How to Arrange Home Care: A Step-by-Step Guide

Where do you start when arranging home care?

Start with the person, not with providers. The instinct when something has gone wrong is to start ringing agencies, and it almost always produces a worse result, because you end up buying whatever is offered rather than what is actually needed. Spend a fortnight first working out where the day is going wrong.

The practical way to do that is to keep a short note. For two weeks, write down the moments that are difficult and when they happen: getting out of bed, the shower, medicines at lunchtime, a meal in the evening, the trip to the bathroom at two in the morning. Note the near misses too, and the things that used to happen and quietly stopped, like going out or cooking properly. Our guide to the signs a parent needs help at home sets out the pattern to look for.

Then have the conversation with the person themselves, early and honestly. Care arranged around somebody rather than with them tends to be resisted and tends not to last. Ask what they would find most useful and what they would find intolerable, because you will need both answers when you come to write a care plan. From there, the rest of this guide runs in order.

Step 1: Request a free care needs assessment

A care needs assessment is a free assessment by your local council's adult social services that works out what support someone needs day to day. Anyone who appears to need care can ask for one, and it is free regardless of income or savings, because it looks only at needs. Money is dealt with separately and later.

Request it by contacting the adult social services department of your council. In our area that is Croydon Council or Bromley Council depending on the address. You do not have to be the person who needs care to ask; a family member, GP, or hospital can request one on someone's behalf, ideally with their agreement.

There is usually a wait, which is the main reason to ask early rather than at crisis point. Even if you intend to arrange care privately, it is worth requesting the assessment anyway, because it costs nothing and it can open up funding and practical advice later. Our guide to the care needs assessment explains what happens on the day and how to prepare so that nothing important gets understated.

Step 2: Work out who pays

If the needs assessment finds eligible needs, the council carries out a separate financial assessment, sometimes called a means test, to work out how much you contribute. In England there are two capital thresholds. Above £23,250 you are generally expected to fund your own care. Below £14,250 your savings are largely disregarded and the council contributes most of the cost, with a sliding scale between the two. Note that the value of the home is not counted when care is being provided at home.

Do not stop at the council. Attendance Allowance is a non-means-tested benefit for people over State Pension age who need help with personal care, it is not affected by savings or income, and a great many people who qualify never claim it. If the needs are primarily health-related rather than social, NHS Continuing Healthcare may cover the full cost, and it is worth asking about explicitly because it is rarely offered unprompted.

It is worth doing this step before you choose a provider rather than after, because the answer changes what you can sensibly commit to. Our costs and funding page lays out every route in one place, and our guide to paying for home care goes deeper into each one.

Step 3: Decide the type and amount of care

Now turn your fortnight of notes into a shape. Count how many separate times a day help is genuinely needed, and at what times. Ask whether anything is happening at night. Ask whether the same carer coming each time matters, which it usually does for dementia and for anyone slow to trust new people. And ask whether there is a clinical need that requires nurse oversight.

Those four answers point at a service. One or two calls a day suggests visiting care. Several calls plus night-time worry suggests either overnight cover added to visits, or live-in care. A family carer at the end of their tether suggests respite as the first move rather than the last. Our guide to the types of home care sets out each option, and the comparison of live-in care vs visiting care covers the point where the sums change.

Two practical warnings. First, do not book visits that are too short: a fifteen-minute call cannot deliver an unhurried shower, and squeezing it helps nobody. Second, start smaller than you think you need and build up. Care plans are meant to change, and it is far easier to add a visit than to withdraw one that was never wanted.

Step 4: Choose a provider

In England, any agency providing personal care must be registered with the Care Quality Commission. That is the first filter and it is non-negotiable: look the provider up on the CQC register and read the inspection report rather than just the headline rating, because the detail tells you what inspectors actually found.

Beyond registration, the questions that separate providers are about carers and continuity. Are carers employed directly or supplied by an agency? Do all of them hold an enhanced DBS check? What training do they get before they work unsupervised? Will the same small group of carers come each time, and what happens when one is off sick? Shortlist three to five and compare them on the same criteria rather than judging each on its own merits.

Two of our guides cover this properly. Our guide on how to choose a home care agency sets out the method for comparing a shortlist, and our companion guide of questions to ask a home care agency gives you the exact questions to put to them.

Step 5: Arrange a free home visit and agree the care plan

Most good providers will visit you at home before anything is agreed, at no cost and with no obligation. Treat that visit as a two-way assessment. They are working out what support is needed; you are working out whether you want these people in the house. How they talk to the person needing care, rather than over their head to you, tells you most of what you need to know.

What should come out of it is a written care plan setting out what will happen at each visit, at what times, by whom, and what it will cost, including whether evenings, weekends, or bank holidays are charged differently. Ask about the notice period and how to change or cancel visits. Get the figures in writing rather than as a verbal estimate.

On timing, the two routes diverge sharply. Privately arranged care can usually start within a few days, sometimes sooner in an urgent situation. Council-arranged care follows the assessment, the financial assessment, and the drawing up of a support plan, so it commonly takes several weeks. If you need something now and the council process has started, there is nothing to stop you arranging private care in the meantime.

The council route or the private route?

The council route is slower but may be substantially cheaper or free, and it comes with an assessment and a social worker's input. The private route is faster and gives you a free choice of provider, but you pay the full cost unless a benefit like Attendance Allowance offsets part of it. Neither is the right answer for everyone, and the two are not mutually exclusive.

In practice, the sensible approach for most families is to do both at once: request the free needs assessment, because it costs nothing and may unlock funding, and meanwhile arrange the care that is actually needed now. If the council later agrees a personal budget, you can often take it as a direct payment and keep the provider you have already chosen rather than switching to one they allocate.

One more thing worth knowing: even if you are told you have no eligible needs, the council still has a duty to give you information and advice, and you can ask for a review if your circumstances change. A first answer is not a final one.

Arranging care with us

We are a CQC-registered, locally run home care provider based in Croydon, supporting families across Croydon, Purley, Thornton Heath, New Addington, Bromley, Beckenham, and Orpington. Our carers are employed directly by us, hold enhanced DBS checks, and are trained before they work unsupervised. Visiting care starts from £26 an hour, confirmed in writing after a free home visit.

If you are at the beginning of this and not sure which step you are on, we are happy to talk it through even if you end up going elsewhere. A free home visit is a conversation, not a sales appointment, and nothing has to be decided on the day.