At some point in our caring role, we may start to realise and accept that we need more help. Perhaps because the care is becoming physically too much for one person, or perhaps we just need a break. Either way, thinking about getting care at home and paid carers in, can be a real help.
Jill Elliott is the Relationship Lead at BelleVie. She shares her wealth of knowledge and expertise around paid home care including the right questions to ask providers, the key things to look out for, and cost expectations. And most importantly, how paid home carers can help our loved ones.
How home care works
Care at home, or ‘home care’ is simply a form of care where a professional, paid carer comes into our home to look after our loved one.
As carers, it can be hard to admit to ourselves that we’re struggling and need some additional support. Partly down to feelings of guilt, and partly because the world of paid home care can feel daunting.
It can be overwhelming, but we’re not alone. To help us get started, here’s Jill’s go-to guide on finding good paid home care.
1. How do I know if we need paid carers at home?
It’s different for all of us. But often we start to think about paid care, when we finally admit that we can’t keep spinning all of the plates ourselves.
Perhaps we’re juggling work, our own family and caring. Maybe there’s simply too many caring tasks for one person or our own health is not great. Or maybe it’s more to do with how we feel about some of the caring tasks we’re undertaking. For example, we may feel uncomfortable with managing someone else's personal care. Or physically unable to do it by ourselves.
The top tip is obviously to get paid help before we need it! Rather than waiting until we’re in a crisis situation or burning out. Whenever we start looking for paid care, it may feel overwhelming. We may have some uncomfortable feelings about it, and we may not know where to start.
It’s helpful to know that we’re not the only ones going through this. And our guide to getting started with home care, is here to make ‘getting started’ that bit easier.
2. What can a paid home carer help us with?
A good home care provider should be willing to help with everything and anything to help our loved one live happily and comfortably at home.
Some of the key services we can expect from a home care provider include:
Personal care
Everything from bathing and shaving to dressing and continence care.
Housework
Helping around the home with cleaning, washing, ironing. And everyday home help tasks such as changing light bulbs, taking out the bins etc.
Meal preparation
Food shopping and helping to prepare and cook daily or weekly meals.
Companionship
Supporting hobbies and interests to help our loved one do the things that they enjoy. Whether that’s a trip to the theatre, a walk in the park or a competitive board game!
Specialist care
Specialist support for those living with Dementia, Parkinson's, Cancer or require end of life care.
Medication
Paid home carers are able to prompt or assist the person we care for to take their medication, as long as it's prescribed by their GP. If they are on medication that needs to be administered such as insulin by injection, the paid home carers or district nurse will have special training for this which will have to be signed off.
“At BelleVie our purpose is to support you to thrive at home and go beyond the services above to help in all aspects of life. Whether that’s sourcing a pendant-fall alarm or house appliance, or organising a trusted gardener, cleaner or hairdresser - we think it’s important to offer more than just the practical side of comfortably living at home.” - Bellevie
3. What does good paid home care look like?
On paper (or often, on a website), most home care providers look good. But it’s that initial conversation we have with them that will be the game-changer.
The quality of a care provider always flows from that very first conversation. Think about the feeling you get and the way in which your enquiry is dealt with from the get-go:
Are they personable, friendly and compassionate?
Do they show an understanding of our, and our loved one’s needs, and what we’re going through?
Are we made to feel like we’re their top priority?
Trust your instincts. If we find they represent a positive culture and can answer yes to the questions above, then we’re on the right track. The follow-up process and level of contact kept with us after the phone call is equally as important to consider.
As for the care and support plan itself, the best home care providers will take a person-centred approach. Spending time building a relationship with our loved one, getting to know their interests and aspirations to create a package that’s completely tailored to them. Look out for a per person, rather than a per hour approach. This means the carers are focused on the relationship, rather than treating our loved one like a list of tasks.
Top tip: All good, trusted home care providers will be registered with, and inspected by, the Care Quality Commission (CQC). They also usually have publicly accessible reviews from other families available on Homecare.co.uk, which is also a great website to start your search as you can find a list of providers in your area.
4. What are the key questions to ask a home care provider before signing with them?
There’s no such thing as asking too many questions!
Any home care provider that’s worth considering will be happy to answer any questions you need, whether that’s 10 or 100. At the end of the day, you need to work out if they are right for you and the person you care for.
Some questions that are super important to ask but may not necessarily be the first to come to mind are:
Are they registered with the Care Quality Commission (CQC) and can we see their latest inspection report?
There have been shortages of care workers recently. How have they been affected? For instance, how often have they had to bring in agency staff because they've been short staffed?
Do they pay your care workers for their travel time and, importantly, for the gaps between visits?
Are they an accredited real Living Wage employer?
How many different care workers is it likely that we'd see in one week?
Do they provide their own in-house training? If so, what kind of training do they provide?
The key things to look out for in their answers are that they are registered and inspected by CQC, that they hire directly with in-house training provided and kept up to date, pay their care workers fairly, and can provide reliable, consistent support.
That way we have peace of mind that their people have the right values and skills to care for our loved one to the highest possible standard.
5. How much does home care cost?
Most home care providers operate on a ‘time and task’ basis charging hourly rates that can vary massively depending on the provider, the location and the type of care we require.
To give you a rough idea, a typical hourly rate for home care varies from £15 to £35 per hour.
“At BelleVie, we take a different approach and instead offer a person-centred monthly package. This allows us to focus completely on that person and their needs, not the clock. So, if on some days those we care for need us to stay a little longer, they don’t have to worry about being charged extra.”
6. How much will local authorities pay for home care?
Local Authorities will provide financial support if you have less than £23,250 in savings. This is achieved through a Financial Assessment or means test.
If the person we care for is receiving local authority-arranged care and support (other than in a care home), they will need to retain a certain level of income to cover their living costs.
They are entitled to a Minimum Income Guarantee (MIG) to ensure that they keep a level of income which covers their living costs. This amount is set by the Department of Health and Social care and is reviewed annually. The amount they are entitled to will vary depending on several factors, such as their age and whether they are married.
Under the Care Act 2014, charges must not reduce their income below a certain amount, but local authorities can allow them to keep more of their income if they wish. This is a weekly amount and is known as the MIG (minimum income guarantee).
In Scotland, there is no financial assessment for people aged 65 and over. With most personal and nursing care being provided free of charge.
7. Are there other funding options available to help towards paying for home care?
There are possible funding opportunities available from the NHS, subject to criteria. Including:
NHS care at home is not means-tested, but only available for people with certain medical conditions, following a needs assessment. Your GP can advise you.
Continuing healthcare - Some people with long-term complex health needs will qualify for free social care. This is arranged and funded by the NHS and can include care in our own home. The UK Care Guide also has a great introduction to NHS Continuing Healthcare.
Direct Payments or a Personal Budget - can offer a more flexible way to choose what care we put in place. We’ll need a Carer’s Assessment (or Adult Carer Support Plan in Scotland) to identify if this route is possible.
Ensure you’re making the most out of the benefits you’re entitled to. Our guide to Carer’s Allowance or Attendance Allowance may be a good starting point.
Often, funding (whether with the NHS or outside of the NHS) can be on the grounds of what is considered ‘medical’ as opposed to ‘social’.
The best place to find out about your own eligibility is to check with your local council who may ask you to complete a financial assessment to see if and what type of funding you qualify for. Find out more about how your local council may pay for home care.
If the council is providing some or all of the home care support, then they must provide a Care and Support Plan.
Expert financial advice can also be found on the following websites:
If we’re self-funding, then the Government website is a good starting point for advice. They also have a list of care support we can get for free.
VAT is not usually charged on home care services, but do take a moment to check if fees quoted by providers include VAT or not.
8. What are the first steps I should take towards putting paid care in place?
1. Start your research using the CQC and Homecare.co.uk websites. We’ll be able to view care providers inspection reports, ratings and reviews to help get a basic understanding of their quality of care.
2. Create a shortlist of those that stand out to us and set aside some time to speak to them. Whether that be via a phone call or face to face - with an email it’s difficult to get an initial gut feeling on whether they are a good fit. We may need to call quite a few before finding one with availability.
Top tip: Before speaking to each provider, put some key questions together (you can include those mentioned above) and ask each one the same thing, that way it will be easier to compare.
3. Once you’ve decided on the best home care provider for our needs and confirm the go-ahead, you'll receive a contract to sign. At this point, make sure you have a thorough read of the T&C’s and have any queries answered before signing.
4. Then it’s a matter of arranging a start date, receiving a welcome pack and being introduced to the person / people who will be doing the first visit, so that you have peace of mind of exactly who will be taking care of your loved one.
9. Home care in your area
We’ve pulled together some useful sites to help you find home care in your area across the UK. Let us know if you have one to add for your own area:
Search for local home care options near you by typing in your postcode with Home Care UK.
Homecare Association also have a nifty tool which allows you to search for local home care affiliated to the UK’s membership body for home care providers.
Find services offering care in the home with the Care Quality Commission.
If you are a carer in Northumberland or Oxfordshire, Bellevie may be an option for you. Simply get in touch with them to find out more.
If you are a carer in Shropshire, take a look at Shropshire’s directory of CQC approved home care (and care home) providers.
10. Top tips for care at home from other carers
It’s always helpful to hear what the actual experience is like, directly from other carers who are just a bit ahead of ourselves. We asked unpaid carers in the Mobilise community to share their experiences and top tips, and as always, they’ve been very generous.
Hopefully, by reading other carers’ experiences, we can be a bit more prepared, avoid some common issues and go in with a solid plan to get the right support, working in the right way.
It's natural to feel uncomfortable having strangers in your home - it gets easier.
Try and delegate the things that are in the paid carers’ skillset. It’s a bit of trial and error but any delegation makes your life easier.
“To be honest, I would not have got through the final 6 weeks with Mum without the love and support from her paid carers. I found the best course of action was to get to know them really well, see how well you and they can work together, build good relationships and that includes with your cared for person. If they aren’t a good fit, tell the bosses and be awkward or change companies till it’s right for you all. Then enjoy a little bit of free time in the knowledge everyone is safe and happy ”
If your local council has chosen the home care company and you aren’t happy with the service they provide, done be afraid to complain and request an alternative provider.
Look at the Care Quality Commission rating of the potential home care providers. And look at reviews on Trustpilot, Facebook and Google.
If you have complaints to make, always put it in writing.
Establish how you will communicate with the paid carers. Will it be written notes or an app? Great communication can prevent lots of problems. There’s no such thing as too much detail!
Trust your instinct. If you’re not happy and a complaint hasn’t worked, it’s OK to change the provider (sooner rather than later).
Jill Elliot is a Relationship Lead at BelleVie. With its Oxfordshire and Northumberland teams of Wellbeing Support Workers, BelleVie helps people to enjoy the later life they want, rather than manage the later life they fear. For more information, please visit: www.belleviecare.co.uk