Choosing care at home

We are the national professional association for homecare agencies. Our priorities are to promote the highest standards of care, to encourage training of homecare workers and to highlight homecare as the preferred option for people who need care.

Homecare organisations that join us are required to comply with our Code of Practice to ensure that:

• the rights of service users comes first;
• the highest standards of care are provided; and
• the rights and welfare of careworkers are protected.

In addition, we help members of the public to find local reputable homecare agencies and organisations that can meet specialised needs, including live-in care.

All homecare workers are required to undergo initial training to make sure they are ready to provide care at home. Many care workers go on to achieve recognised qualifications in care.

In the United Kingdom, homecare workers undergo a criminal record disclosure, previously known as a police check.

All homecare agencies are required to register with their statutory regulator if they provide personal care. They are obliged to meet a high standard of service and undergo regular inspection. In addition, our Code of Practice requires member organisations to operate at a higher standard than the legal minimum.

Homecare agencies are required to comply fully with health and safety legislation to identify and minimise risks to people receiving care and their careworkers.

Our member organisations operate effective procedures to respond to comments and complaints, so that in the unfortunate event of a problem arising, it is resolved as quickly as possible.

Your local council's social work team are obliged to perform an assessment of your care needs if you request it. If they agree that you need care, they will then undertake a financial assessment. Taking your income and savings - but not the value of your home - into account, the financial assessment will establish whether you qualify for financial assistance from the state. In Scotland there is no financial assessment for people aged 65 and over as the majority of personal and nursing care is provided free of charge.

There are several ways that care can be funded. In some cases local councils, general practitioners (GPs) or Integrated Care Boards (formerly Clinical Commissioning Groups) will pay all or part of the costs of care. In England and Wales people may be required to make a financial contribution to their package of care.

Once the council has decided that you have eligible needs for care, they will discuss with you how these can be met.

What happens next depends on where you are in the UK and on your local council. The council may provide your care itself, or ask an approved agency to provide it on their behalf. Or the council may offer you a personal budget - a notional amount to spend - which would give you more choice and control over your care. This could also be spent using a direct payment - cash given to you by the council to arrange your own care.

You can either buy services from a regulated homecare agency or take on the responsibility of employing your own personal assistant (PA). Regulated agencies carry out careful checks on staff they recruit, consider health and safety risks, and account to the Revenue for tax and national insurance. They are inspected by a care regulator and must carry out staff training. In contrast, PAs are not regulated and you would need to arrange checks, training and PAYE, as well as comply with the law as an employer - a burden some would prefer to avoid.

Instead of a direct payment, you could ask the council to buy council services or services from a homecare provider for you, using your personal budget.

Finally, you or your family can fund your own care, without state assistance, and use a local homecare agency privately to provide care, or add to the care the council provides.

VAT is not usually charged on homecare services so it is important to check if fees quoted by providers include VAT or not.

A comprehensive list of homecare agencies committed to the our Code of Practice is available here.

Alternatively:

• You will find agencies listed in Yellow Pages under "Nurses' Agencies and Care Agencies" or "Home Care Services" and on www.yell.com.
• The Thomson Directory lists providers under "Home Care Services" or "Home Help Services - Private". Look out for the UKHCA logo in adverts.
• Local council Social Services departments may be able to provide a list of their approved organisations in your area.

Care regulators can also supply lists of providers in your area, along with copies of recent inspection reports:

• England - 03000 616161 or www.cqc.org.uk 
• Wales - 0300 7900 126 or cssiw.org.uk/?lang=en 
• Scotland - 0345 600 9527 or www.careinspectorate.com 
• Northern Ireland - 028 9051 7500 or www.rqia.org.uk 

Telephone one or two homecare agencies, confirm whether they are one of our members and ask them to send you their brochure and price list. A wide range of services are available and providers are usually happy to design a care service for your particular needs.

If you think you may be entitled to free or subsidised homecare you can contact your local council's Social Services department for assistance.

The following questions may help you select a suitable service. You may want to choose two or three that are particularly important to you:

• Can you provide the care that I need and meet my personal preferences?
• How will you and your staff respect my privacy and dignity?
• Have you cared for someone with similar needs to mine?
• How will you match the most suitable careworker for my needs?
• Is your organisation a member of the Homecare Association, committed to complying with their Code of Practice?
• Are you required to register with a statutory regulator and if so, are you currently registered?
• Is your organisation insured in order to protect my safety and interests?
• Do you interview all your care workers before offering them work?
• Do you obtain at least two written references from your careworkers' previous employers?
• Do all your careworkers undergo a criminal record disclosure from the Disclosure and Barring Service (in England and Wales) or Disclosure Scotland (in Scotland) or Access NI (in Northern Ireland)?
• What sort of training do your careworkers receive before they start work and during their employment?
• What proportion of your careworkers and managers have obtained a recognised qualification in health and social care or management?
• If my care isn't provided by a local council, do you have a standard contract that I can read before signing?
• Can I contact your agency during the day, outside office hours and in an emergency?
• What happens if my regular careworker is sick or on holiday?
• What charges, if any, will I be expected to pay?
• What payment methods are available (cheque, direct debit etc)?
• Is there a minimum charge if I only need a small amount of care?
• Are there any hidden extras in the prices you quote? (Prices normally include National Insurance contributions, travel expenses and any VAT payable.)