Home Support Needs Assessment (HSNA)
Home Support Needs Assessment (HSNA)
What is the HSNA?
The Home Support Needs Assessment (HSNA) is a structured assessment designed to identify a person's unmet support needs in self-care and domestic life activities that are essential for sustainable community living. Unmet needs are those that remain despite the person's own strategies, use of assistive technology, and available informal or formal supports.
The HSNA systematically evaluates the person's capabilities in light of environmental factors, current support arrangements, and the use of assistive devices to determine whether additional interventions or services are warranted. Its methodology is distinctive in that it integrates the lived experience of the person, collateral input from other key people, and the clinical reasoning and observational findings of the assessing therapist to inform scoring and recommendations.
Description
The Home Support Needs Assessment (HSNA) comprises 27 items across three domains: Self-Care (12 items), Domestic Life (13 items), and Supports (2 items). Each item includes prompts to guide assessors on what is covered by the item.
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Assessors should base item responses on the person's current living situation, taking into account their use of assistive devices and any formal or informal supports already in place. ​
To accurately reflect the person’s circumstances, information may be gathered from multiple sources:
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The person being assessed: Their own perspective is recorded directly.
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Other key people: Input from those familiar with the person’s functioning in their home environment may be included when needed.
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Observation: Used selectively to clarify functioning when verbal reports are insufficient.
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Standard tasks and clarification: These are used when discrepancies arise between sources or when further detail is needed.
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Once clarity is achieved, the assessor records an overall item response, supported by notes as necessary. The corresponding item score is then circled. Scoring every item is essential to build a complete profile of the person’s current supports and any unmet needs.The total HSNA score is calculated by summing the number of items marked as “Not OK.”​
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Following the assessment, the Priorities for Action section (pages 10–11) is used to summarise findings. Each “Not OK” item should be assigned a level of risk, and planned actions should be documented to address the identified unmet needs.
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The HSNA can be used as an outcome measure by repeating the assessment after interventions to evaluate changes in the person's support needs over time.
What are the strengths of the HSNA?
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Enhances professional reasoning: The HSNA is designed to complement clinical judgment, supporting structured and evidence-informed decision-making.
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Facilitates sensitive conversations: It provides a framework that can help guide challenging discussions with consumers and carers about support needs.
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Supports intervention planning: By clearly identifying unmet needs, the HSNA assists clinicians and case managers in prioritising interventions effectively.
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Improves team communication: The assessment helps convey a consumer’s support needs clearly across multidisciplinary health teams.
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Responsive to change: The HSNA is sensitive to improvements or changes resulting from interventions that address unmet support needs (participation restrictions).
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Demonstrates service impact and informs resource allocation: It can be used to illustrate the benefits and outcomes of therapeutic services which can aid resource planning and allocation.
