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Organising a home care service

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Home care services are a form of social or personal care.  Many of us have grown up with NHS services and understand what they do and the fact that they are free to all.  By contrast, many Carents have no experience of either using or commissioning social or personal care services and it is not always clear what they do, how much they cost and how good they are.

The guides in the want to know more section below will help you understand what you should expect and what to do if you have concerns about the quality of the service being delivered. Below we give some practical insights based on our Carents’ experiences.

What is home care?

Home care (also known as domiciliary care) services help people to live in their own homes by helping with specified activities such as daily personal tasks like bathing, shaving, dressing, or preparing meals.

Daily care visits are usually provided in scheduled time slots ranging from 30-45 minutes up to an hour.

How much does it cost?

An average cost of £20 per hour would be typical but the pricing is not always fully transparent and you should beware of higher prices at weekends, and even higher prices over bank holidays.  Some service providers also add in “travel” costs which can inflate the overall price reduce the direct contact time.

Basically, if you organise three 30 minute slots per day, based on £20 per hour you can expect to pay £30 per day, £210 per week, £840 per month, £10,920 per year.   The length and frequency of the slots are the key drivers of cost. The national guideline for home care services recommends that more visits should normally be longer than 30 minutes.

Will the Council pay?

Council adult social care funding is means tested. In England, if you have capital over £23,250 (thresholds vary across countries within the UK) then you will usually have to pay for all of your care. The test is free but if your savings are such that your care is unlikely to be funded, you could proceed directly and miss the test out.  However, the test could help you access equipment to help around the home.

Will the NHS pay?

NHS funding is not means tested but is limited to those whose care needs are mainly for healthcare.  Qualifying for NHS funding entails a rigorous two stage assessment process. For the 1st stage, a health care professional such as a nurse completes a Continuing Healthcare Checklist.  The results of this checklist – which covers 11 areas of care – determines eligibility for a much more extensive second stage assessment.

How can I find a good service provider?

Your local council will have information about local care service providers which you will usually find in the Adult Social Care section of their website.  You can also generate a list of possible home care service providers by typing in your relative’s postcode into one of the sites listed below.

The NHS Find Homecare Service or The Care Quality Commission (CQC)

We suggest you check the relevant CQC reports for and service providers you are interested in. These reports can give you some indication of the quality of the services provided but it’s even better if you can – but not always feasible – supplement this information with insights and views from someone you know and trust and who has had some experience of using the service.

Beware! After all of your research you might find that your preferred provider is full to capacity and cannot help.

When you contact a service provider they should be able to give you some idea about their availability and their prices over the phone and will then organise for a care coordinator to meet you and your parent(s) to undertake a needs assessment.

What will the needs assessment entail?

The needs assessment will often last at least 30 -45 minutes and will typically take place at your parent’s home to ensure any safety or security issues can be addressed.  It’s often helpful if you can contribute. The assessment will explore the type of help that is required whilst noting all the relevant health and social issues.

What else should I consider?

When commissioning a care service you might also want to discuss the following before “placing an order“:

  • How will the service ensure that the same care workers visit to enable familiarity and avoid a trail of strangers entering my home?
  • How will you get in touch to tell me about any changes to the care arrangements (timing, people, price)?
  • What contingency arrangements will be put in place in case if a care worker is late or misses a visit?
  • How can I be assured that the care workers have had the right training?
  • How can I make adjustments to the care package or provide feedback about what is or isn’t going well for me?

What our carents say

Mum is 93 and by the time she had washed and dressed in the morning, she was just too exhausted to eat her breakfast. I organised a private care service to come and help every morning and it has been a huge help. They are really good and ring me if they think she’s not herself.

I wish I had simply organised some carers myself and hadn’t bothered getting the council involved. Dad’s savings meant he was not eligible for social care and if I had known that in advance it would have been quicker and easier to sort things myself.

I organised carers twice a day but only on weekdays because I knew I could save money by going in myself at the weekends.

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July 2020

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