Homecare services, also called domiciliary care – are paid-for services to help elderly people remain living independently at home. Having made the decision that more help is needed, the next decisions are what kind of care, and who might provide it.
There are two main ways to finding a carer, either through a Home Care/Live-in Care Provider or Agency, or to hire one privately. Whichever option you choose, we have listed some of the key questions you need to ask.
Questions to ask yourself when hiring a home carer
If you have already answered ‘yes’ to the question “does my elderly relative need more help at home?” and visited our page on types of help they might need, well done, you are a good way through the thought process. However, when talking to a good home care provider or interviewing a potential home carer, it is good to have the answers to the below questions clear in your mind. Both the provider/agency and the carers themselves should ask you these questions about the person they are to care for.
What are their care and medical needs? What medication are they on?
This seems like an obvious one but if your elderly relative has particular medical needs that require specialist training, it is imperative that the carer or care agency/provider knows so they can provide the right experience.
In addition to their medical needs, it is also good to know what level of physical care they require. For example - are there any incontinence or mobility problems? These will both affect the suitability of carer and how long each session needs to be.
What is their level of communication?
An older person's ability to talk, listen and see are all useful to consider when employing a home carer. Their individual level of communication might require a carer with more experience with people who can't express their thoughts and feelings well.
Caring for someone with a reduced mental capacity can be very difficult and requires carers with experience and in some cases specialist training.
It is also very important to know if the person poses any safety risk to the carer, so that they can alter their methods accordingly or take precautions.
Do they have any dietary requirements?
If a home carer is going to take care of mealtimes for your elderly relative, it is imperative that they be made aware of any dietary requirements and allergens. However, it is also really good for them to know what the person likes, their favourite meal, and what they don't like eating.
Do they have any religious or cultural needs?
For a home carer to provide a thoughtful, sensitive and holistic service, it is really good for them to know any religious or cultural needs. This will give them time to prepare and plan so they can care appropriately.
Who else is involved in their care?
Knowing who else will be involved with the care plan, is really useful. You can then coordinate who does what and when. For example, if a family or friend visits every Tuesday lunchtime, this might be a good time for the carer to do the weekly shopping. It can also help the home carer to know who is closest and can be contacted if necessary.
When is care required?
You want to make sure you mark out clearly when a carer would be useful and that it enables your parent to live their preferred routine. For example, what time does your parent get up in the morning - and therefore when should a carer start work?
How will a carer get access to the home?
Whether this means getting another key cut or sorting out a key safe, the carer needs to be able to access the property. Especially important if the older person is not able to answer the door themselves. We recommend getting a keysafe that is located on the exterior of the property.
Questions to ask a home care provider
If you are using a live-in or home care provider there are lots of questions you should consider asking to make sure that you get a carer that works for both you and the person needing care. We have listed the most common questions below, you can click each one for more information. However, for more detailed information, read our guides on how care companies recruit and hire carers and what a home carer does (links).
How do you recruit your carers?
This question is all about making sure the provider has strict requirements that prospective carers have to meet before they employ them. You can also ask about the interview process, what they look for with regards to carer qualifications /experience and whether they hire with specialist care in mind (e.g. dementia care).
Do you train your carers?
Carer providers are more likely than agencies to train the carers they employ. Find out whether this is the case, how extensive it is, and what is included in the training. For example, are carers taught emergency health scenarios and CPR?
How will you approach providing for my relative's needs?
This is an important question, as it will help you to find out how far a domiciliary provider or agency will go to personalise their care to your relative's needs. Can they meet both nursing and physical requirements? Can they share examples where they have provided care for someone in a similar scenario? What process do they use to create a suitable match?
- Will they provide a care needs assessment beforehand?
- Can I meet/interview them?
- What is the ongoing management/review process to make sure the care plan is adapted over time?
- What training do you provide your carers?
- How easy is it to change carers if it's not working out?
How will the care work?
This question will depend a lot on individual circumstance and what your relative requires. However, you might ask some of the following questions to get an idea on how homecare visits will work.
- Can I choose the times?
- What happens if I need to change the amount or length of visits?
- Will it be the same carer every time?
- What is your policy if a carer misses a visit?
- What happens in the result of an emergency?
- Is care limited to the home or can it include trips out etc?
How much will it cost?
With providers you pay the company and in turn they pay the carer. There are lots of different factors that influence how much homecare costs. Different carers and domiciliary care providers will have different policies around how charges are worked out - so it is good to ask beforehand and be prepared.
- What is the standard contract?
- Can I see a brochure with different price and payment options?
- How is cost calculated? Hourly/weekly/per visit?
- What do the charges cover/not cover?
- Do prices vary depending on the time of day?
- Are weekends and bank holidays a different price?
- Are there any extra costs I should be aware of e.g. fuel, food, expenses?
- Is there a minimum charge for those who require less care?
- What is your cancellation and rescheduling policy?
- Am I refunded if my relative is in hospital and therefore does not require care visits?
- Is there a trial period?
- How do I terminate a contract and what is the notice period for doing so?
Can I meet the carer before choosing them?
The answer a provider will give you will differ between companies and the type of care you are looking for. For example, live-in carers are often brought in from different areas of the country so sometimes you won't be able to meet them (in person anyway) before committing to them.
What happens if I don't like them? How do complaints work?
It is always worth asking this before committing to a carer in case they don't click with your relative. There might be fees that you are unable to get refunded if you decide to switch a carer and your relative might be without care for a short time.
Knowing how the complaints procedure works is also a good idea.
What happens if they are sick or when they have holiday?
Usually providers will have a system set up to put in a back-up carer at short notice, and it is a good idea to know how it works if it is necessary.
What is your CQC rating?
Live-in and home care providers differ from agencies in that they are required to be signed up, regulated and inspected by the CQC (Care Quality Commission). Find out more about where you can find a provider's CQC rating.
Questions to ask a home care agency
A live-in or home care agency will introduce you to carers in your area who they have background checked and are happy to recommend. They don’t directly employ carers, they simply use their expertise to find you the right domiciliary carer and hand over all employment and management duties to the family. The questions you might have for a care agency will be more focussed on how much interaction they have with potential caregivers.
What are my employer responsibilities?
It is important to know the extent of the responsibilities you have to hiring the home carer. For example, are you their employer (or are they self-employed), can you complain to the agency about someone they introduce, are you responsible for finding night-time, respite or emergency carers?
You can find more information on our guide to hiring a home carer privately. <LINK>
Do you train the carers?
Some live-in and home care agencies offer a base level of training. However as they don't employ the carers neither the agency nor the carer has a requirement to undergo further training. It's worth noting that the carers experience and references will be checked in order for them to be on a care agency's books and therefore you can ask to see what previous training they have had before making a decision.
What are the minimum requirements a carer has to fulfill to be recommended by you?
This is an important question for families to feel safe and secure in both the agency and the carer. Find out how a home care agency recruits potential caregivers and how much they scrutinise them before introducing them to you. What are the minimum carer skills or years of experience needed in order to be on the agencies books.
Can I meet the carer before they arrive?
Sometimes the answer to this question is no. This is because carers can come from any part of the country (especially live-in carers). However, it is always worth asking how you are able to ask any questions of a carer beforehand to make sure you make the right decision.
What do I do if I am unhappy with a carer?
The contract you have with a live-in or domiciliary carer is directly with them and therefore it is important to find out about employment law and if the agency has any contractual obligations. The care agency should be able to guide you with regards to the complaints procedure and termination.
How are your carers monitored and regulated?
As live-in and home care agencies are unable to be regulated by the CQC, they should have some internal regulation procedure in place to make sure a high standard of care is maintained. Ask them how they regulate the carers they introduce.
What happens if a carer is sick?
Agencies might be slightly more complicated to deal with here and it may be that you need to find a backup carer yourself. However, some home and live-in care agencies are able to supply short term carers on short notice.
One of the best and quickest things you do to increase the independence of an elderly relative is by using a personal alarm. They can be used to alert the carer if the wearer has fallen, needs help and can even display their GPS location.
Questions to ask carers
Whether you hire a home carer privately or through an agency, it is likely that you will want to ask some questions of the carer themselves. This might be to organise and coordinate how care will work in harmony with the care that already exists for someone, or to help you make sure that they are a suitable fit for you and your relative.
What type of companionship will you provide?
Take some time to find out what your carer likes to do with the people they care for, beyond taking care of any physical or medical needs. What do they enjoy about their job and working with older people? Let them know what your relative likes doing and what they might like to do together, whether it is watching a film, battling over their favourite board game, solving a crossword or simply chatting over a 'cuppa'.
What training/experience do you have?
This is especially important if your relative has particular medical care needs. Dementia care uses a different skill set compared to caring for someone who has had a stroke, for instance.
What languages can you speak?
Communication is vital in making sure the relationship between a caregiver and receiver is the best it can be. Don't be afraid to ask this question so that you employ a carer that is able to communicate with your relative.
Can you cook?
If they are going to responsible for your parent's mealtimes you'll want to make sure that they can cook. Perhaps ask them to share a menu of meals they would be happy to cook.
Are there any times that you are unable to visit?
Domiciliary care differs from live-in care because the carer is employed for set period of time and usually this is not all day. It might be that they are unavailable at some times and you will need to coordinate with them as to how you will share responsibilities.
Are you comfortable with pets?
If your relative has a pet, they will need to be comfortable with animals. Something you will certainly want to find out sooner rather than later!
Can you drive?
Most home carers can drive (they are required to get from house to house), but some live-in carers can't. If you require that a live-in carer can drive, whether it be to appointments with your relative or just to the shop, this is something you should ask for. When hiring private carers in the home you might even be able to add them onto your car insurance.
When can you start?
It seems like an obvious one but it is an important question to ask, especially when hiring a carer privately.
Specific questions when hiring a live-in carer
Lots of the questions above are relevant when hiring either a home carer or a live-in carer, however, the nature of live-in care requires some additional considerations.
What do they need to be able to live in your home?
It is a good exercise to just consider any live-in carer as a guest in your home, and provide them with private space, a room to themselves and access to washing facilities. They will also need a key (or access to one), space for their own food to be kept, potentially a parking space and others. If you are hiring through a provider or agency, they will have a list of things you need to get ready before their arrival. Read our page on preparing your home for a live-in carer.
How many hours a week can you work and how shall we share responsibilities?
Live-in carers are usually allowed a 2 hour break every day (off premises) in an 8-10hr work day. They will most likely be eligible for two days off a week too.
Find out what the limits are and how you can best work with them to cover all the times when your elderly relative needs care.
How do I cover night-time care?
It is impossible to ask for a live-in carer to be available and responsible for care throughout the night, as well as the day. If you are hiring a live-in carer privately, finding a night-time carer will be your responsibility. Providers and agencies might supply a night-time non-resident carer to be there at night.