Introduction The Carer Support Needs Assessment Tool (CSNAT) is an evidence based tool for comprehensive assessment of carers' needs. Use of the tool in practice requires a shift from informal practitioner-led methods of identifying carers' needs to a carer-led, practitioner-facilitated approach.

Aim(s) and method(s) To identify training requirements to enable practitioners to move from practitioner-led to carer-led carer support needs assessment. The CSNAT was implemented in six palliative home care services as part of a stepped wedge cluster trial. Pre-implementation training was provided to practitioners at each site. Qualitative data were obtained on practitioners' experiences of implementing the CSNAT via focus groups, interviews and site visits/contacts (where field notes were made). Ongoing analysis identified challenges in adopting carer-led assessment and was used to revise training materials for subsequent training sessions.

Results The CSNAT was often perceived as a ‘form’ representing an ‘add on’ to usual practitioner-led practice. The training was therefore modified to promote the underlying principles of the ‘CSNAT approach’ (i.e. the process of carer-led assessment). The stages of the CSNAT approach comprise: Introducing the CSNAT, Carer's consideration of needs, The Assessment Conversation, Shared Action Plan and Shared Review. Each stage is facilitated by the practitioner, but led by the carer.

Conclusion(s) Understanding of the CSNAT approach is fundamental to achieving carer- led assessment and support in palliative home care. The CSNAT approach resources are currently being tested as part of a CSNAT toolkit.