Buying care at home

If you are looking for support with domestic tasks, see our information on House, garden and pet care.

If you need more personal care to help you with everyday tasks (such as washing, dressing, preparing meals or going to the toilet), there are a lot of care providers and care services.

Probably the most important consideration is whether you want your care to be fully managed for you by someone else or whether you prefer to manage your own care.

The most common ways to purchase the care you need at home are:

1. Using a home care agency

Home care or ‘domiciliary care’ agencies can provide a “fully managed” service. They directly employ, train and supervise the carers which they supply to you and take complete responsibility for the management of the care service.

They are regulated and inspected by the Care Quality Commission (CQC) who inspect the services that are being offered. It is a good idea to read the latest inspection report for any agency you are considering using.

You will find a link to the latest report for all CQC registered Home Care and Nursing Care agencies listed in our Marketplace Directory.

Which? provides a useful checklist of questions to ask home care agencies. This information can be downloaded as a booklet.

If you would like some help to find the right home care for you, you could use a free care brokerage organisation such as CHS Healthcare. There are other organisations who are able to provide independent advice and help to source the right care. They will usually charge a fee for this service; always ask for details of fees up front.

 2. Employing or engaging a Personal Assistant 

If you would like to manage your own care, you could engage or employ a personal assistant (PA).

You could:

• Directly employ your own PA

You have full choice and control over who works for you. You will need to take on, and fully understand, the responsibilities of being an employer.

You can find detailed information about this on the Hampshire PA Finder website.

• Engage the services of a self-employed PA

If you want to have choice and control over your care and support, but don’t want to take on the responsibility of being an employer, you could engage or contract with a self-employed PA.

People acting as self-employed PAs are in business for themselves. They offer an agreed set of services in exchange for a fee. If you want to engage or contract with a self-employed PA, they should send you a quote for their services, send you an invoice to take payment, say when they want to work and should bring their own equipment. They’re also responsible for making their own tax and National Insurance contributions.

You can read further guidance from Skills for Care 

• Engage the services of a PA through, for example, an ‘introductory agency’ or matching service

If you are finding it difficult to find a PA, you might choose to use an ‘introductory agency’ or online market place. Some home care agencies also offer an introductory service.

Introductory agencies usually specialise in ‘live-in carers’ but some also offer home care packages. The carers they introduce to you will usually work on a self-employed basis, will take care of all their own tax affairs and are free to be registered with a number of care agencies. You will pay an ‘introductory’ fee to the agency.

Most introductory agencies will carry out checks and ask for references for any personal assistants on their books but you should always ask what their recruitment processes are and check their full terms and conditions.

Introductory agencies are not regulated or inspected by the Care Quality Commission as they do not have an ongoing role in the management of your care.  

You can read further guidance from Skills for Care.

Your local authority can only provide care services if you meet certain eligibility criteria.  You will then have a financial assessment and you may have to pay for any care you receive. 

To find out more, contact the adult social care department of the local authority where you live. This could be:

• Hampshire County Council
• Portsmouth City Council
• Southampton City Council

N.B. Some people with long-term complex health needs qualify for free social care arranged and funded solely by the NHS. This is known as NHS continuing healthcare (CHC). Before your local authority offers services, they will need to consider whether your primary need is health-related and whether you may be eligible for CHC. If you think you may be eligible, you can contact your local NHS Continuing Healthcare team directly for an assessment. You may also find our information page Health and social care roles explained useful.

See our information on Protecting adults at risk if you have any safeguarding concerns.

If you are not happy with the service you are receiving from a home care agency, speak to the manager to try to resolve any problems. Ask to see their complaints procedure. See information on how to complain from CQC.

If you have employed or engaged a PA, see information from Hampshire PA Finder on how to sort out problems.  You could also call the ACAS helpline for advice: 0300 123 1100 (available Monday to Friday 8am-6pm).