There are, of course, benefits and drawbacks to using domiciliary care services, which you and your relative will want to weigh up before going any further.

The benefits of domiciliary care services

  • Home comforts: they allow older people to stay in their own homes for longer.
  • Time: they may prevent, or delay, a move into sheltered housing or a care home.
  • Stability: your relative can maintain contact with friends and their local community.
  • Peace of mind: for you, and your family, that your relative is being looked after and is not alone.
  • Flexibility: home care services are flexible and your relative can have as little, or as much, help as they need. Care can be tailored to fit their needs.
  • Agency responsibility: most care is provided by agencies, which means that the agency is responsible for vetting staff and will cover absences if necessary.
  • Duty of care: local authorities have a duty of care to provide help to those with eligible needs.
  • Standards: care agencies must be registered with national regulators who check that they are working to set standards and, in England, rate their services.
  • Cost: receiving care at home might be a lot cheaper than moving into a care home, depending on the amount of care needed.
  • Pets: if your relative has pets, they can continue to live with them.

The drawbacks of domiciliary care services

  • People are not around 24/7, unless your relative has a live-in careworker. If your relative needs this reassurance, they may prefer to move into extra care housing or a care home. They should also consider an alarm system and perhaps other device such as a fall detector or bed sensor.
  • Different staff: with an agency, although the aim is usually to provide consistency of care, sometimes different staff may be used in times of staff sickness, holiday or when there is a shortage of careworkers. Careworkers will try but might not always call at the arranged times (for example, if they have to deal with an emergency at their previous call), which can be particularly difficult if the older person needs to be helped to the toilet.
  • Geographical limits: your relative’s choice of care services may be limited by what’s available in their area.

Employing a personal assistant

If your relative is thinking about employing a personal assistant, there are other issues to consider:

  • Employer responsibilities: there can be a lot to think about if you are employing personal assistants or helpers directly – for example, pay and contracts, and ensuring they are doing their job properly.
    Registration: individual personal assistants do not have to be registered with a workforce regulator so there is no national body to check up on them. If this is something that concerns you or your relative, you could use a regulated agency instead.
    Lack of replacement cover: if personal assistants or helpers are self-employed/private individuals, your relative could be left without any replacement cover if the helper is absent from work. This could, however, be addressed using agency cover.

More information

Page last reviewed: August 2016 
Next review due: March 2018