Having a paid carer come to visit you in your home can make a huge difference to your life, especially if you have difficulty walking or getting around. It can help you stay living independently in your own home.
This type of care is known as homecare or domiciliary care or sometimes home help.
Help at home from a paid carer costs around £20 an hour, but it varies according to where you live. Sometimes, the council will contribute to the cost.
Homecare is very flexible. You might need a paid carer for only an hour a week or for several hours a day. You might need a live-in carer.
It can be temporary – for example for a few weeks while you recover from an illness. Or it can be long term.
When should I consider help at home from a paid carer?
You might want to consider care at home if:
- you're finding it difficult to cope with daily routines, such as washing, dressing and getting out and about
- you do not want to move into a care home
- you can still get about your home and it's safe for you to live in – or it can be adapted to make it safe
How can homecare help me?
A paid carer can visit you at home to help you with all kinds of things including:
- getting out of bed in the morning
- washing and dressing
- brushing your hair
- using the toilet
- preparing meals and drinks
- remembering to take your medicines
- doing your shopping
- collecting prescriptions or your pension
- getting out, for example to a lunch club
- getting settled in the evening and ready for bed
This is slightly different to homecare and means day-to-day domestic tasks that you may need a helping hand with such as:
- cleaning (including putting on clean bed sheets)
- doing the washing up
- doing the laundry
You might want some home help instead of or as well as homecare.
How to get help at home from a paid carer
- your local council can arrange homecare for you if you're eligible for it
- you can arrange your own homecare
How your council can help
If you want the council to help with homecare for you, start by asking them for a needs assessment.
Your needs assessment will help the council to decide whether you're eligible for care.
If you're eligible, the council may recommend help at home from a paid carer. They will arrange the homecare for you.
If you're not eligible for care, the council must still give you free advice about where you can get help in your community.
Even if you're intending to make arrangements yourself with an agency or private carer, it's still a good idea to have a needs assessment as it will help you to explain to the agency or carer what kind of help you need.
Paying for homecare
Depending on your circumstances, your local council may contribute to the cost of homecare or you may have to pay for it yourself.
If your needs assessment recommends homecare, you may get help with the cost from the council.
What you'll contribute depends on your income and savings. The council will work this out in a financial assessment.
If the council is paying for some or all of your homecare, they must give you a care and support plan.
This sets out what your needs are, how they will be met and your personal budget (the amount the council thinks your care should cost).
You can choose to receive your personal budget as a direct payment each month. This gives you the control to employ someone you know to care for you at home rather than using a homecare agency, though you'll then have responsibilities as an employer.
If you're not eligible for the council to contribute to your homecare costs, you'll have to pay for it yourself.
Benefits that can help you with homecare
Check if you're eligible for benefits.
Some, such as Attendance Allowance and Personal Independence Payments, are not means tested and they can help you meet the costs of homecare.
Find out how to apply for:
How to choose a paid carer
If you're arranging your own homecare, there are 2 main ways to do this:
- use a homecare agency
- employ your own carer
Homecare agencies employ trained carers and arrange for them to visit you in your home. You may not always have the same carer visiting your home, though the agency will try to match you with someone suitable.
How much do they cost?
It costs around £20 an hour for a carer to come to your home, but this will vary depending on where you live.
If you're paying for yourself, the agency should be able to give you a clear price list. They'll send you a monthly bill for your homecare.
How to find a local agency
There are 4 main ways to do this:
- search the NHS website for local homecare services and agencies and a list of national homecare organisations and then contact the ones that interest you
- ask your council's social services department for information on the homecare agencies in your area. They may have a directory of homecare agencies on their website
- contact the Care Quality Commission (CQC). All homecare agencies must register with the CQC. It can give you the latest inspection report on an agency
- ask the United Kingdom Homecare Association (UKHCA) for a list of approved homecare agencies in your area
Questions to ask the agency
Here are some questions you may want to ask an agency before employing them:
- what charges, if any, will I be expected to pay
- what services are charged as extras?
- have your paid carers looked after someone with similar needs to mine?
- how will you choose the most suitable paid carer for me?
- will the paid carer agree to visit in a specific time slot? And will they tell me if they're delayed or running late?
- what sort of training do your paid carers get?
- if I'm paying for my own care, do you have a standard contract I can read before signing my own?
- if the council is contributing to my care can I see a copy of the contract they've signed with the agency?
- how can I contact your agency during the day, in an emergency or outside office hours?
What to expect from agency carers
Homecare agency carers should treat you in a respectful and dignified way. For example, they should always:
- knock and ring the front door bell and announce their arrival before coming into your home
- bring an identity card
- know where your keys are kept if they're not in your home
- keep any entry codes to your house confidential
- know what to do if they cannot get into your home
- know what to do if you've had an accident
Employing your own carer
Instead of using an agency, you can hire your own carer, sometimes called a private carer or personal assistant.
If you employ a paid carer, you have the legal responsibility of an employer. This includes arranging cover for their illness and holidays.
Which? Later Life Care has advice on employing a private carer.
How to complain about homecare
You have the right to complain if you're not happy about the help at home you're receiving. This might be because paid carers:
- arrive late and leave early
- do not give your medicines to you properly
- leave your home untidy after visits
- give you poor care like dressing you wrongly
First complain to your local council or, if you're paying for yourself, the agency. The council or agency should have a formal complaints procedure on their website. Try to be specific about what happened and include staff names and dates if you can.
If you're not happy with the way the council or agency handles your complaint, ask the Local Government & Social Care Ombudsman to investigate further. An ombudsman is an independent person who's been appointed to look into complaints about organisations.
You can also tell the Care Quality Commission (CQC), which checks social care services in England.
Your local council must provide you with an independent advocate (someone to speak up for you) to help you make a complaint if you need one.
- the charity, Independent Age, has good advice on homecare
- the CQC has a good booklet on what to expect from a good homecare agency
- read how to organise homecare from Which? Later Life Care
- Age UK has information on all aspects of homecare
- this homecare website has reviews of homecare agencies
- if you need help with one-off jobs like changing a light bulb or moving furniture, the charity GoodGym has volunteers who will come round to help
Watch this video about John, who has dementia and is cared for at home instead of in residential care.
Media review due: 30 September 2021