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The hidden costs of home care

One alternative to a care home in later life is having professional carers look after you in your own home, but many people aren't aware of the hidden costs

The hidden costs of home care

With a large proportion of deaths occurring in care homes during the coronavirus crisis, some people might be wondering whether residential care is the right choice in later life. A recent survey found that, since the pandemic, 31% of Which? members are less likely to consider a care home for themselves or an older loved one.*

Care homes have now introduced stringent new safety guidelines to protect against infection, but they aren’t the only choice for later life care.

A popular alternative is home care – also known as domiciliary care – where professional carers visit you in your own home to help you with personal care and other support, while allowing you to stay as independent as possible.

Home care can help older people who are finding it difficult to cope with daily tasks, such as washing, dressing or getting out and about. If your home still largely meets your needs but you’re struggling with personal care routines, home care might be worth exploring. As the pandemic progresses, it could become a more important option than ever.

This type of care is most commonly provided by domiciliary care agencies who manage the entire service and employ the carers. But you can also choose to employ private carers directly yourself.

To find out more about how people set up this type of care, and whether there were any concerns, Which? surveyed 367 people who receive home care or have helped to arrange it for a loved one.** Our research revealed a number of problems that came up time and time again.

Almost a third of those surveyed said they had concerns about the service they had received in the past year. Those who had concerns flagged up issues around unfair or confusing charges, as well as issues around care quality and communication.

Here we take a closer look at the hidden costs of arranging home care.

Unclear pricing and confusing rules

Some people who’ve organised home care have found themselves confused by how much they would pay for various aspects of the service, such as the basic costs they’d incur, how charges would vary for bank holiday and out-of-hours care, and any additional costs for cancelled visits. On top of that, of the people in our survey who had a concern in the past year, one in four have had to deal with incorrect billing.

One respondent told us they experienced a shock when they received their first invoice as the difference between hourly and half-hourly rates hadn’t been discussed. They discovered that the half-hourly rate was 88% of the hourly rate, so they were paying an unwanted premium for arranging visits that were not rounded off to an hour. To make matters worse, after seven weeks of care they still hadn’t received a contract.

But such a lack of clear information about costs was not unique. In fact, 28% of people did not receive a contract with terms and conditions up front. This may partly explain why only about one in four people were ‘very clear’ on when prices could be increased and by how much.

Home care arrangements are often put in place at short notice, such as when someone has had an accident or is discharged from hospital. This is one reason why people may sign up for a service without having a clear understanding of the exact fees they could expect.

Paying more for ‘unsocial’ hours

People’s care needs don’t fit neatly into the working day. Needs are often greater 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.

Some respondents didn’t realise that, very often, the standard hourly rate quoted by a home care provider only applies to visits during regular working hours – eg Monday to Friday, 9 am–6 pm. Home care fees can be far higher outside these times, including at weekends. And when it comes to bank holidays, some agencies charge almost double the standard hourly rate.

Find out about home care fees and how they can vary according to where you live in the UK

Penalised for a change of plans

You can’t plan for every eventuality, and it’s especially difficult to do so when it comes to later life care. Inevitably people will find themselves needing to make changes to regular care arrangements. But as our survey found, this can bring unexpected and confusing costs.

For example, an unexpected hospital stay could mean that home care visits need to be cancelled, 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 this ranges up to 14 days notice in some cases.

We heard examples of unplanned medical issues resulting in people paying significant fees for unused care visits.

One respondent told us: ‘Mum then had an accident and was admitted to hospital and we were charged for two weeks as we had not given notice.’

How to steer clear of hidden home care fees

Care prices usually depend on where you live and what your specific needs are. And fees can be more expensive for overnight care, or support during weekends and bank holidays. If you’re arranging home care for yourself or a loved one, ask to see a standard contract before you commit. Check the terms and conditions thoroughly. And try to compare fees from a number of local service providers before you make the final decision.

We’ve created a detailed checklist to help you pinpoint the key questions you’ll want to ask a care provider before signing up.

Here are some tips to get started with:

1. 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?

2. 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.

3. What happens if you need to change the schedule?

Ask about what will happen if you wish to change agreed schedules, either to a more suitable time or to increase the length 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 will have to give.

4. 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.

How much does home care cost?

Navigating the cost of care can be tricky. Home care fees will vary depending on your individual needs and location. The UK Home Care Association recommends a minimum charge of £20 per 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.

If you live in England, our Cost of Care calculator can cut through the complexity of care fees and help you see what you can expect to pay for care in your area.

  • Find out more about the options for financing domiciliary care, from local authority funding to equity release: Home care finance

* An online survey of the Which? Connect panel conducted in June 2020

** The results are based on an online survey of the Which? Connect panel conducted in February 2020


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