Home care basics: questions answered

Question 1

Does the NHS provide domiciliary care?

Accepted Answer

Usually not; most domiciliary care in England is social care, arranged by the council or paid for privately, not the NHS. The NHS does fund care at home in some cases: free reablement or intermediate care for up to six weeks after hospital, NHS continuing healthcare for people with a primary health need, and community nursing such as district nurses. Everyday help with washing, dressing and meals is normally means-tested by the council.

Question 2

What is the difference between personal care, companionship and domestic help?

Accepted Answer

Personal care is hands-on help with the body, such as washing, dressing and toileting, and must be provided by a CQC-registered service. Companionship care is social support: conversation, outings, hobbies and keeping someone company. Domestic help covers practical jobs like cleaning, laundry and shopping. Companionship and domestic help on their own are not CQC-regulated activities, so they can be provided by unregistered services, and are often cheaper per hour.

Question 3

What is companionship care?

Accepted Answer

Companionship care is non-medical support focused on company and wellbeing. A companion might chat, play games, go for walks, accompany someone to appointments or social groups, help with letters and phone calls, and do light errands. It suits people who are lonely or anxious but do not need help with washing or dressing. If the companion also gives personal care, the service must be registered with the Care Quality Commission.

Question 4

Can a home carer do housework and shopping?

Accepted Answer

Yes, most agencies will include light housework and shopping in a care plan. Typical tasks are washing up, tidying, changing beds, laundry, emptying bins and collecting shopping or prescriptions. Heavy or specialist jobs, such as deep cleaning, gardening, moving furniture or DIY, are usually excluded. If someone only needs domestic help, a home help or cleaning service may be cheaper than a care agency.

Question 5

Can home carers give medication?

Accepted Answer

Yes, trained home carers can support medication if it is written into the care plan and the agency's medicines policy allows it. Support ranges from reminding someone to take their tablets, to handing them pre-dispensed doses, to fully administering medicines and recording each dose on a medication record. Carers should not change doses or decide what to give. NICE guidance on managing medicines for people receiving social care in the community sets the standards agencies should follow.

Question 6

Can a home carer give injections or dress wounds?

Accepted Answer

Usually not as standard. Clinical tasks such as injections, complex wound dressings, catheter changes or PEG feeding are normally done by district or community nurses. Some may be delegated to a care worker if a registered health professional trains them, signs them off as competent and the agency agrees to take on the task. Simple tasks like applying prescribed creams or emptying a catheter bag are more commonly done by carers.

Question 7

What are home carers not allowed to do?

Accepted Answer

Home carers generally cannot carry out clinical nursing tasks unless trained and delegated by a health professional, change medication doses, handle a client's bank cards or PINs, borrow money or accept significant gifts, make decisions for someone who has capacity, or do heavy domestic work outside the care plan. Rules vary by agency, so check its policies. Anything outside the agreed care plan should be raised with the agency first.

Question 8

How long does a home care visit usually last?

Accepted Answer

Most home care visits last 30 minutes to an hour, with longer visits of two hours or more for outings, shopping or companionship. NICE guidance says visits shorter than 30 minutes should only be used in limited cases, such as a medication check, where the carer knows the person and the visit is part of a wider package. Agencies often set a minimum visit length, commonly 30 minutes or an hour.

Question 9

Are 15-minute home care visits allowed?

Accepted Answer

They are not banned, but NICE guidance in England says visits of under 30 minutes should only be made when the care worker already knows the person, the visit is part of a wider care package, and it is for a specific short task such as a medication check. Fifteen minutes is not enough for personal care like washing or dressing. If short visits are causing problems, ask the council or agency to review the care plan.

Question 10

How many home care visits a day can someone have?

Accepted Answer

There is no set limit; visits are planned around need. A common pattern is one to four visits a day: morning to get up and washed, lunchtime for a meal, teatime, and an evening call to get ready for bed. People needing more help can have longer visits, overnight care or live-in care. Council-funded packages are based on the needs identified in the care needs assessment and the person's care and support plan.

Question 11

How do I work out how many hours of home care someone needs?

Accepted Answer

List what the person cannot do safely alone across a full day and night, such as getting up, washing, meals, medication, toileting and going to bed, then estimate how long each takes with help. That gives a daily total and the times visits are needed. A council care needs assessment or an agency assessment visit will do this formally. If help is needed many times a day or at night, live-in care may be more practical.

Question 12

How quickly can home care start?

Accepted Answer

Privately arranged home care can often start within a few days, and sometimes within 24 to 48 hours if an agency has capacity. Council-arranged care usually takes longer because it needs a care needs assessment first, though councils can put interim support in place in urgent cases. Availability depends heavily on the area; rural areas and evening or weekend visit times can be harder to fill.

Question 13

Can I get home care set up before leaving hospital?

Accepted Answer

Yes. Hospital discharge teams in England can arrange short-term support at home, often reablement or intermediate care, before someone leaves hospital, and this is free for up to six weeks. If ongoing care is likely, the council should assess longer-term needs during or after that period. Families can also arrange private care themselves to start on the day of discharge if they want a particular agency or extra hours.

Question 14

Is care free for six weeks after a hospital stay?

Accepted Answer

Often, yes. In England, intermediate care and reablement are free for up to six weeks to help someone recover and regain independence after a hospital stay or illness. It is provided by the NHS and council together and is not means-tested. It is not automatic for every patient: it depends on whether the person is assessed as able to benefit. Any ongoing care after the free period may be means-tested.

Question 15

Does a home care agency have to be registered with the CQC?

Accepted Answer

Yes, if it provides personal care. In England, helping people with washing, dressing, toileting, eating or medication in their own home is a regulated activity, and the agency must be registered with the Care Quality Commission, which inspects and rates it. Services that only provide companionship, cleaning or shopping do not need CQC registration. Introductory agencies that just match clients with self-employed carers may also be exempt.

Question 16

Is companionship care regulated in England?

Accepted Answer

Not on its own. Companionship, domestic help and shopping are not regulated activities, so a service offering only these does not need to register with the Care Quality Commission and will not be inspected or rated. Once a companion starts helping with personal care, such as washing, dressing or toileting, CQC registration is required. When using an unregulated service, ask about DBS checks, insurance, training and references yourself.

Question 17

Do more people get home care than live in care homes?

Accepted Answer

Yes. In England, more adults receive care in their own homes than live in care homes, and home care has become the default first option for councils and families. Most older people say they would rather stay at home. Care homes remain important for people with high or round-the-clock needs, but many people move into one only after home care no longer keeps them safe.

Question 18

Do I need a council needs assessment before getting home care?

Accepted Answer

No, not if you are paying privately; you can contact an agency directly and it will do its own assessment. A council care needs assessment is free and is needed if you want the council to arrange or help pay for care. It also helps identify needs you might miss and can lead to equipment, adaptations or a personal budget. Anyone in England who appears to need care can request one.

Question 19

Can home care work for someone with dementia?

Accepted Answer

Yes, many people with dementia live at home with home care, especially in the earlier and middle stages. Consistent carers, regular routines and visits timed around meals, medication and bedtime help most. Look for agencies whose carers have dementia training. As the condition progresses, needs often grow to longer visits, overnight care or live-in care, and some people eventually move to a care home.

Question 20

Will my parent have the same home carer every visit?

Accepted Answer

Not always, but good agencies aim for a small, consistent team. NICE guidance says people should be supported by the same care workers where possible and that new carers should be introduced before visiting. Expect some changes for holidays, sickness and weekends. Ask agencies how many different carers a typical client sees each week and whether they send a weekly rota.

Question 21

Do home carers need qualifications?

Accepted Answer

No formal qualification is legally required to start, but CQC-registered agencies must make sure staff are competent and trained. New care workers in England are expected to complete induction training such as the Care Certificate, covering areas like safeguarding, infection control, moving and handling and dementia awareness. Many go on to take qualifications in adult social care. Ask an agency what training its carers have.

Question 22

Are home carers DBS checked?

Accepted Answer

They should be. Care workers providing personal care to adults are in regulated activity, so CQC-registered agencies must carry out an enhanced Disclosure and Barring Service (DBS) check, including a check of the adults' barred list, before they start. If you employ a carer privately, you can ask to see a recent DBS certificate or whether they are signed up to the DBS update service.

Question 23

What is a care plan in home care?

Accepted Answer

A care plan is the written agreement setting out what support someone receives, when visits happen, what tasks carers do and how the person likes things done. It should cover risks, medication, communication needs and preferences. A copy is usually kept in the home, and carers record each visit in a care log or app. The plan should be reviewed regularly and whenever needs change.

Question 24

Can a home carer help someone have a shower or bath?

Accepted Answer

Yes, help with washing, showering or bathing is one of the most common home care tasks. The carer should do a risk assessment first and may recommend equipment such as a shower seat, bath lift or grab rails, which an occupational therapist can assess for. Allow enough visit time, often 45 minutes to an hour, so it is not rushed and the person's dignity and privacy are respected.

Question 25

Can a home carer take my parent to appointments or out for the day?

Accepted Answer

Yes, many agencies offer escorts to GP or hospital appointments, shopping trips, lunches and social outings as part of a care plan. The time is usually charged at the normal hourly rate, plus mileage if the carer drives. If the carer uses their own car, check they have business-use insurance. Outings like these are often booked as longer companionship visits.

Question 26

Can home carers help with continence and toileting?

Accepted Answer

Yes. Help with using the toilet, commodes, changing continence pads, catheter bag emptying and keeping skin clean is part of personal care and is routinely provided by trained home carers. The NHS continence service can assess the person and may supply pads free of charge. Carers should report signs of infection, sore skin or sudden changes in continence to the family, GP or district nurse.

Question 27

How do I become a companion for elderly people in the UK?

Accepted Answer

You can work for a home care or companionship agency, which will usually provide training and a DBS check, or set up as a self-employed companion. No formal qualification is required for companionship alone, but the Care Certificate, first aid and dementia awareness help. If you plan to give personal care, it is usually easier to join a CQC-registered agency. Volunteering through befriending charities is another route.

Question 28

Can a family member be paid to care for a relative at home?

Accepted Answer

Sometimes. If the council arranges care through direct payments, these normally cannot be used to pay a close relative who lives in the same household, unless the council agrees it is necessary. Relatives living elsewhere can often be employed as personal assistants. A family member caring for at least 35 hours a week may instead claim Carer's Allowance of £86.45 a week, if they earn £204 a week or less after deductions and the person gets a qualifying disability benefit.

Question 29

Can home carers help with meals and eating?

Accepted Answer

Yes. Carers can plan and cook simple meals, heat ready meals, make drinks, help with shopping, and support someone to eat and drink, including cutting up food or assisting with feeding. They can also keep an eye on how much someone is eating and drinking, which matters for preventing dehydration and weight loss. Special diets, such as for diabetes or swallowing difficulties, should be written into the care plan.

Question 30

What is a double-up home care visit?

Accepted Answer

A double-up visit is when two carers attend together, usually because the person needs moving with a hoist or has complex handling needs that one carer cannot do safely. It is charged at roughly twice the single-carer cost, because two staff are paid for the visit. An occupational therapist or moving and handling assessment usually decides whether two carers are needed and what equipment should be used.

What it means

What is home care for elderly people?

What does domiciliary care mean?

What does a home carer actually do?

What counts as personal care?