Home care

Home care (also known as domiciliary care) covers a wide range of services to ensure you get the help and support you need in your own home.

It might be something for you to think about if you are struggling with day-to-day activities. Home care includes personal care, such as washing or dressing, housekeeping or domestic work, cooking or preparing meals, and companionship.

You can receive different types and levels of support at home. You might need 24-hour care, or you might only need a short visit once a day. You might just need care in an emergency – for example, if the person who normally helps you in the home is unable to help you.

When might I need home care?

After a stay in hospital

Some people may begin receiving some help at home following a stay in hospital. If you are admitted to hospital for a length of time, you might receive an assessment by hospital staff to see if you are finding things at home hard to manage. They may then help you get some help at home when you are discharged. This may only need to be temporary until you recover, or it could be longer term.

After diagnosis

After your diagnosis you might start thinking about the support you might need in the future, in the knowledge that your condition is here to stay. With dementia, it’s common to dismiss memory problems as down to tiredness, stress, or another temporary problem. A diagnosis can be a useful confirmation that you could find ongoing help around the house useful.

Sometimes it’s hard to tell

Many of us will adapt over time as things become more difficult for us, finding alternative ways to do things and putting off getting help. It’s hard to tell when it’s time to ask for regular help. It’s easy to adjust our idea of what is “normal” and see our difficulties as just part of day to day life. Sometimes it takes a family member or friend to notice just how much you’re struggling and suggest getting help.

How to get home care

Visiting your local council

If you are struggling with day-to-day activities and you feel you need some help, one of the first things to do is contact your local councils’s adult social care department to book a care needs assessment. This is a good first step where you’ll discuss your situation with a professional and talk about what care and support you might need.

The local authority must assess the needs of any person who appears to need a community care service that they can either provide or arrange. Depending on the outcome of the assessment, they might arrange care services for you or they might recommend local services that can help. They might refer you to other services who can help you at home, such as occupational therapy, physiotherapy and telecare.

Depending on your financial situation, they might be able to pay towards the cost of your care. However, certain services around the home, such as cleaning, may not be eligible for financial support from your local council. The council will, however, be able to provide you with information and advice regarding those services.

Click here to find your local council and get in touch.

For more information about the care needs assessment and what happens afterwards, read our guidance below:

The care needs assessment

How much does home care cost?

The cost of home care can vary hugely depending on your provider and how much care and support you need. If you’re worried about funding the cost of home care, take a look at our section on money and financial support.

Depending on your financial situation, you may be eligible for financial support from your local council who may be some or all of the cost of your care. The council will carry out a “means test” to see if you’re eligible for financial support. This will only happen if you’ve already been assessed as having “eligible need”. For more information, read our page on the social care financial assessment.

Arranging home care yourself

If you are not eligible for help from the local council with arranging your home care, or you wish to make your own private arrangements, you can organise care yourself. You may want to consider using a care agency, or you may wish to employ a personal assistant.

Agencies

An agency will have a team of care workers who they employ. Care workers will have been recruited and trained by the agency, will have received a Disclosure and Barring Service (DBS) check and will have provided references before being accepted for employment. DBS checks are designed to identify if someone has been barred from working with vulnerable people. You can find out more about DBS checks by following this link.

Agencies will also manage their staff so that they can cover periods of absence and sickness. They will also talk to you about the type of support you are looking for and how they can support you.

Agencies require regulation by the Care Quality Commission (CQC), though they do not regulate the services provided by cleaners, handymen or gardeners. CQC will check that agencies are meeting national minimum standards. This will help you get an idea of how good an agency is.

To help you decide on the right home care agency check the following

  • That they have trained staff to meet specific needs you may have
  • That they are registered with the UKHCA
  • Their latest CQC inspection report

It’s a good idea to ask the following questions when you speak to agency managers

  • Ask for a copy of their statement of purpose, their standard contract and price list
  • Check how absences, bank holidays and weekends are covered
  • What is the procedure if staff cannot get to clients because of bad weather or an accident en route.
  • If you will have regular carer(s) each day/visit or lots of different ones
  • What training and qualifications their staff have
  • How staff keep a record of their visits
  • Their insurance cover in the event of accidents involving their staff
  • Extra support they can provide if required and estimated costs
  • Emergency contact

Personal assistants

You can hire a “personal assistant” to act as a homecare worker for you. Personal assistants can offer you all that you’ll get from an agency worker, but you’ll also get the continuity, familiarity and ongoing relationship with your assistant. Approved personal assistants are usually trained and DBS checked by the local authority and you should be able to find a list of approved personal assistants in your area from your local authority’s social services department.

If you pay somebody directly to provide you with practical help or care, you’ll immediately take on certain responsibilities as an employer. These include:

  • Providing your care workers with a contract and terms of employment
  • Paying them at least the national minimum wage
  • Managing holiday and sick pay
  • Health and safety responsibilities
  • Deducting income tax and National Insurance contributions.

These responsibilities can feel a little bit daunting, so it’s a good idea to get support with becoming an employer. You might want to read:

You can also get advice on various aspects of employing from the following organisations:

  • National Minimum Wage Helpline – 0800 917 2368 or visit www.hmrc.gov.uk
  • The Pensions Regulator (for pension scheme enquiries) – 0845 600 1011 or visit www.thepensionsregulator.gov.uk
  • Skills for Care (general advice on employing a carer) – 0113 245 1716 or visit www.skillsforcare.org.uk
  • Being the Boss (advice from other disabled people who employ personal assistants) – 0787 203 8370 or visit www.beingtheboss.co.uk
  • Health and Safety Executive – 0300 003 1747 or visit www.hse.gov.uk

Finally, Skills for Care have developed a toolkit on employing personal assistants.

Private individuals

You may know someone directly who provides home care support on a private basis. If you know them, or know other people who are using them who are able to recommend them, or they have good references, then you may prefer this option. You could employ someone via a recruitment agency or check adverts in local newspapers or the yellow pages. Private carers may offer a lower priced service as they don’t have the overheads of agencies.

Private individuals are not regulated or trained in the way that agency staff or personal assistant should be. So find out what kind of training they have and if you have any specific care needs, check that they have the training to be able to support these. Check if they have DBS clearance.

If you are paying a private carer you must draw up a contract so that you are both clear on what is expected. You will need to find out if they are self-employed or whether you need to take on the role of employer. If that is the case, see our information on personal assistants on what responsibilities you have as an employer.

Homecare from charities

Charities such as Age UK and Carers Trust, the Red Cross, and the Leonard Cheshire Foundation can provide home help and domestic assistance services.

You could also contact the local branch of any national charity supporting people with specific long term conditions. These organisations may not always provide regular care but they may offer short term respite to give your carer a break from their caring responsibilities.

Live-in carers or residential care homes

If you are worried you won’t be able to cope even with carers visiting several times a day you may be thinking about moving into residential care. (Hyperlink to section on this). You might also consider live-in carers if you have enough bedroom space and can manage financially.

Live in carers will need a bedroom of their own and will need time off each day. You will need other carers to cover those off-times and also regular leave and sick leave cover. Live in care is not as expensive as residential care generally but is not funded by social services. So you will need to look at ways of funding this kind of care (hyperlink) or ways of freeing up finances to cover the cost.

Resources for arranging home care

  • Your adult social care department can be contacted via your local council. You can contact the HERE helpline to find out the contact details for your local department, or you can follow this link to find your local authority.
  • NHS Choices directories provide information about care providers in your area.
  • The Care Quality Commission (CQC) website gives you access to the inspection findings for home care agencies, including how safe, well-led, effective, caring and responsive the care agency was found to be when it was inspected. It will also give information about any recommendations for improvements an agency has received. You can also contact CQC by phone with any general enquiries. Their number is: 03000 616 161.
  • The UK Homecare Association (UKHCA) has a list of home care agencies who are committed to the UKHCA code of practice. You can call them on 020 8661 8188 to access this list, or follow this link. They also provide further information about choosing a care at home. Their leaflet is available here, or you can visit their website. They also have a helpline telephone number: 020 8661 8188.
  • Skills for Care have put together a personal assistants tool kit to help you if you are considering employing a personal assistant to help you at home. They also have information on their website, if you follow this link.
  • Which Elderly Care? also provide information regarding personal assistants on their website.
  • Some charities also provide support for people in their own home. This includes, for example, Age UK and Carers Trust. You can contact the HERE helpline to see what is available in your local area.

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