighting for the night route. A personal alarm option discussed with her honestly, as her choice rather than her sentence. A referral recommendation for strength and balance work through her provider. And the things assessed as fine left alone, in writing, because a report that respects what is working earns trust for what it asks to change.
Why both women could act on it
Because the mother keeps her home and her say, the daughter gets a plan instead of a fear, every recommendation names its evidence and its funding route, and nothing in the document treats staying at home as a risk to be argued out of rather than a goal to be engineered.
What it costs, and who pays
For Support at Home participants, our assessments sit in the clinical care category, which is fully government funded with no participant contribution under current settings; we work as an associated provider with the person’s registered provider. CHSP clients can be referred through the allied health stream. Medicare covers OT under a GP chronic condition management plan (up to five shared allied health sessions per calendar year). Privately, the Home Safety Assessment Package is a fixed $450: the home visit, a prioritised written plan and a phone follow-up, with travel included across Greater Sydney. Where the situation needs the full evidence report for equipment or modification funding, the Comprehensive Assessment and Funding Report Package is a fixed $850.
Not sure which applies? That is normal, and it is our job to sort, not yours. Call and we will tell you honestly, including when the answer is “start with My Aged Care on 1800 200 422”, which is the entry point for aged care assessments and funding.
Funding settings are current as at August 2026, are indexed, and are subject to ongoing aged care reform. Whether any service or item is funded for an individual is decided under the relevant program’s rules. Confirm current settings with the registered provider or My Aged Care.
Home safety assessments: your questions
My parent does not want “to be assessed”. How do you handle that?
Will you tell us our parent cannot live at home any more?
Is the assessment really free under Support at Home?
What if my parent is not in any aged care program yet?
How quickly can you come after a fall?
Do you just leave a report, or do things actually get done?
Is this the same as a falls risk assessment?
Book a home safety assessment
Send an enquiry below or call 1300 316 664. Adult children enquiring for a parent are very welcome; the assessment itself always belongs to the person whose home it is.
Their home, made to fit them again
Talk to our mobile OT team about a home safety assessment anywhere in Greater Sydney. We come to the home, and the plan starts from the person.
Book an assessment or call 1300 316 664