If you see a sudden change in your relative’s health or behaviour, speak to their GP or call NHS 111. In an emergency, call 999.
Home care is paid help from a carer who visits a person at home. It is also called domiciliary care (care given at home). It can be short term, for example while someone recovers from illness, or long term.
This guide is for England. Rules can differ in Scotland, Wales and Northern Ireland.
What does a home carer do during a visit?
A carer helps with personal care and with tasks around the house. The tasks depend on what your relative needs.
- Personal care: getting in and out of bed, washing, dressing and using the toilet.
- Household tasks: cleaning and preparing meals.
"Home help" is slightly different from home care. It covers cleaning, laundry, washing up and gardening. Most councils do not provide home help. Charities may be able to help, but it may not be free.
Ask any agency exactly what its carers can and cannot do. Get the answer in writing.
How do visits work: how often, how long, and who comes?
Home care is flexible. It can be one hour a week, several hours a day, or overnight.
Agencies employ trained carers. The same carer may not always visit, but the agency should try to match someone suitable.
Before you choose an agency, ask these questions:
- Will carers keep to a time slot?
- Will you be warned if a carer is delayed?
- Can you read the standard contract before you sign?
Carers should be respectful. For example, they should announce their arrival before coming in.
If you arrange care privately, ask the agency to write down what it will do at each visit.
How do I arrange home care, and where do I start?
A care needs assessment is a check of what help your relative needs. It is free, whatever their income or savings.
- Ask for the assessment. Contact the adult social care team at your council.
- See what the council decides. If your relative is eligible, the council may recommend a paid carer and arrange the care. If not, it must still give free advice on local help.
- Choose how care is provided. You can use an agency, or a live-in carer, who lives in the home. Some live-in care organisations offer specialist nursing care, such as dementia or stroke care.
- Check the provider. In England, home care agencies must register with the Care Quality Commission (CQC). The CQC regulates health and care services. You can search for local providers on its website and ask for the latest inspection report.
If the council pays for some or all of the care, it must provide a care and support plan. This sets out the needs, how they will be met, and the personal budget (the amount the council thinks the care should cost).
The assessment is worth having even if you plan to pay privately. It helps explain your relative’s needs to an agency.
A direct payment lets a person employ someone they know instead of using an agency. They then become the legal employer. That includes arranging cover for illness and holidays.
Before you sign anything for your relative, ask the council or a trusted advice service what authority you need to do so.
What does home care cost, and who pays?
Costs vary by where you live. Compare current quotes from several agencies. Our free care cost calculator can help you see what care at home may cost and whether the council may help.
The council sometimes contributes. It decides this with a financial assessment, which comes after the needs assessment finds eligible needs. Our rights and benefits guide explains more.
A self-funder is someone who arranges and pays for their own care. Self-funders should get a clear price list and a monthly bill from the agency.
Attendance Allowance and Personal Independence Payment are not means tested. Either can help pay for home care.
If you live in Teesside and are thinking about a carer who lives in the home, see our live-in care page for Teesside.
What if my relative doesn’t want care, or the carers change too often?
If your relative says no, go slowly. These steps often help:
- Start with a small amount of help, such as one short visit a week.
- Let them make choices, such as the time of day or which tasks to start with.
- Ask about a trial visit, so they can see what it is like before they commit.
If carers change too often, tell the agency. Ask them to match your relative with a small team of carers. If you are unhappy with the care, make a complaint. Complaints go first to the council or, for self-funders, to the agency.
If your relative is living with dementia
- Ask the agency for the same few carers where possible. Familiar faces can help.
- Ask if carers have experience with dementia, and if the agency offers specialist care.
- Keep visit times regular, so the day follows a pattern.
What to do next
- Ask your council for a free care needs assessment.
- Write down the help your relative needs, and when.
- Read the NHS homecare guide, and search the CQC website to check providers.
- Get quotes from several agencies. Ask for a price list and the contract.
- Check whether you can claim Attendance Allowance or Personal Independence Payment. Age UK’s home care guide has more detail.
If you live in Teesside or Darlington, you can ask our care team for help.