Home care services explained

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. Home care helps people who need 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 some daily tasks, such as washing, dressing or getting out and about      
• your home 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?

Home care offers a flexible option for people who need extra support in their own home. The care can be tailored to meet your individual needs. This may vary from just a few hours of help or companionship a week, to full-time live-in care if you have much greater care needs. Home carers can help with a wide range of tasks, including:

• getting out of bed in the morning      
• washing, dressing and maintaining personal appearance      
• preparing meals and drinks      
• help with toileting      
• health-related tasks, as agreed with a medical professional      
• picking up prescriptions and helping to manage medication      
• 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.  

Who can provide home care services?

If you want to arrange care at home, there are a number of options to consider:

• Home care agencies: a popular option is to use a regulated home care provider. These agencies supply their own professional care staff and will manage the entire service for you. Read our guide on how to choose a home care agency.      
• Private carers: alternatively, you can directly employ one or more individuals to provide the support you need. Read more in our article on employing private carers.      
• Introductory agencies: these are agencies that help you find and recruit a suitable carer or personal assistant. They’ll do background checks and may provide training, but the carer works on a self-employed basis and you may take on the responsibilities of an employer.      
• Non-profit organisations: charities such as Age UK or Friends of the Elderly may provide care services in your area. These services may cost less than a private agency, although this isn’t always the case.      
• 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.  

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. If this is the case, you may not need a professional carer. It’s worth asking around to see if friends can recommend anyone to help with these tasks.

It’s also worth contacting local branches of charities such as Age UK or the Royal Voluntary Service to find out what they offer in your area. Age UK offers a paid-for service that helps with day-to-day domestic tasks such as shopping, housework and meals. 

Also check what support your local council can offer. They may provide meals on wheels, for example, or an affordable handyperson service for help with repairs and maintenance.

Temporary care if you’ve been in hospital

If you need additional support at home following a stay in hospital, the NHS may provide up to six weeks of free, temporary support called NHS Intermediate Care. This is usually care or support at home and is arranged by the hospital social work team before you’re discharged.

How do I arrange home care?

The best place to start is by requesting a free care needs assessment from your local authority. This will look at various aspects of your life – including physical and mental health and general wellbeing – to work out what level of support you need. It will also provide information about different kinds of help that may be available. This can include domiciliary care, adaptations to your home, equipment such as mobility aids or assistive technology, or help to pay for a care home.

You are entitled to this assessment, regardless of your financial position.

If you’re assessed as having eligible needs, the local authority will then carry out a financial assessment (or ‘means test’) to determine whether you qualify for financial support towards the cost of your care.

Even if you expect to have to pay for your own care, it’s still important to get a needs assessment. It provides a formal record of the type of support you need, and this will help a care provider to meet those needs.

• Find out more about how to get local authority-funded care at home.

If you qualify for local authority support

If you are eligible for local authority support for home care, the council may offer to arrange the service for you – either through their own in-house home care service or, more commonly, through a commercial domiciliary care agency. Alternatively, you may be offered a personal budget, which you can use to arrange the support you need independently. 

Personal budgets are designed to give people more control over the care services they use. Read more about how they work in our guide to personal budgets and direct payments.

If you’re a self-funder

If you’re paying for your own care, 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.

See the following articles for tips on how to choose the right care provider:

• How to choose a home care agency     
• How to employ private carers  

 Read more about different options for paying for care at home

Regional differences

In Northern Ireland and Scotland, personal care at home is normally free for adults 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 (or local HSC Trust in Northern Ireland) if you think you would benefit from extra support at home. Charges may still apply for other services that are not classed as personal care, such as day care, meals and personal alarms.

Pros and cons of home care

To help you decide whether home care is right for you, consider the pros and cons.

Advantages of home care          

• Home comforts: allows you to stay in your own home for longer.
• Peace of mind: for you and your family that someone is calling in regularly and you 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.              
• 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 may be cheaper than moving into a care home, but this depends on the amount of care needed. 

Disadvantages of home care          

• 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.          
• Different staff: although care agencies usually aim to provide consistency, sometimes clients will be visited by different care staff. This can cause disruption or confusion for some older people, especially if there is a constant turnover of carers. Carers might not always call at the arranged times, which can cause distress for a client who is waiting for essential help. 
• Geographical limits: your choice of care services may be limited by what’s available in your area. 

What are the alternatives to home care?

Home care can support people with complex needs to continue living at home. But this doesn’t mean it is the right 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 grab rails, ramps or a stairlift to choosing smaller items that can help with day-to-day living, such as gadgets to help with preparing food safely or making it easier to turn knobs or taps.      
• Telecare and personal alarms provide extra security and reassurance if you are living alone.      
• 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. Some schemes, known as extra-care housing, also include help with personal care.      
• Care homes provide accommodation, 24-hour support, meals and communal activities for people who can no longer live safely or comfortably at home. 
• Nursing homes also provide nursing care, for those with a higher level of healthcare need.