NDIS Assessments
The Care and Needs Scale, CANS, is a standardised tool used to assess personal care and supervision needs, particularly for people with acquired brain injury.
In the NDIS context, CANS may help clinicians describe support intensity, particularly when preparing evidence for plan reviews, Supported Independent Living, SIL, or home and living pathways.
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Care and Needs Scale (CANS) Definition
The Care and Needs Scale, CANS, is a structured assessment tool used to measure the level of supervision and personal care a person requires across a 24 hour period.
It is commonly used within Functional Capacity Assessments and home and living evaluations where a person’s level of care, supervision or support needs must be clearly documented.
This tool can be useful when preparing NDIS plan review evidence, SIL assessments, and other reports that help explain higher levels of support need.
If you require a structured NDIS Functional Capacity Assessment to support SIL, SDA or complex funding reviews, you can learn more about our assessment process here.
This guide breaks down what CANS is, when it’s used, how it supports NDIS funding decisions, and how it compares to other common assessment tools like WHODAS 2.0 or PEDI-CAT.
What is the Care and Needs Scale (CANS)?
The Care and Needs Scale is a validated scale that measures a person’s need for personal care and supervision over a 24 hour period.
CANS was originally developed to assess care needs in people with acquired brain injury, ABI. It may also be referenced in disability and NDIS related contexts where a clinician needs to describe a person’s care and supervision requirements.
The adult CANS is not a 10 point scale. It is commonly scored from Level 0 to Level 7, with Level 4 including sub levels, such as 4.1, 4.2 and 4.3.
CANS scores range from Level 0, where the person does not need support and can live in the community independently, through to Level 7, where the person cannot be left alone and requires support or monitoring across a 24 hour period.
CANS helps identify the intensity of care required and may support evidence for daily living supports, overnight care, or Supported Independent Living, SIL, when used as part of a broader clinical assessment.
Care and Needs Scale Levels
| CANS Level | General Description |
|---|---|
| Level 0 | Does not need support and can live in the community independently |
| Level 1 | Can live alone but needs intermittent support, less than weekly |
| Level 2 | Can be left alone for almost all week but needs support at least once a week |
| Level 3 | Can be left alone for a few days a week but needs support a few days a week |
| Level 4 | Can be left alone for part of the day and overnight but needs support for up to 11 hours per day |
| Level 4.1, 4.2, 4.3 | Sub levels within Level 4 that describe different support need groupings |
| Level 5 | Can be left alone for part of the day but not overnight, needing support for 12 to 19 hours per day |
| Level 6 | Can be left alone for a few hours but needs support for 20 to 23 hours per day |
| Level 7 | Cannot be left alone and needs support or monitoring 24 hours per day |
The Level 4 sub levels should not be treated as separate points in a 10 point scale. They are part of the validated CANS scoring structure and should be interpreted by clinicians familiar with the tool.
When is CANS Used in the NDIS?
CANS may be used during:
- Functional Capacity Assessments, FCAs
- SIL or SDA related funding assessments
- Plan review evidence submissions
- Home and living evidence
- Transition planning from informal to formal supports
- Assessments involving complex care or supervision needs
CANS should be used as one part of the broader evidence base. It does not replace clinical reasoning, functional observation, risk assessment, support worker evidence or other standardised assessment tools.
Why CANS Supports ‘Reasonable and Necessary’ Criteria
Under section 34 of the NDIS Act, all supports must meet the reasonable and necessary criteria.
CANS may strengthen funding evidence by:
✅ Quantifying care needs in a structured way
✅ Describing support and supervision requirements across the day and night
✅ Helping explain risks where informal supports are overused
✅ Supporting evidence for 1:1, shared or higher intensity supports where appropriate
✅ Providing a clearer picture of the participant’s care needs when combined with clinical examples
Tools such as the Care and Needs Scale are sometimes included as part of broader NDIS plan review evidence submitted during reassessments when participants require increased supports.
Sample CANS Score Impact
Participant A (CANS Level 6):
- Requires support for most of the day.
- Can only be left alone for short periods.
- Needs prompting and assistance with hygiene, meals and daily routines.
- May be unsafe without regular supervision due to cognitive, physical or behavioural support needs.
Supports that may be considered as part of broader assessment evidence
- Daily support worker shifts, Core
- Overnight support or monitoring, depending on risk
- Assistive technology to support safety and independence
- Consideration of Supported Independent Living, SIL, where home and living needs support this
The CANS score should always be interpreted alongside the participant’s functional assessment, goals, risks, living situation and current support arrangements.
How CANS Scores Influence SIL Funding Decisions
CANS scores may be referenced when preparing evidence for Supported Independent Living, SIL, or other home and living supports.
Higher CANS levels generally indicate that a participant requires more regular support, supervision or assistance with daily living activities.
Example interpretation
Participants at lower levels may require intermittent support.
Participants at mid range levels may require regular support during the week or during parts of the day.
Participants at higher levels may require support for most or all of the day and night.
When combined with a Functional Capacity Assessment, CANS scores can help demonstrate the level of staffing or supervision required to maintain safety, dignity and independence.
CANS should not be used as a standalone SIL eligibility tool. It is most useful when combined with detailed functional evidence and real life examples of the participant’s support needs.
CANS vs Other Assessment Tools
| Tool | Purpose | Best Used For |
|---|---|---|
| CANS | Quantifies personal care and supervision needs | SIL evidence, personal care planning, support need documentation |
| WHODAS 2.0 | Measures disability across 6 domains | FCA evidence, plan reviews, functional impact |
| PEDI CAT | Assesses function in children and young people | Early intervention, paediatric supports |
CANS does not replace WHODAS, PEDI CAT or other clinical assessment tools. It complements them by providing a practical care level framework focused on support and supervision needs.
Where to Reference CANS in Your Reports
CANS scores may be included in:
- Functional Capacity Assessments
- SIL application supporting documents
- Home and living assessments
- Behaviour support plans, if supervision is linked to safety or behaviour support needs
- Plan reassessment evidence
Sample report line
“The participant’s care needs were considered with reference to the Care and Needs Scale. Based on the available assessment information, the participant’s needs appear consistent with CANS Level 6, indicating that they can only be left alone for short periods and require support for most of the day. This rating should be interpreted alongside the broader functional assessment findings, risk information and support evidence.”
Final Tips for Clinicians
- Use CANS scores to describe care and supervision needs accurately.
- Do not describe CANS as a 10 point scale.
- Remember that Level 0 reflects independence, not Level 1.
- Do not treat Level 4.1, 4.2 and 4.3 as separate points in a 10 point scale.
- Combine CANS with daily examples and support worker logs.
- Always link CANS findings back to functional needs, risks, NDIS goals and outcomes.
- Use the tool in line with its validated purpose and scoring structure.
Need help structuring your FCA or funding evidence?
Learn how to structure your report and evidence for a Functional Capacity Assessment Report →
When Support Coordinators Should Consider a CANS Assessment
Support coordinators may consider requesting a Care and Needs Scale, CANS, assessment when a participant’s level of supervision or daily care requirements need to be clearly documented by an appropriate clinician.
Situations where CANS scoring may be helpful include:
- Preparing evidence for Supported Independent Living, SIL, funding
- Demonstrating supervision requirements during NDIS plan reviews
- Documenting risk where participants require regular prompting or monitoring
- Supporting Functional Capacity Assessments for participants with complex support needs
- Clarifying care needs across the day and night
When combined with clinical observations and daily living examples, CANS scoring can help strengthen evidence submitted to the NDIA.
Participants or providers who require a structured assessment can submit a Functional Capacity Assessment referral here.
Conclusion
The Care and Needs Scale can be a valuable tool in the NDIS landscape when used accurately and in the right clinical context.
CANS helps describe a participant’s daily care and supervision requirements. It is not a 10 point scale. The adult CANS scoring structure runs from Level 0 to Level 7, with Level 4 sub levels.
When used correctly, CANS can help justify the level of support a participant requires by clearly outlining their daily care, supervision and safety needs.
Incorporating CANS into assessments may improve evidence quality, support clearer clinical reasoning, and better assist participants to live safely and as independently as possible.
Looking to arrange a NDIS Functional Capacity Assessment for SIL funding, plan review evidence, or complex support needs?
Author: Phil Bamback is a Director within regulated disability services, focused on governance frameworks and structured operating pathways across the NDIS.