Care Agencies in the UK

Finding a good home care agency in the UK

Home care — domiciliary care, in the jargon — is help in a person's own home: a carer calling for half an hour or an hour to help with getting up, washing, dressing, medication, meals and getting to bed, once or several times a day; or a live-in carer who stays in the house and provides support round the clock. For most older people it is what they want instead of a care home, and for many it is cheaper too. It also covers younger adults with disabilities, people recovering after hospital, and end-of-life care at home.

Agencies must be registered with the Care Quality Commission in England (the Care Inspectorate, CIW and RQIA elsewhere), which inspects and rates them exactly as it does care homes — Outstanding, Good, Requires Improvement, Inadequate — and the reports are public. A good agency assesses needs at home before anything starts, writes a care plan with the family, sends a small consistent team of carers rather than a different face each day, is honest about the length and timing of visits, and has a manager who answers the phone. The alternative is employing a carer directly, which is cheaper per hour but makes you the employer.

Care is paid for privately, by the council after a needs and financial assessment, or through NHS Continuing Healthcare for those with primary health needs; direct payments let a person who qualifies choose their own agency. The listings here show each agency's reviews, the care it provides, its inspection rating, and contact details, so you can see who covers your area, who offers live-in and dementia care, and what families say about them.

What home care agencies provide

Hourly visits: personal care, medication prompts, meals, housework and shopping, from one visit a day to four, seven days a week.

Live-in care: a carer living in the home, with breaks covered, as an alternative to a care home for someone who needs support through the day and night.

Specialist care: dementia, Parkinson's, stroke recovery, learning disabilities, and palliative and end-of-life care at home working with district nurses.

Respite and reablement: cover so a family carer can take a break, and short-term intensive support after a hospital stay to get someone back on their feet.

Companionship and outings: sitting services, help getting to appointments, and company for someone living alone.

Before you choose a home care agency

• Ask the council for a care needs assessment first; it decides what care is needed and whether the council will contribute.
• Read the inspection report and rating, and ask when it was last inspected.
• Ask how many different carers will visit, how they cover sickness and holidays, and what happens if a carer is late or misses a call.
• Get the hourly and live-in rates in writing, with the minimum visit length, evening and weekend rates and the notice period.
• Ask about carer training, DBS checks and how medication is handled and recorded.
• Ask for references from current clients and read the reviews from families.

What home care costs in the UK

As a rough guide, agency home care costs £25 to £35 an hour in most of the country and £30 to £40 in London, with half-hour visits at £15 to £22, evening and weekend rates 10 to 25 per cent higher, and bank holidays double. Two visits a day, seven days a week, runs £700 to £1,000 a week; live-in care £1,300 to £2,000 a week, more for two people or complex needs. Employing a carer directly costs £15 to £22 an hour but you become the employer with all that involves.

The council pays some or all of the cost for those with assets under £23,250 in England after an assessment, and NHS Continuing Healthcare covers everything for those who qualify; Attendance Allowance is available regardless of savings to anyone over state pension age who needs care. Get the assessment before committing to a package.