What is a home care agency?
Home care agencies employ care workers and arrange for them to visit you to provide care services, such as help with:
- eating and drinking
- bathing and personal hygiene
- getting in and out of bed
- getting dressed and undressed
- taking medication
- doing your weekly shopping.
Some home care agencies are also registered to provide nursing care to people in their own homes. Any nursing care must be carried out, or planned or supervised, by a registered nurse.
All home care agencies must register with the Care Quality Commission (CQC), which regulates and inspects them. The CQC will only register a home care agency if it meets their minimum standards. These requirements do not apply to employment agencies that help you find self-employed nurses and care workers.
Find out whether the home care agency staff have had a Disclosure and Barring Service (DBS) check to make sure they don’t have a criminal record or anything else in their past that would make them unsuitable to work for a home care agency.
Working out what care you need
If you think you need some help, the first step is to get a care needs assessment from your local council’s adult social services department. This is free and looks at what you can do and what you need help with. Even if you’re going to organise your own care directly with an agency, it’s a good idea to get an assessment first so you can explain to the agency what help you need.
It may also be useful to ask for an occupational therapist to be involved in your assessment. They might recommend disability equipment or an adaptation to your home that could make life easier.
You can have a friend, relative or an independent advocate with you during the assessment. Let the council know you want this when you make the arrangements. If you don’t have an appropriate person to support you and the council thinks you need help to understand or remember what's being discussed, weigh up options or communicate your views, they must provide an independent advocate.
The council will use the assessment to work out whether you qualify for support to meet your care needs. If you don’t, the council must still give you information and advice about where to get help and support.
Paying for home care
If the council agrees that you need extra help at home, they will usually carry out a separate financial assessment to see if you can get help with costs.
You’ll usually have to pay for your care yourself if you have savings or capital over £23,250. This doesn’t include the value of your main or only home. Even if you’re paying for your own care, you can ask the council to arrange care for you, although they can charge you an arrangement fee for this.
If you qualify for financial support, the council should tell you how much they think it will cost to meet your needs. This is called your personal budget. You can let the council manage this money and organise care services for you or, if you prefer, you can control your own budget and choose a home care agency yourself. Our factsheet Social care: ways to use your personal budget has more information.
How to find a home care agency
Your local council will have information about home care agencies in your area and may also have an online directory. You can also search for agencies on the CQC website or ask them for a list.
The United Kingdom Home Care Association has a database of its members. These agencies have agreed to meet certain quality standards.
What to look for in a home care agency
All home care agencies must have a ‘statement of purpose’ and a service user’s guide which includes:
- the aims and objectives of the agency
- the type of services they provide
- who the service is for.
Good home care agencies should have policies and procedures in place to protect you, as well as effective guidance for staff. You can find more information about what you can expect from a good home care agency on the CQC website.
The National Institute for Health and Care Excellence (NICE) has a list of six quality statements which can also give you an idea of what you should expect.
Our factsheet Getting care services at home has a checklist of questions you may wish to ask.
How your care will be organised
Once you’ve chosen a home care agency, they must carry out an assessment and work with you to produce a care plan. This should be consistent with the council’s care needs assessment if you’ve had one. They should also give you:
- a written contract
- a clear price list, with details of what’s included in the basic charge and any extras
- information about how to end the contract, if necessary
- a copy of their complaints procedure.
They should also keep you informed about any issues related to your care.
The agency staff must keep a written record of all the care they provide, including medication they give you, changes in your health or any accidents.
You may be asked to sign timesheets. Make sure the time has been recorded accurately and don’t sign any timesheets in advance or you may be charged for care you haven’t received. You should receive an invoice charging you for the amount of care you’ve had in the previous month.
Many home care agencies use an electronic monitoring system which records when care staff enter and leave your home. The care worker may need to use your phone for this but you won’t be charged for the calls.
If you’re unhappy with your home care agency
If something goes wrong – for example your care is rushed or the carer is late or doesn’t turn up – first try to raise your concerns with a social worker if the care was organised by the council, or the manager of the agency.
You can find contact details for your local council at gov.uk/find-local-council