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Occupational therapist conducting an in-home SIL assessment with a participant in their living environment

What is a SIL Assessment?

A Supported Independent Living (SIL) assessment is a detailed occupational therapy evaluation of your 24-hour support needs. Conducted in your home by an AHPRA-registered OT, it documents the level of daily and overnight support you need to live safely and participate in your community.

SIL assessments feed directly into the NDIA's Roster of Care process. The report provides evidence for support ratios, overnight support type, and why SIL is the right model for your situation. At Flourish Health, we are not a SIL provider, so our assessment is independent and free from conflict of interest.

  • Independent assessor, not a SIL provider, no conflict of interest
  • 24-hour support profiling including overnight determination
  • AHPRA-registered occupational therapists
  • NDIS plan-managed and self-managed participants
  • In-home assessments across Melbourne metro

What We Assess

24-Hour Support Needs

A full day-and-night profile of your support requirements, broken down by morning, daytime, evening, and overnight periods with recommended support ratios.

Overnight Support

Clinical determination of sleepover or active overnight support. Includes evidence from incident logs, sleep patterns, and nocturnal support requirements.

Self-Care & Personal Hygiene

Bathing, dressing, grooming, toileting, continence management, and medication administration. Each task assessed for level of assistance needed.

Household & Meal Preparation

Cooking, cleaning, laundry, household safety, and financial management. Assessed in your actual home environment for accuracy.

Community & Social

Community access, social participation, transport, appointments, and engagement in meaningful activities outside the home.

Safety & Risk

Emergency response capability, fire safety, wandering risk, behaviours of concern, and whether you can be safely left alone and for how long.

Understanding SIL Assessments

Who needs a SIL assessment?

A SIL assessment is needed when an NDIS participant requires evidence to support a request for Supported Independent Living funding. Common situations include:

  • Transitioning from the family home to supported accommodation
  • Moving from one SIL arrangement to another with different support needs
  • Requesting a change in support ratio (such as from shared 1:3 to 1:1)
  • Applying for active overnight support instead of sleepover
  • NDIS plan review where current SIL funding does not match actual support needs
  • First-time SIL application as part of the Home and Living pathway

The SIL assessment process

Our SIL assessment follows a structured process designed to produce evidence that meets the NDIA's reasonable and necessary criteria:

Pre-Assessment Review

We gather existing reports, current support arrangements, NDIS plan details, and the Behaviour Support Plan if applicable. We consult with your support coordinator to understand what support model is being requested.

In-Home Assessment

Your OT visits your home to observe and assess how you manage daily tasks across all domains. This typically takes 2 to 4 hours and includes standardised assessment tools.

Standardised Scoring

We use validated clinical tools including the Care and Needs Scale (CANS), WHODAS 2.0, and other instruments to provide objective, measurable evidence of your support needs.

Report and Delivery

A comprehensive report is prepared covering all 12 functional domains, 24-hour support profile, overnight determination, and numbered recommendations with clinical justification.

What is included in the SIL report

Your SIL assessment report is a detailed clinical document designed for the NDIA's Home and Living decision process. It aligns with the Roster of Care and includes:

  • Functional assessment findings across all daily living domains
  • Standardised tool results (CANS, WHODAS 2.0, and other validated instruments)
  • 24-hour support needs profile broken down by time of day
  • Overnight support determination with clinical evidence (sleepover vs active overnight)
  • Support ratio recommendations (1:1, 1:2, or 1:3 shared) with justification
  • Informal support assessment including carer sustainability analysis
  • Alternatives analysis explaining why SIL is the most appropriate model
  • Skill development goals framed within a capacity building context
  • Cultural and linguistic considerations relevant to support delivery
  • Numbered recommendations linked to observed functional deficits

Why independent assessment matters

The NDIS Commission has identified conflict of interest as a significant concern in the SIL sector. When the same organisation provides both the assessment and the SIL accommodation or daily support, recommendations can be influenced by operational needs rather than the participant's clinical needs.

Flourish Health is an occupational therapy practice. We do not operate SIL accommodation, we do not deliver daily SIL support, and we do not employ support workers. Our role is limited to the independent clinical assessment.

This means:

  • Our recommendations are based on your clinical needs, not on filling vacancies or staffing rosters
  • We have no financial interest in the outcome of your SIL funding decision
  • The NDIA can rely on our assessment as independent evidence
  • Your support coordinator can present our report with confidence that it is free from provider bias

Support ratios and overnight support

Two of the most important determinations in a SIL assessment are the support ratio and overnight support type. These directly affect the level of funding the NDIA approves.

Support ratios describe how many participants share one support worker during a given period:

  • 1:1 support is recommended when there is a continuous safety risk, complex behaviour requiring full individual staff attention, or full hands-on personal care needs
  • 1:2 or 1:3 shared support may be appropriate when supervision or prompting (rather than full hands-on assistance) is the primary need, and housemates are compatible

Overnight support is determined by the level of awake support needed during the night:

  • Sleepover support is funded when up to two hours of awake support is required overnight
  • Active overnight support is funded when more than two hours of awake support is required, supported by evidence such as incident logs, nocturnal seizure records, or documented night-time wandering

Our assessment documents the clinical evidence for each recommendation so the NDIA has a clear basis for their funding decision.

Funding options for SIL assessments

SIL assessments can be funded through several pathways.

Self-Managed NDIS

You manage your own NDIS funds and choose your providers directly.

  • Pay Flourish Health directly from your plan
  • Claim from the NDIS portal after each session
  • Full flexibility to choose any provider
We accept self-managed

Plan-Managed NDIS

A plan manager handles your invoicing and claims on your behalf.

  • Your plan manager pays Flourish Health directly
  • No upfront cost to you
  • Can access registered and unregistered providers
We accept plan-managed

Private Pay

Self-fund your SIL assessments with no external funding or referral required.

Home Care Packages

SIL assessments can be included in your government-subsidised HCP.

TAC / WorkSafe

We accept Transport Accident Commission and WorkSafe Victoria funding.

Your SIL assessment journey

From your first contact to receiving your report, here is how the process works.

Step 1

Get in Touch

Call us, submit a referral, or have your support coordinator reach out.

Step 2

Pre-Assessment

We review existing reports, current supports, and consult with your SC on the request.

Step 3

In-Home Assessment

Your OT assesses daily tasks, overnight needs, and safety in your home (2 to 4 hours).

Step 4

Report Writing

24-hour support profile, standardised scores, and recommendations prepared.

Step 5

Delivery & Follow-Up

Report delivered to you and your support team. Available for NDIA follow-up questions.

Book Your SIL Assessment

Frequently Asked Questions

What is a SIL assessment?

A SIL assessment is a comprehensive occupational therapy evaluation that documents your 24-hour support needs for Supported Independent Living. It covers all daily living activities, overnight support requirements, safety, behaviour, community access, and skill development. The report provides evidence for the NDIA to determine the type and level of SIL funding in your NDIS plan.

How is a SIL assessment different from an FCA?

A SIL assessment is a specialised type of functional capacity assessment. While a standard FCA covers broad functional abilities, a SIL assessment goes deeper on 24-hour support profiling, overnight support determination (sleepover vs active overnight), support ratios (1:1 vs shared), and why SIL is the most appropriate support model compared to alternatives like ILO or drop-in supports. A SIL assessment is typically 10 to 16 hours of OT time.

How much does a SIL assessment cost?

SIL assessments are quoted in hours at the NDIS rate of $193.99 per hour. A standalone SIL assessment typically takes 10 to 16 hours ($1,940 to $3,104). If you also need a full FCA, a combined FCA and SIL assessment takes approximately 30 hours. You receive an itemised quote before we book.

Why does it matter that you are not a SIL provider?

When the same organisation provides both the SIL assessment and the SIL accommodation or daily support, there is a potential conflict of interest. The NDIS Commission has flagged this as a concern. Flourish Health does not deliver SIL accommodation or daily living supports. We only provide the independent OT assessment, so our recommendations are based solely on your clinical needs, not on filling beds or staffing rosters.

Can I use my NDIS plan to pay for a SIL assessment?

Yes. SIL assessments are funded under Capacity Building, specifically the Improved Daily Living line item for occupational therapy (15_617_0128_1_3). We work with plan-managed and self-managed NDIS participants. Your support coordinator or plan manager can confirm available funding in your plan.

What does the NDIA look for in a SIL report?

The NDIA evaluates your SIL assessment against the reasonable and necessary criteria under Section 34 of the NDIS Act. A strong report must include standardised assessment scores (such as CANS and WHODAS 2.0), a 24-hour support needs breakdown, evidence for overnight support type, an informal support sustainability analysis, and a clear explanation of why SIL is the most appropriate model compared to alternatives.

What is the turnaround time for a SIL assessment?

We typically complete the full process within 3 to 5 weeks from initial contact to report delivery. This includes the pre-assessment review, in-home assessment visit (2 to 4 hours), and report writing. We can discuss expedited timelines for urgent housing transitions.

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Occupational therapist during a home visit in Melbourne

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