In short, a rehabilitation assistant helps someone practise agreed goals in real life, session by session, and an occupational therapist assesses, writes the report and recommends what those goals and strategies should be. If a plan already exists, from the NHS, a private therapist or a case manager's team, rehabilitation support is usually the right place to start. If nobody has yet looked at how the person manages at home, or a funder needs a written assessment, start with the home assessment.
This post is for families and case managers weighing up the two services you can book online from Axon Neuro. It describes England, where we support people at home; NHS pathways and funding differ in Scotland, Wales and Northern Ireland. It is general information, not advice about one person. Axon Neuro is an independent reablement provider, not part of the NHS, and nothing here replaces what a GP, therapist, nurse, pharmacist or the person's own team says.
What sits inside, and outside, a rehabilitation assistant's role?
A rehabilitation assistant works alongside the person on goals that have already been agreed, practising real tasks in the real places they happen. They do not assess, prescribe or make clinical decisions, and the support is not personal care or nursing.
In a session, that looks like doing things together rather than for the person: making lunch in their own kitchen, or using a memory strategy at the moment it is needed. The assistant follows the strategies a therapist has set, notices what is and is not working, and feeds that back to the person's team in session notes. Our note on what reablement involves day to day walks through a typical visit and week.
What sits outside the role:
- They do not assess needs, transfers, swallowing, medicines or home safety. That is a registered professional's job, done in person.
- They do not write a treatment plan, prescribe equipment or change a programme another therapist has set.
- They do not provide personal care such as washing, dressing or toileting, and they do not give medication or nursing care.
- They are not an emergency service. For sudden face, arm or speech symptoms, a first seizure or one lasting more than five minutes, a serious fall or head injury, chest pain or difficulty breathing, ring 999. Use NHS 111 when it is not an emergency.
"Rehabilitation assistant" is not a protected title. The Health and Care Professions Council (HCPC) regulates occupational therapists, physiotherapists, speech and language therapists and practitioner psychologists, and says that "to use one of these titles, an individual must be registered with the HCPC": see the professions the HCPC regulates. Rehabilitation assistant is not on that list, so ask any provider about the training, checks and supervision behind the role; the page on rehabilitation support at home explains the vetting and enhanced DBS checks behind ours.
What does an occupational therapist do that a rehabilitation assistant cannot?
An occupational therapist is a registered professional who assesses how someone manages the activities of daily life, works out what is getting in the way, and recommends what would help. The Royal College of Occupational Therapists describes it as "a science-based, health and social care profession that's regulated by the Health and Care Professions Council": see what occupational therapy is. The assessment, the professional judgement and the written recommendations are what a rehabilitation assistant cannot supply.
At Axon Neuro, the occupational therapy service is a home assessment. An HCPC-registered occupational therapist visits, looks at how the person manages where they actually live, and writes a report. The report is the person's own, to act on with us or with their existing team; any ongoing support is agreed afterwards, and nothing further is booked until they decide. The page on occupational therapy at home explains the visit and what can follow.
What the therapist looks at on the visit, and what goes into the report, is set out in our post on what happens at an occupational therapy home assessment.
We are not a supplier of aids or equipment, so a recommendation in the report is not a delivery. Anything that involves moving someone differently or fitting equipment needs a qualified professional to assess and demonstrate it in person before anyone at home tries it.
Which service fits your situation?
Start with rehabilitation support when a plan already exists, and start with the occupational therapy assessment when nobody has looked at the home yet.
Rehabilitation support usually fits when:
- The person has been discharged with therapy goals from an NHS or private team, and what they need now is regular practice between or after appointments.
- A case manager has already commissioned the assessments and wants someone to carry the agreed strategies into the person's week.
- The family wants steady, practical support with getting out, everyday tasks and confidence, at a pace the person sets.
The occupational therapy assessment usually fits when:
- Nobody has assessed how the person manages at home, or the last assessment was on a ward rather than in the house they went home to.
- A case manager, solicitor or funder needs a written report before agreeing a package.
- The family is unsure what is realistic and would rather hear a professional view than book hours on a guess, or something has changed and the old plan no longer fits.
If you are still unsure, the assessment is the more cautious first step: it answers the question before any hours are booked.
How do the two services work together?
The usual order is assessment first, then support. Where a plan already exists, rehabilitation support picks that plan up instead.
In the first pattern, the occupational therapist assesses at home and writes the report. If it recommends regular practical support, that can be arranged afterwards with a rehabilitation assistant who works to the strategies in the report, and the therapist can stay involved in how they are working. Session notes go back to the team.
In the second pattern, the plan comes from elsewhere: an NHS community team, a private physiotherapist, or a case manager's multidisciplinary team. A rehabilitation assistant practises what that team has set and feeds back to them. We do not rewrite another professional's plan; we help someone live it.
Both patterns follow national guidance for reablement in England. NICE guideline NG74 on intermediate care including reablement says intermediate care practitioners should "develop goals in a collaborative way that optimises independence and wellbeing", review goals with the person regularly, and consider providing intermediate care in people's own homes wherever practical: see NICE guideline NG74, published 22 September 2017. (Last verified September 2026.) Progress is rarely a straight line; feeding notes back is how the plan bends with the person.
What about physiotherapy, speech and language therapy or psychology?
Those are not services you can book from Axon Neuro. They are accessed through the NHS, usually via a GP or the hospital team, or arranged privately. A rehabilitation assistant can then practise what those therapists set.
Each is regulated by the HCPC, like occupational therapy, and each answers a different question. A physiotherapist works on movement, strength and balance; our note on what a neuro physiotherapist does sets that out. A speech and language therapist assesses communication and swallowing. A practitioner psychologist, such as a clinical psychologist, works on mood, behaviour and thinking. What they share is that they assess in person, set a programme, and rely on it being practised between sessions.
That last part is where rehabilitation support fits. If a physiotherapist has set a walking programme, a session can be built around the walk; if a speech and language therapist has given strategies for a busy cafe, a session can happen in the cafe. The assistant does not change the exercises or the strategy; they help the person do them, and report back. Where a programme touches exercise, swallowing, eating and drinking, or moving in a new way, ask the therapist who set it before anything changes.
How do you choose and book the right one?
Choose the service in our online booking tool, enter a postcode, and it shows you whether we can reach that address and what the support would cost. Looking commits you to nothing.
A few honest points first:
- Occupational therapy coverage is narrower than rehabilitation support coverage. We support people at home across England, and can recruit to fill a request anywhere in England, but whether an occupational therapist can reach a given postcode depends on who is available near it.
- Funders do not pay by card. A case manager, solicitor, insurer, council or NHS body receives a quote and an invoice. Our page for case managers explains how a referral runs and how you follow visits, goals, session notes and progress through secure online access that our staff set up for you.
- The person should be involved in decisions about their own support, even when someone else is arranging it. We support adults and children; associates who work with children hold an enhanced DBS check for work with children.
For a wider checklist for comparing providers, not only ours, see our guide to how to choose a reablement service.
Frequently asked questions
Can a rehabilitation assistant work from a plan written by an NHS therapist?
Yes. The assistant practises what the NHS team has set and feeds back what they notice; the NHS therapist decides whether the plan changes.
Do I need an occupational therapy assessment before booking rehabilitation support?
Not if a suitable plan already exists. If the person has current goals from a therapist or a case manager's team, rehabilitation support can start from those. If nobody has assessed how they manage at home, the assessment is the better first step.
Is a rehabilitation assistant the same as a carer?
No. Titles vary between services, and a reablement support worker is often the same role under another name, but a carer helps with personal care and daily needs; a rehabilitation assistant works to rehabilitation goals with the aim of the person needing less help over time, and does not provide personal care, medication or nursing. Where personal care is also needed, that is arranged separately through the council or a regulated care provider.
How do I check that an occupational therapist is registered?
Search the HCPC register by name. The HCPC keeps "a Register of health and care professionals who meet our standards for their training, professional skills, behaviour and health": check the HCPC register. NHS advice on occupational therapy says the same, and notes that in England you can ask a GP about a referral, ask your local council, or pay for it yourself: see the NHS page on occupational therapy. (Last verified September 2026.)
If you want to talk it through
If you are still not sure which service is the right first step, you are welcome to get in touch and we will say plainly which one fits, or whether neither does yet. We cannot give clinical advice about an individual or arrange NHS services, and questions about an existing therapy plan belong with the team that wrote it. No pressure, and no obligation.