Choosing a home care agency: questions and checklist

Before ringing agencies, write down what needs to happen from getting up to going to bed. Include the help you want, what you prefer to do yourself and anything that must happen at a particular time. Explain the result you need: being washed and dressed for an appointment is more useful than simply asking for a morning call.

Make a separate note of what happens on a difficult day. Does getting out of bed take longer? Is eating harder? Does someone need reassurance before accepting help? A package based only on a good day can leave too little time when support matters most.

You can ask your council for a free care needs assessment, including when you expect to pay for care yourself. An agency also needs to understand what it is agreeing to provide. The NHS explains how to request an assessment. If you are still deciding where care should happen, read care home or care at home first.

Ask for the name and CQC location details of the branch responsible for your care. A national brand name is not enough to identify the local service. Read its report and publication date, then ask the manager what has changed since the assessment. Our CQC ratings guide explains how to read the evidence behind the rating.

Registration depends on the work and how the service operates. CQC distinguishes agencies that manage personal care from introductory agencies with no ongoing role in it. Do not assume that every business advertising help at home is regulated in the same way. CQC explains the registration distinction.

Ask directly who employs or engages the carers, who supervises the work and who arranges replacements. If the service only introduces a carer, establish which responsibilities fall to you before comparing its price with a managed agency.

Ask for a proposed schedule showing arrival windows and visit lengths. Identify which times are preferences and which relate to assessed needs, such as support with meals or medicines. Have the relevant professional explain any timing requirements rather than accepting a convenient slot that may not work.

Then walk through one visit with the assessor. Where does the carer enter? What needs preparing? How long does the person usually need? Where will the carer record what happened? Ask whether the quoted visit length is time in the home and whether travel is charged separately.

A minimum visit length is a commercial term, not proof that the visit will be long enough. Ask what happens if the agreed tasks repeatedly cannot be completed without rushing. Get the review process and any extra charges clear before accepting the schedule.

Instead of asking only whether you will have the same carer, ask how many people are likely to form your regular team, how the rota is shared and how new carers are introduced. Explain any preferences about communication, language or personal care. Ask what the agency can reliably accommodate.

Follow the ordinary week with a harder question: who comes if the regular carer is ill at short notice? Ask whether replacement staff will already know the care plan and any equipment involved. For a visit needing two carers, ask how both places are covered.

CQC describes a good service as reliable, with enough skilled staff, and says people should be told about a short notice change of carer. Read CQC's expectations for home care. Your practical aim is to hear a specific staffing plan, including its limits. A promise of one person at every visit deserves questions about holidays, sickness and days off.

Use a simple example in the assessment: the morning carer has not arrived and the person cannot get out of bed without help. Ask the manager to talk through what happens next. Who notices the visit has not started? Who checks the person's immediate situation? Who phones them, and who arranges replacement support?

Ask how the agency distinguishes a small delay from a visit that has become unsafe to postpone. The answer should relate to the individual care plan. There is no useful universal number of minutes that makes every delay acceptable.

Get a number answered outside office hours, the escalation route if nobody responds and the agreed contact order. Do not let a vague reference to family support become the cover plan. Record any help relatives have explicitly agreed to provide and what happens if they are unavailable.

Also ask what happens when a carer arrives but cannot get in, or the person declines care. A record saying the visit was attempted does not answer who checks whether further action is needed. Ask how missed or shortened visits appear on the bill and how recurring problems are investigated.

Ask about the specific work, rather than collecting course names. If the person needs moving assistance, how will carers learn the agreed method and equipment? If medicines support is part of the package, what exactly can they do, who checks their competence and how are concerns escalated?

Ask how a new worker is introduced, observed and supported before working alone. Find out who reviews care records and how the manager checks that visits match the plan. A manager looking up a training record is a sensible way to give an accurate answer.

Recruitment questions should include identity, references, appropriate criminal record checks and continuing suitability. A DBS certificate has no official expiry date and records information available when issued. Ask how the agency manages checks over time, rather than asking whether a certificate is simply in date. GOV.UK explains DBS validity.

Use this table during calls. Keep a separate copy for each agency and write the actual answer beside it. These are prompts for your decision, not a points system or an official quality rating.

Mark an answer as unresolved when it is unresolved. An attractive total price does not settle a gap in essential support. Ask for the missing detail before choosing.

Give every agency the same proposed schedule. Ask for the cost of that schedule, including weekends, bank holidays, two carer visits and any travel or administration charges. Check minimum visit charges and whether prices change with the level of support. An hourly headline cannot show all of that.

For a transparent calculation, multiply each type of visit by its charge and by the number needed each week, then add separately priced services. Ask the provider to confirm the resulting total. Keep estimates distinct from a quote accepted after assessment.

Read the terms for cancelling a visit, a hospital admission, reducing hours, ending the service and annual price changes. Ask whether notice periods apply differently to an individual visit and the whole arrangement. Our guide to paying for care in England explains the main funding routes. The care cost calculator is a starting point for budgeting, not an agency quote.

Start with the person receiving care: how do they want updates, and who do they want involved? Ask how consent or other appropriate authority for sharing information will be recorded. A relative paying the bill should still ask what information they are entitled to receive.

Find out what is recorded after each visit and how urgent concerns reach the right person. An online care record can help, but it should not be assumed to replace a phone call when somebody needs a response. Ask how people without a smartphone receive equivalent information.

Agree one ordinary contact for questions, one route for urgent care concerns and the complaints procedure. Keep the numbers somewhere the person can reach. Before the first visit, confirm how carers identify themselves and how access instructions are kept secure.

Before starting, agree when you will review the service together. Keep short notes about arrival times, familiar carers, unfinished tasks and anything the person says is working well or making them uncomfortable. A specific example gives the manager something to investigate.

At the review, compare the actual service with the written plan. Has enough time been allowed? Are changes reaching every carer? Does the person feel listened to? Ask for actions, an owner and a date to check progress. If essential needs are no longer covered, contact the provider and relevant care professional promptly rather than waiting for a routine review.

When you are ready, search for care at home on Find Care using your postcode district. Check availability and suitability directly with each service. Keep the comparison sheet beside you when you call.