Getting an occupational therapy assessment

Major home adaptations step-by-step guide

Step 1: Getting an occupational therapy assessment

This step takes between 1 to 40 weeks.

What happens in this step?

Major adaptations start with an occupational therapist (OT) assessment. You can either use a private OT or get a referral to Surrey County Council's (SCC) OT team. If you make a referral to us, we start by gathering information on your needs. The OT Duty team deals with this.

Contact our Information and Advice team to ask for an OT assessment.

Contact us to ask about an OT assessment

The duty OT and/or OT Assistant (OTA) will send referrals to your local SCC Adult Social Care (ASC) team. They will contact you to ask you about your situation. This initial assessment can happen by telephone, virtual assessment or email.

We aim to empower you by working together in a strength based approach. This means we will focus on what is most important to you. We will aim to:

  • understand your concerns
  • find out what you have already tried
  • work with you to plan the best next steps

We will be transparent and present you with all available options. During this, we encourage you to ask questions.

We may also use technology to help us in our work. For example, we may complete a virtual assessment or ask you for photos. This means we can meet your needs in a timely way.

We will look at different options to resolve your query in the best way:

  • we may signpost you to a service which may better meet your assessed needs
  • if we have enough information, we may order equipment from Duty. This means we can meet your needs quickly
  • if we order equipment, we may need to ask you about your home. Some teams may ask you to complete an EQuip Notebook or send photos by email, FaceTime or WhatsApp

We may be able to meet your needs at this stage of the process. If we can't we'll do a further OT assessment.

At this stage, if you can leave your home, we may ask you to attend an OT Clinic if this service is available in your area. If this is not an option, and you have access to a mobile phone, tablet or laptop, we may invite you to a virtual assessment.

If neither of these options are possible, we will contact you for a face-to-face assessment. You should be aware that Surrey County Council OT teams have different waiting times, some up to 12 months. When we contact you, we will let you know how long you may need to wait.

Your OT may ask you to show how you are managing your day-to-day tasks.​ We call this a functional assessment. Functional assessments help us to understand what you find difficult. We can then use our clinical skills and experience to work out how to meet your current and long-term needs.

Your OT will consider how we can meet your needs in the most cost-effective and least disruptive way. If equipment or simple adaptations can meet your needs, we may provide them.

We first check if equipment or minor adaptations could meet your needs. We may ask you to try out specialist equipment. ​The next couple of examples explain how this works in practice.

You may find it hard to get up and down stairs. Your OT will first look to see if you could get help from a health colleague, like a physiotherapist. They will also see if stair rails could make it easier for you before considering a stairlift. If a stairlift is not suitable for you, your OT will need to consider a through floor lift.

You may find it hard to get in or out of the bath. Your OT will first look to see if you could get help from a health colleague, like a physiotherapist. Your OT will also see if there is a shower in the property you may be able to use instead of the bath. They will see if equipment like a bath or shower board or a bath seat or lift could help you get in and out of the bath. If the equipment is not meeting your needs, your OT will decide if you need bathroom adaptations. ​

You can find out more about how equipment might help you by searching our Home equipment finder. District and borough councils also offer a range of technology like personal alarms or motion sensors. See Technology enabled care.

If your OT thinks major adaptations would help, they may ask you questions to see if the DFG pathway is suitable. Your OT will tell you how the DFG process works and the organisations involved. Your OT will ask if you want to use your district or borough council's housing improvement agency to act as your agent throughout the DFG process. They will tell you what this means and will present all the options available to you.

For more information on the DFG see Disabled Facilities Grant.

Your OT will start an OTMAR if:

  • the OT assessment shows you need a major adaptation and
  • you might be eligible for Disabled Facilities Grant (DFG) funding

Doing the OTMAR may need several visits to your home. Your OT may bring people from equipment companies with them. They may also ask for a feasibility visit with your adaptations team. They will then fill out the OTMAR and send it to you to consider, sign and return. Once you've sent your OTMAR back, your OT will pass it on to your adaptations team.

Get involved

The OT assessment needs to capture your true ability so your OT can make a plan to meet your needs. You need to be honest and let your OT observe and understand your needs and situation. In turn, we want you to understand the OT assessment process and the reasons for our recommendations. This approach will build trust and let you and your OT have confidence in the plans you make.

Consider, sign and return the Occupational Therapist Major Adaptation Report (OTMAR)

You will need to sign and return paperwork at various stages of the Disabled Facilities Grant (DFG) application. You must do this before moving onto the next stage of the application process. Any delay in responding will mean a delay in the process.

During the assessment stage, we will ask you to consider, sign and return the OTMAR. Your OT cannot start the DFG application process until this happens. If there are any issues with the report, let your OT know as soon as possible. They can make changes if needed.

Tell us about a change in your needs

If your needs change during the DFG process, you must contact your OT as soon as you can. They will need to reassess your needs and may need to make changes to their recommendations.

They will let your adaptations team know about any changes. The team will then work out if this impacts the allocated DFG. This could include:

  • new plan designs
  • new quotes for the work
  • new permissions from your landlord
  • new planning permission

A change in your needs will not mean you need to restart the process. It is likely to mean though that the works will take longer to complete. This is because we want to make sure the adaptations meet your needs.

How long it takes

The Disabled Facilities Grant (DFG) application can take a long time. During the process, your OT may give you equipment if it is safe for you to use. Your OT will explain the risks to you. If you decide to carry on using equipment that your OT does not recommend, they may need to complete a risk assessment. They may also need to carry out a Mental Capacity Assessment.

Following triage on Duty, you may have to wait for further OT assessment.​ Some teams may have a long waiting list for a face-to-face OT assessment.

If another professional sent your referral, it may take some time to reach us.​

Your OT may need to visit you at home several times to try out equipment. They will also need to work out what minor or major adaptations may meet your assessed needs. This can make the assessment process longer.

Funding the adaptations yourself

See Self-funding your adaptation.

OT documentation

Throughout the assessment stage, you may get various documentation.

Duty stage

  • contraindications letter
    sent to you if we provide you with equipment. This explains any associated risks
  • EQuip Notebook with cover letter and other information
    this may be sent to you to complete, to help us to know what equipment we could provide to you
  • OT closure letter
    this will let you know when our service has ended

Further assessment stage

Consent to Share document (action required).

  • OT assessment (no action required unless amendments are needed)
  • OT review (no action required unless amendments are needed)
  • OT Report for Major Adaptations (action required).
  • OT Clinic Notebook and documentation (action required)

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