Home care and unexpected charges
Home care – also known as domiciliary care – can help people who are finding it difficult to cope with daily tasks, such as washing, dressing or getting out and about. It is most suited to people whose home still largely meets their needs but who are struggling with personal care routines or mobility issues. It’s most commonly provided by a domiciliary care agency, but you can also choose to employ private carers yourself.
Home care can be less expensive than full-time residential care, although this will depend on individual needs and circumstances.
However, research by Which? in 2020* revealed that not all home care providers are transparent about the true costs of their services. Our research uncovered hidden costs, unexpected charges and other frustrations that older people and their families can encounter when choosing a home care provider.
Unclear prices and confusing rules
Some people have found themselves confused about how much they would pay for various aspects of their home care service, such as the basic costs they’d incur, how charges would vary for bank holidays and out-of-hours care, and additional costs for cancelled visits.
On top of that, in our 2020 survey almost one in three people said they did not receive a contract with terms and conditions in advance, and one in four had to query items on their bill.
Home care arrangements are often put in place at short notice, such as when someone has had a fall or unexpected illness, or is discharged from hospital. This is one reason why people may sign up for a service without having a clear understanding of the actual fees they can expect.
Hidden costs to look out for
Here are some of the most common causes of frustration we’ve heard about when it comes to home care fees:
1. Higher prices for ‘non-standard’ visits
Home care services are usually charged by the hour – although 24-hour live-in care is more commonly priced at a weekly rate. However, if you request home visits that are not rounded off exactly to an hour, you might be charged a higher rate.
For example, a half-hour visit won’t necessarily be charged at 50% of the standard hourly rate. In fact, we’ve heard of care agencies charging more than 80% of the hourly rate for a half-hour visit.
2. Paying more for ‘unsocial’ hours
People’s care needs don’t fit neatly into the working day. Needs may be greater early in the morning or later in the evening, especially in relation to personal care tasks such as dressing, bathing, getting into or out of bed, taking medication and eating.
But it may come as a surprise that the standard hourly rate quoted by an agency often only applies to visits during regular working hours – eg Monday to Friday, 9am–6pm. Home care fees can be far higher outside these times, including at weekends. And when it comes to bank holidays, some agencies will charge almost double the standard hourly rate.
When it comes to bank holidays, some agencies will charge almost double the standard hourly rate
3. Paying a penalty if you change your plans
You can’t plan for every eventuality, and people will often find themselves needing to make changes to regular care arrangements. But this can also bring unexpected costs.
For example, a trip to the hospital could mean you need to cancel home care visits. But unless this is planned well in advance, it can lead to unwanted charges. Many agencies require 72 hours’ notice to change or cancel a care visit, but some insist on an even longer notice period – up to 14 days’ notice in some cases.
We’ve heard examples of unplanned medical issues resulting in people paying significant fees for unused care visits.
Likewise, if you want to pause care arrangements to go on holiday or for other personal reasons, this needs to be planned in advance. Be clear on the agency's policy on changes or cancellations to scheduled visits or you could end up paying significant fees for unused care visits.
How to avoid hidden care costs
If you’re arranging home care for yourself or a loved one, always ask to see a standard contract before you commit. Check the terms and conditions thoroughly and ask questions about anything that isn’t clear. And try to compare fees from a number of local service providers before you make the final decision.
You might feel under pressure to put arrangements in place as quickly as possible, but it’s important to ask for a contract in advance.
We've created a detailed checklist to help you pinpoint the key questions to ask a home care provider before signing up.
Here are some key tips to get started with:
- Find out what’s included in the care: Be clear on what the costs cover. Will they increase as your loved one’s care needs increase? Does it include personal care or just home help and companionship?
- Ask what the standard rate really means: Check the hourly rate carefully. Fees may increase for early mornings, evenings and weekends. While bank holidays could cost almost double the standard hourly rate in some cases. Make sure you’re aware of the different rates before you commit to a home care provider.
- What happens if you need to change the schedule?: Ask about what will happen if you wish to change agreed schedules, this could be moving visits to a different date or changing the duration of visits. Find out if there are further charges for cancelling or moving visits. Will you still have to pay if you are admitted to hospital? Check the contract for details on how to terminate the service and make sure you find out how much notice you’ll have to give.
- Get clued up on price increases: Find out if you can expect an annual hike in home care fees. The contract should detail when prices can increase and by how much.
- Other issues to look out for: Our survey also uncovered other challenges you could encounter when arranging a home care. These included a high turnover of care staff and problems communicating with the agency. Find out more: Five challenges of arranging home care.
How much does home care cost?
Home care fees will vary depending on your individual needs and location. The Homecare Association recommends a minimum charge of more than £20 an hour. However, as our survey found, the basic rate is only part of the picture, as many providers charge more for certain times and services.
Find out more about the options for financing domiciliary care.
* Online survey of 367 members of the Which? Connect panel conducted in February 2020