The Care and Needs Scale (CANS): A Practical Guide for NDIS Professionals

What Is the CANS?

The Care and Needs Scale was developed at the University of Sydney specifically for adults with acquired brain injury. It is an 8-level ordinal scale that captures the intensity of supervision, prompting and physical support a person requires across a typical 24-hour period. Levels range from CANS 1 (no support required) through to CANS 8 (24-hour care with two attendants).

When to Use the CANS in an NDIS FCA

We use the CANS in FCAs for participants with ABI, severe intellectual disability, complex behaviour, late-stage neurodegenerative conditions and dual diagnosis. It is particularly powerful in SIL assessments because the level numbers translate cleanly into ratio recommendations (CANS 5–6 typically maps to 1:1, CANS 7–8 typically maps to 2:1 or active overnight).

CANS Levels — Quick Reference

• —CANS 1 — No support required
• —CANS 2 — Supports available but rarely used
• —CANS 3 — Supports for a few hours per week
• —CANS 4 — Supports for part of every day
• —CANS 5 — Supports for most of the day but able to be alone at night
• —CANS 6 — Supports for most of the day and contactable supports at night
• —CANS 7 — 24-hour support including active overnight
• —CANS 8 — 24-hour 2:1 support including active overnight

Limitations and Cautions

The CANS was not developed for psychosocial disability, paediatric populations or episodic conditions, and should be used alongside — not instead of — domain-by-domain functional assessment. It is a complement to the NDIS functional domains, not a substitute.