What is domiciliary care?
Domiciliary care is another name for home care. It is support provided in your own home, either from a home care agency or a private care professional (also known as a personal care assistant). Home care enables someone who needs extra support to stay in their own home for as long as possible.
You might want to consider home care if:
- you’re finding it difficult to cope with daily routines, such as washing, dressing or getting out and about
- your home still meets your needs and is suitable and safe for you to live in (or can be adapted to suit)
- you prefer not to move into a care home.
How does home care help?
Professional carers can visit you at home to help with a wide range of tasks, including:
- getting out of bed in the morning
- washing, dressing and maintaining personal appearance
- help with toileting and using continence aids
- preparing meals and drinks, and help with eating and drinking
- picking up prescriptions and helping to manage your medication
- health-related tasks, as agreed with a medical professional
- nursing care from a registered nurse
- helping with shopping, paying bills or collecting pensions
- getting out of the house and meeting friends
- supervision and companionship
- getting settled for the evening and going to bed.
Help in this way can make a huge difference, not only to your life, but also to your close friends and family, especially if they are caring for you.
The social worker arranged a daily visit and a weekly clean, which was a great help. I knew someone was checking on Mum every day and making sure she took her pills.
The pros and cons of home care
To help you decide whether home care is right for you, consider the main pros and cons.
The advantages of home care
Home comforts: allows older people to stay in their own homes for longer.
Peace of mind: for you and your family that you’re being looked after and aren’t alone.
Time: it may prevent, or delay, a move into a care home.
Stability: you can maintain contact with friends and your local community.
Flexibility: care can be tailored to your needs. You can have as little, or as much, help as needed – from a few hours a week to 24-hour live-in care. Home care services can also be used temporarily.
Agency responsibility: when care is provided by an agency, they are responsible for vetting staff and will cover absences if necessary. Care agencies must be registered with national regulators who check that they are working to set standards.
Cost: care at home can be cheaper than moving into a care home, depending on the amount of care needed.
Pets: if you have pets, they can continue to live with you.
Carers aren’t around 24/7: unless you have a live-in carer. If you need this reassurance, you may prefer to move into extra care housing or a care home. You could also consider a personal alarm system or other telecare devices.
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 carers. Carers 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 difficult if the older person needs to be helped to the toilet.
Geographical limits: your choice of care services may be limited by what’s available in your area.
Who provides home care services?
If you’re considering arranging support at home, there are a number of ways it can be provided:
- Home care agencies: home care agencies employ the professional carers and manage the entire care service. Read our guide on how to choose a home care agency.
- Private individuals: you can employ one or more individuals to help with various aspects of care. Read more in our article on employing private individuals.
- Introductory agencies: help you find and recruit suitable private carers or personal assistants. They’ll do background checks and may provide training, but the carer works on a self-employed basis and you take on the responsibilities of an employer.
- Non-profit organisations: charities such as the Royal Voluntary Service or Age UK may provide support services in your area, including help around the home, companionship or transport. Care services may cost less than through a private agency, although this isn’t always the case.
- Home help: you might find that help with basic household tasks like cleaning, gardening or home maintenance is all that you need if you are starting to slow down or have mobility issues. Domiciliary agency help could follow in due course.
- Family and friends: it may be possible for family or friends to help with personal care. This might be a solution in itself or it could supplement professional care.
Get a needs assessment
Your need for help might come suddenly, as a result of an illness or fall, or your situation may be changing gradually. Whatever the reason, if you’re considering care at home, the first step is to get a free needs assessment from the social services department of your local authority.
Even if you plan to personally arrange or pay for home care services, a needs assessment is important. It gives you a professional assessment of the type of care and support you need, and can help to make you aware of the range of options that are available.
How do I arrange home care?
A good place to start is by requesting a needs assessment (see above). This will help to establish the level of support you need and what help may be available.
If you’re self-funding, any of the home care options listed above are available to you. Choose the type of provision that’s best suited to your situation, or consider combining two or more kinds of help to create an effective support network.
If you are eligible for support from the local authority following a needs and financial assessment, you may be given a personal budget. This is the amount of money the local authority is prepared to contribute towards your care. It gives you three options for how your care is organised.
You can ask your local authority to organise the care on your behalf (but you will still have a right to approve who the local authority employs). The majority of local authority care is contracted out to commercial domiciliary care agencies.
You can choose to accept the personal budget, which should be offered to you in the form of a direct payment. This will give you a greater choice over who cares for you; you can choose to use it to arrange employees from a care agency or to recruit your own personal assistant. For more information, read about personal budgets and direct payments.
A third party (which could be a home care agency) might manage the personal budget on your behalf. This is called an individual service fund.
Read more about different options for paying for home care:
In Northern Ireland and Scotland, personal care is free to those aged over 65 who have been assessed by their local authority as needing it. This support is not means-tested, so regardless of your financial position, contact your local council if you think you would benefit from extra support at home. Charges may still apply for non-personal care services, such as day care, meals and alarms.
Care Information Scotland is a useful resource of information about care services for older people living in Scotland.
What are the alternatives to home care?
Home care services can support people with medical and complex needs to live at home. This means that people can choose to remain living at home, rather than move into a care home.
But this doesn’t mean it is the ideal solution for everyone who needs extra support.
For example, you may need some help to stay independent, but don’t feel you need regular professional care at home. Alternatively, you might want the additional reassurance of knowing someone is around 24 hours a day, seven days a week. Whatever your situation, consider the other options that could supplement or take the place of daily home care.
- Making adaptations to your home could be enough to help you stay living independently for longer. These can range from installing stairlifts and using electronic wheelchairs to choosing smaller items that will ease the comfort of day-to-day living, such as gadgets for preparing food and drink safely, as well as simple alterations to make the bedroom or bathroom safe and comfortable.
- Telecare and personal alarms can operate 24/7 and provide extra security and peace of mind between carers’ visits.
- Live-in care, where a carer lives in your home, so that your needs can be met 24/7.
- Sheltered housing may offer warden services and an emergency alarm system in a secure environment. Extra care housing schemes may also include help with personal care.
- Care homes provide residential accommodation, together with nursing or personal care, and are suitable for those who need substantial help with personal or nursing care, and who are prepared to relinquish some of their privacy in exchange for increased support and social contact. A nursing home provides nursing care, for those with a higher level of healthcare need.
The professional needs assessment should give you (and your representatives, where appropriate) the opportunity to discuss alternative options and help select the most suitable in the circumstances.
Use our step-by-step guide and checklist to help you find the best home care provider for your needs.
Live-in care helps you to stay in your own home rather than move to a care home. Find out if it could be right for you.
Guidance on employing personal care assistants, with information about legal issues and financial matters.