Which step in asthma management would a home nebuliser be used?

Rarely: Nebulizers allow you to take albuterol aerosolized rather than through an inhaler device. For adults, there is really no benefit to this except maybe cost. There are some other nebulized meds, but they typically have to be used more often than the meds available via other inhaler devices. They are best for children or sick elderly who can't use a more-complicated inhaler.