What is domiciliary care?
Domiciliary care is care provided in your own home either from a home care agency (also known as domiciliary care providers) or a personal assistant.
When should I consider home care?
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.
Get a needs assessment
Your need for help might come suddenly, as a result of an illness or fall, or your situation may have been changing gradually over time. 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 really important. It gives a professional assessment of the type of care and support needed, and can make you aware of a range of options you may not have known were available.
It’s good to be aware of the benefits you may be eligible for, including Attendance Allowance. Our full guide to benefits and pensions offers more detailed information about other benefits that might be available.
Home care services
Home care services provide professional carers or personal assistants who can visit you at home to help with a wide range of jobs, including:
- getting out of bed in the morning
- maintaining personal appearance, such as brushing your hair
- help and support with toileting and using continence aids
- preparing meals and drinks
- help with eating and drinking
- picking up prescriptions
- giving, or prompting to take, prescribed medication
- health-related tasks, as agreed with medical practitioners or community nurses
- nursing care from a registered nurse
- shopping (either with you, or on your behalf)
- collecting pensions
- helping with money, managing and paying bills
- 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.
In addition to arranging personal care from a domiciliary care agency, you might also want to find someone locally that can help with basic household tasks, such as:
- cleaning: regular kitchen or bathroom cleaning, one-off spring cleans, vacuuming or cleaning floors, tidying and dusting
- doing the washing up
- general home maintenance.
You might find that this level of support is all that you need if you are starting to slow down or have mobility issues. Domiciliary care agency help could follow in due course. Read more on this subject in our article on home help and other support.
How much help will I need?
The level of support and care in the home that each person needs will vary. You might need assistance with some, or all, of the above tasks: you might need care for only one hour a week, a couple of hours a day, or need to have a full-time or live-in carer.
Home care services can be used temporarily – for example, while you recover from an illness or operation – or long term. One of the benefits of home care services is their flexibility, which allows you to choose the right level of help and support for you.
In this guide, we look separately at home care agencies (providing personal care) and home help services (providing help with practical household tasks). Local authorities tend to focus their limited budgets on home care agencies rather than home help.
If you’re looking for a nursing home, look for a small one. If you’re looking for a care agency, look for a big one with a lot of staff.
Local authorities have an obligation to provide some services, including personal care or preparing meals for those who have no other way of getting a meal, but they are unlikely, in most cases, to provide help with household tasks, except where it’s part of a more complex care arrangement. If you need help with cleaning and gardening, or with shopping and paying bills, it’s likely that you’ll have to look elsewhere – although your local authority may be able to provide useful information to help you find someone suitable.
What are the alternatives to home care?
Many home care services can support people with medical and complex needs to live at home, as agreed with medical practitioners or community nursing nurses. This means that people can choose to remain living at home, supported by home care, rather than move into a care home.
If you want the reassurance of knowing someone is around 24 hours a day, seven days a week, it might be worth considering other options to supplement, or instead 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. If safety is an issue, there are various personal electronic alarms to give you extra security and peace of mind in case of emergency.
- Live-in care, where a carer lives in your home, so that your needs can be met 24/7.
- Telecare and assistive technologies can operate 24/7 and provide extra support in between carers’ visits.
- Sheltered housing may offer warden services and telecare.
- Extra care housing may offer 24/7 emergency support and some schemes include help with personal care, either as part of the arrangement or as an additional item to be paid for separately.
- 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.
Home care services can be provided by a range of organisations or even private individuals.
Many older people are eligible for local authority help with their care. Find out about the needs assessment for care.
Here are the questions to ask a home care agency. Prepare for your meeting and get the answers you need.