Care in your own home

Introduction

The best kind of care is the kind that does just enough to meet your needs, so you still feel like you’re living your own life and aren’t over-dependent on someone else. Many people find that homecare provides this satisfying balance for them, making their life easier while letting them retain their freedom.

What is homecare?

If a care worker visits or lives with you in your own home, that’s homecare. Sometimes you’ll hear it called ‘domiciliary care’, to avoid confusion with a ‘care home’ (which is known as residential care).

Some people choose homecare if they need support in everyday life, but not enough to require moving to a care home. However, many find that homecare can be a comprehensive alternative to residential care, providing similar or even better levels of support.

Do I need homecare?

The first sign that you may need some form of care is if you start to find everyday tasks difficult. This may be due to physical problems (e.g. pain that makes it hard to get up, climb stairs, dress and so on) or problems associated with dementia (e.g. forgetfulness, memory or comprehension issues, or loss of coordination).

There is no need to wait until your difficulties are severe, as you can arrange for just enough homecare to suit your needs. In fact, arranging a small amount of care in good time may keep you more able and self-sufficient for longer. Having a care worker on hand will also help you stay aware of your changing care needs.

Delaying homecare for as long as possible is generally not a good idea, as if your health deteriorates suddenly it may limit your options.

What can a homecare worker do for me?

A homecare worker ‘fills in the gaps’. They help you with whatever you can’t do fully by yourself, so you can continue to lead as normal a life as possible. For example, if you’re still relatively self-sufficient but have mobility problems, you might engage a care worker to help you get out and about, go shopping and meet friends. You can also have someone come in to help with general housekeeping, cleaning, gardening, cooking and so forth. This sort of light support is sometimes called ‘home help’.

 If your needs change over time, you may increase the care you receive to include things like:

  • Preparing meals
  • Washing and dressing
  • Going out to fetch shopping, collect your pension or pick up prescriptions
  • Using the toilet
  • Taking medication
  • Help with eating
  • Help with everyday administration (such as paying bills)

Broadly speaking, a homecare worker can help with anything except specialist healthcare. But those without medical training can still help administer medicines and alert qualified nurses or doctors if necessary.

Last but not least, a homecare worker provides companionship. Loneliness can be a health hazard on a par with smoking, so having regular company is one of the most under-rated benefits of homecare.

Do I need a live-in care worker?

If you need a lot of care throughout the day and/or at night, it may be best to have a care worker who lives with you some or all of the time. Conditions where this may become necessary include dementia, serious mobility issues and generally poor health.

A live-in careworker can attend to your needs at any time of the day or night, within the limits of their employment contract. One way is to have two or more carers working in rotation (e.g. two weeks on, two weeks off); alternatively you may have just one live-in carer and make alternative care arrangements when they are not on duty.

Live-in care can be a solution if your needs reach the stage at which residential care is the only practical alternative. The cost is usually higher than that of a residential care home (see below), but on the plus side you will be able to retain more independence, get to stay in your own home, keep pets and so on. Also, if you are in a couple and you both need care, live-in care may be more cost effective than two places in a care home.

How to choose your homecare worker

You have two main options here: use a homecare agency, or hire a care worker directly yourself. Using an agency may be slightly more expensive, but will be a much simpler process for you.

Before you do anything else, make a list of your likely care needs and put them in order of priority (remember you can include things like ‘companionship’). You don’t want to pay for more care than is necessary, but it is good to plan ahead. Think of your needs on a ‘bad day’ and build your wish-list around that, rather than trying to put a brave face on things.

Finding your care worker through an agency

Care agencies in the UK are regulated by the Care Quality Commission, which inspects the quality of their services and allocates a rating (from ‘Outstanding’ to ‘Inadequate’). Unbiased will only match you with agencies rated outstanding or good.

Contact a few different agencies and discuss your needs with them. Ask if you can meet the individual care worker(s) who would be looking after you – given that you’ll be spending a lot of time together, you will want to get along well and have complete confidence in them.

A few basic precautions at this stage can provide extra reassurance. Ask about staff qualifications and training, the agency’s DBS (criminal records) checking procedures, and their insurance. The best agencies will have all this information ready on request. Also look at the CQC’s inspection reports to confirm the agency is as good as it appears. Certain warning signs (e.g. high staff turnover or noticeably below-average areas of service) may indicate underlying problems, so if anything looks questionable, ask questions.

Hiring a care worker directly

The CQC does not regulate freelance care workers, so you should take extra care when choosing one. As well as checking their qualifications and training, ask for testimonials from previous clients’ families if available. If you’ll need specialist care (e.g. if you have dementia) then check that they have the necessary experience.

If you choose to hire a care worker yourself, you (or someone in your family) will become their employer. Being an employer places a number of legal responsibilities on you, so first make sure you know what these are, and decide whether or not you are ready to handle them. Also, like any employer, you’ll want to interview a number of different candidates before choosing one, so settling on the right care worker may take some time.

How much does homecare cost?

Care in your own home costs around £15 per hour on average (nights and weekends may be more expensive). Live-in care usually starts at about £100 per full day, or £37,000 per year (somewhat more than the average cost of a residential care home). Find out more about the costs of different kinds of care.

How can I pay for homecare?

The first thing to do when considering home care is to notify your local authority (your GP can do this for you) to arrange a care needs assessment. The local authority will then conduct a means test to see if you’re eligible for financial assistance. You should receive some help with funding care if your assets total less than £23,250 in England and Northern Ireland, £26,500 in Scotland or £30,000 in Wales.

If you don’t receive enough financial assistance to cover all your care costs, you have a number of options for funding your care yourself. Find out here about how to pay for care.

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