How to Choose a Home Care Provider in the UK: A Guide for Families

Choosing who will come into your relative’s home is a big decision. You are trusting someone with a person you love, in the place where they should feel safest. It is no surprise if you feel unsure where to begin.

Here is the short answer to how to choose a home care provider. Start with what the person needs and wants. Then check that the provider is registered with the Care Quality Commission (CQC), read its latest inspection report, ask how carers are recruited, trained and supervised, and find out how care is planned, how visits are managed and what goes wrong and how it is put right. Compare at least two or three providers on the same questions, get the price and contract in writing, and trust your sense of how they listen. No single rating, price or promise tells you everything, so look at the whole picture.

This guide is written for families in England. Registration and regulation differ in Scotland, Wales and Northern Ireland, so check local arrangements if you live there. If you are new to the subject, our guide, What Is Home Care? A Guide for UK Families, explains the basics first.

What are the most important things to look for?

If you only have time to check a handful of things, check these:

1. Registration. Is the provider registered with the CQC for the care it offers, and can you read its latest report?
2. People. How are carers recruited, checked, trained and supervised?
3. Planning. Will someone assess needs properly, write a care plan with you, and review it?
4. Reliability and continuity. How does the provider keep to visit times, and how often will the same carers come?
5. Communication. Who do you ring, how quickly will they respond, and how will they keep the family informed?
6. When things go wrong. What happens with a late or missed visit, a complaint or an emergency?
7. Price and paperwork. Is the cost clear, including extras, and is there a written agreement you understand?
8. Fit. Does the provider listen, and respect the person’s dignity, privacy and preferences?

The rest of this guide takes each in turn.

How do you know when professional home care might help?

Many families wait until a crisis. It can be better to start looking before then. Signs that extra support may help include difficulty washing, dressing or using the toilet; missed meals or weight loss; missed or muddled medicines; more falls or near-misses; confusion, or leaving cookers and taps on; withdrawal from friends and activities; and a family carer who is exhausted.

If you are seeing several of these, talk with your relative first. Then consider speaking to their GP and asking your local council’s adult social services for a care needs assessment. The NHS says anyone can ask for one and that it is free. An assessment can help you work out what is needed, even if you plan to arrange and pay for care yourself.

Asking for help is not a failure, and it does not mean giving up independence. Often it is the thing that makes staying at home possible.

Start with the person: what do they need and want?

Before you compare providers, write down what you are looking for. This keeps conversations focused and stops you being swayed by whoever has the smoothest sales pitch.

Needs. What does the person find difficult? Think about personal care, meals, medicines, mobility, getting out, continence, memory and safety.

Routines. What does a good day look like? When do they like to get up or go to bed? Do they prefer a bath or a shower, tea or coffee, a quiet start or a chatty one?

Preferences. Would they prefer a woman or a man to help with personal care? Is there a language, faith, cultural or dietary need? Do they have pets?

Goals. What do they want to keep doing for themselves? What would make life better: getting to a lunch club, tending the garden, seeing friends?

Risks and worries. Is there a history of falls, wandering, swallowing difficulties or skin problems? What worries the family most?

Practicalities. How many visits, at what times, and for how long? Is overnight or live-in help likely to be needed soon?

Keep the person at the centre. If they are able, they should help write this list. If they have difficulty communicating, involve the people who know them best, and use what you know of their life story.

What kinds of support are you looking for?

Providers describe services in different ways, and not every provider offers every type. Be clear about what you need, then ask whether and how the provider delivers it.

• Visiting care. Carers arrive at agreed times, for example morning and evening. Some providers, including Proritas Healthcare, describe home or domiciliary care that can start from around one hour per visit, depending on location.
• Live-in care. A carer stays in the home. Proritas Healthcare also lists live-in care.
• Respite care. Short-term cover that gives a family carer a break.
• Overnight support. Waking or sleeping night care, which not every agency offers.
• Specialist support. Help with conditions such as dementia, Parkinson’s disease or stroke recovery. The NHS says some homecare providers can support specialist needs, but you should not assume a provider can. Ask about experience, training and supervision relevant to the person’s condition.
• Nursing care. Home care workers are not nurses. If clinical tasks are needed, ask who will carry them out and how.

A provider should be willing to say “we can’t do that”, or “we can do part of it”. A provider that says yes to everything deserves a few more questions.

How do you check that a provider is registered?

In England, health and social care providers must register with the CQC to carry out regulated activities, and personal care is one of them. The CQC says homecare agencies apply to register for personal care. The NHS states that all homecare agencies must register, and that you can check an agency’s latest inspection report on the CQC website. Age UK advises looking for agencies registered with the CQC.

Practical steps:

1. Search for the provider’s name on the CQC website and check that the registered name and address match the company you are dealing with.
2. Check which service types and activities it is registered for.
3. Open the most recent inspection report, if there is one, and note the date.
4. Ask the provider directly if you cannot find it, or if the names differ.

Registration is a legal requirement. It tells you that the provider has met the entry standard, not that every visit will be good. Some services described as “home care”, such as help with housework or companionship alone, may not involve personal care, and CQC’s scope of registration guidance sets out which activities need to be registered. If you are unsure whether a service must be registered, ask the provider which activities it is registered for.

If you are considering employing a carer yourself rather than using an agency, the NHS notes that this makes you legally responsible as an employer, including arranging cover for sickness and holidays. That is a very different arrangement from choosing an agency, so weigh it carefully.

How should you read inspection reports, and what are their limits?

The CQC rates adult social care services in England across five questions: whether they are safe, effective, caring, responsive and well led. Ratings are generally described as Outstanding, Good, Requires Improvement or Inadequate. CQC has said that a service rated Good or Outstanding provides safe, effective, compassionate, high-quality care; that a Requires Improvement provider must send CQC a plan to put things right; and that for Inadequate services CQC will consider further action to protect people.

Use reports well:

• Check the date. A report from several years ago may not reflect today’s service. Staff, managers and practices change.
• Read the detail. The summary rating is a starting point. Look at what inspectors said about care planning, staffing, medicines, safeguarding and leadership.
• Look for themes. Repeated comments about missed visits, communication or staffing are more telling than a single issue.
• Check the size and type of the inspection. Some reports cover a few people’s care, and the evidence base can be limited.
• Remember that not every provider has a rating. Newly registered providers, or those not yet inspected, may not have one. A missing rating is not automatically a bad sign, but it means you need to rely more on your own questions and checks.
• Don’t use ratings in isolation. A good rating is reassuring, but it doesn’t tell you whether the provider is a good fit for your relative.

Reports are one input. Combine them with what the provider tells you, what you see when you meet them and what other families say.

What should you ask about recruitment, training, supervision and safeguarding?

These questions tell you a lot about how a provider runs its service.

Recruitment and checks

• How do you recruit carers, and what checks do you carry out, such as Disclosure and Barring Service (DBS) checks and references?
• Are carers employed by you, or are they self-employed or supplied by another agency?
• How do you check that carers have the right to work in the UK?

Training

• What induction do new carers have before they work alone, and what ongoing training do they receive?
• How are carers trained in moving and handling, medicines, infection control, dementia awareness and safeguarding?
• Do you follow nationally recognised standards for new care workers, such as the Care Certificate?
• If my relative has a particular condition, what training relates to it?

Supervision and quality

• How are carers supervised, and do managers observe care being given, for example through spot checks?
• How do you check that visits happen on time?
• How do you gather feedback from the people you support and their families?

Safeguarding

• Who is your safeguarding lead, and what do carers do if they suspect abuse or neglect?
• How are concerns reported, and to whom?
• What is your policy on gifts, money and keys?

Proritas Healthcare states on its website that its carers are fully vetted and DBS-checked, and its footer links to a safeguarding statement and a complaints procedure. A published policy is a good sign, and you should still ask how it works in practice, whichever provider you choose.

How should care assessments and care plans work?

A reputable provider will want to understand your relative before starting. Expect a conversation, usually in the person’s home, covering health, medicines, mobility, daily routines, home environment, risks, preferences and who to contact.

A good assessment and care plan should:

• involve the person receiving care, and family if they wish
• record needs, preferences, goals and risks in writing
• say what carers will do at each visit, and at what times
• describe how medicines support will work, if it applies
• be shared with you, with a copy kept in the home where appropriate
• be reviewed at agreed times and whenever needs change, such as after a hospital stay or a fall

Ask: Who will carry out the assessment? How soon after we first talk can care begin? How often is the plan reviewed? How do we ask for changes?

If a provider offers a price without asking about needs, or promises to start immediately without any assessment, be cautious. Urgent starts are sometimes needed, for example after a hospital discharge, but a proper assessment should still follow quickly.

How do you judge continuity, reliability, punctuality and communication?

For many families, these day-to-day things matter more than anything else. The NHS suggests asking whether visits will keep to set time slots and whether you will be told about delays, and how carers are matched to clients.

Questions to ask:

• Will the same small group of carers visit my relative? How do you handle holidays and sickness?
• How are carers matched to clients, and can we meet a new carer before they start?
• What does “on time” mean? Is there a visit window, and what happens if a carer is running late?
• How will you tell us if a visit is late or cannot happen?
• Who is the main contact at the office, what are the opening hours, and who do we call in the evening or at weekends?
• How will you keep the family updated, for example by phone, notes in the home or an online record? (Ask what the person has agreed to share.)
• How much travel time do carers have between visits? Tight schedules can lead to rushed visits.

Continuity is not always possible to guarantee, because carers do get ill, leave and take holidays. What matters is how openly the provider talks about it and what it does to keep the changes to a minimum. Proritas Healthcare says on its website that it matches carers to clients by personality and interests and offers 24/7 carer access for emergencies, which you can ask any provider to explain in practice.

What happens when things go wrong?

Every provider has bad days. What distinguishes a good one is how it responds. Ask about each of these before you sign anything.

Late or missed visits. What is the procedure? Will someone be sent as cover, and how quickly? Will you be told? How are missed visits recorded and reviewed?

Complaints. Is there a written complaints procedure? How long will it take to respond? Age UK’s advice on problems with homecare is to raise it informally first, then ask for the formal complaints procedure if needed, keeping records of what was said. If you are not happy with the outcome, you can ask the Local Government and Social Care Ombudsman to look at it. Healthwatch gives similar guidance and says to complain to the provider first. The CQC regulates services, but it does not deal with individual complaints. It may use the information you give to look into the service further.

Emergencies. What do carers do if someone is found unwell or on the floor? A carer should call 999 for a medical emergency, and a provider should be clear about this. A home care worker is not a replacement for emergency medical services. How do carers contact the family and the office afterwards?

Changing needs. How quickly can hours be increased after a hospital stay or fall? What happens if needs go beyond what the provider can safely meet?

Abuse or neglect. If you suspect it, contact your local council, which has a safeguarding duty, and call 999 if someone is in immediate danger. Age UK also lists the Hourglass helpline (0808 808 8141) for concerns about abuse of older people.

What should you ask about price, minimum visits, cancellations and extras?

Cost is a real concern, and the clearest way to avoid unpleasant surprises is to ask for everything in writing. The NHS suggests asking what charges apply and what counts as an extra. Useful questions include:

• What is the hourly or per-visit rate, and does it differ by time of day, weekends and bank holidays?
• Is there a minimum visit length? Do you charge for travel time or mileage?
• Are there set-up, assessment or administration fees?
• What is the notice period for cancelling or changing visits, and what happens if my relative is in hospital?
• How and when will prices rise, and how much notice will we get?
• Are two-carer visits, equipment, overnight care or specialist needs charged differently?
• How will you bill us, and how often?

Do not compare providers on the hourly rate alone. A lower rate with long minimum visits, travel charges and short notice periods can cost more than it looks. Ask each provider to cost the same example week, so that you can compare like with like.

The NHS has quoted homecare prices of £15 to £30 an hour depending on location, but that page was last reviewed in January 2024, so use it only as a rough pointer and ask for current quotes. Proritas Healthcare does not publish prices and says costs depend on the type and level of care, with a tailored quote after a free consultation.

How does funding affect your choice?

How the care is paid for can affect who you can choose and how the process works.

• Council-arranged care. If the council assesses that your relative has eligible needs, it may arrange care and may ask them to contribute following a financial assessment. In that case, the council may use providers it has contracts with. Ask what choice you have.
• Direct payments. The NHS and Age UK explain that a personal budget can be taken as a direct payment, so that the person arranges their own care. This can give more choice, but it brings responsibilities, such as keeping records and, if you employ someone, being an employer.
• Self-funding. If you pay privately, you can generally choose any provider. You can still ask the council for a needs assessment and advice. Age UK says that, in the council’s financial assessment, capital above £23,250 means no entitlement to council help with care costs, and that the value of the home is not counted for care at home. Thresholds change, so check current figures with the council.
• NHS continuing healthcare. This is care arranged and funded solely by the NHS for adults with long-term complex health needs, based on assessed needs rather than diagnosis. If your relative may qualify, ask about an assessment before committing to long-term private arrangements.
• After hospital. Age UK notes that care after hospital may be arranged through “discharge to assess” or “home first” approaches and advises checking costs, which vary by area.

If you are unsure what applies, Age UK’s free Advice Line (0800 678 1602, 8am to 7pm every day) can help you think it through.

How do you assess compatibility, dignity, culture, privacy and consent?

A provider can be well run and still not be right for your relative. Think about the human side.

Dignity and privacy. Do carers knock, introduce themselves and explain what they are doing? How is personal care provided in a way that respects modesty? Who has a key, and how is it kept safe?

Consent and choice. Does the provider ask the person what they want, and respect a refusal? How does it handle someone who lacks capacity for a particular decision, and who is involved in that?

Culture, faith and language. Can the provider meet the person’s religious, cultural, dietary and language needs, for example carers who speak the person’s first language?

Personality and fit. Matching matters. Ask how it is done, and whether you can meet or have a conversation with the carer before they begin.

Atmosphere. Pay attention to how people speak to you during the first call or visit. Do they listen to the person at the centre of this, or just to you?

It is reasonable to ask for a different carer if it is not working out. A good provider will treat that as normal.

What should be in a home care agreement?

The NHS suggests asking whether there is a standard contract you can read. Do this before you commit, and take your time over it. Check that it covers:

• the services to be provided, and the care plan
• visit times and lengths
• fees, extras, billing and how prices can change
• notice periods and cancellation terms, including during a hospital stay
• how and when the agreement can be ended by either side
• complaints procedure
• how information is shared and how personal data is handled
• insurance, and what happens if something is damaged or lost
• who the main contacts are, and out-of-hours arrangements

If you are not sure about any term, ask for it to be explained in plain English. You can ask a family member, Citizens Advice or your local Age UK to look it over. Do not feel pressured into signing at the first meeting.

What warning signs should make you ask more questions?

None of these proves a provider is poor, but each is a reason to ask more.

• It cannot show you its CQC registration, or the names do not match.
• It will not give you a written price, a contract or its complaints procedure.
• It pressures you to sign quickly or to pay up front for a long period.
• It promises specific outcomes, for example that your relative will never fall, or that a certain carer will always come.
• It says yes to everything, including needs it has no obvious experience in.
• It is vague about training, supervision or what happens when a carer is sick.
• Nobody asks to speak to the person who needs care.
• Calls and messages are not returned, or you cannot find out who is in charge.
• Reports or reviews mention recurring problems that the provider cannot explain.
• Your gut says something is off. That counts for something.

How do you involve the person receiving care?

Whenever possible, the person should be part of the decision, and ideally the one who makes it. It is their home, their body and their daily life.

• Ask what matters to them before you start looking.
• Let them meet or speak to providers. Many people feel more comfortable once they have met someone.
• Explain options without taking over. Offer choices instead of conclusions.
• Respect hesitation. Many people are anxious about having a stranger in the house. A gradual start, such as one short visit a week, can help.
• Plan for communication needs. If they have hearing loss, memory problems or other difficulties, arrange the conversation to suit them, and involve someone they trust.
• Where they lack capacity for a particular decision, those involved should act in their best interests and follow the legal processes that apply. Ask the council or an adviser if you are unsure who can make decisions.

How do you arrange a first conversation or assessment?

A sensible approach looks like this:

1. Shortlist two or three providers using CQC information, recommendations from friends, GP or hospital teams, local Age UK, or your council’s list of approved agencies, which Age UK says some councils hold.
2. Make a first call, using your list of needs and the questions above.
3. Ask for written information: a service guide, price list, sample contract and complaints procedure.
4. Arrange a home visit or consultation, with your relative present if possible.
5. Compare answers using the scorecard, and talk them through.
6. Ask about a trial or review point, so that you can check how things are going after the first few weeks.
7. Confirm everything in writing before care begins.

Proritas Healthcare describes a free, no-obligation consultation as the first step, followed by a discussion of care needs, and then a match with a carer and a care plan if it is a good fit. Whichever provider you speak to, bring your list and ask for answers in your own words.

When should you reconsider a provider?

You are not locked in. Even a good start can change. Think about reviewing or changing arrangements if:

• visits are often late, short or missed
• the carers keep changing and no one explains why
• the person is unhappy, withdrawn or frightened
• tasks in the care plan are not being done, or the home is not being left safe
• you are not getting answers, or complaints are brushed aside
• needs have grown beyond what the provider can safely meet

First raise the issue with the provider, and give it a chance to put it right. If it does not, use the complaints process. You can generally change providers, though you should check notice periods and terms in the agreement. If the council arranges or funds the care, speak to the council before making changes. If you are worried that someone is being harmed, contact the council’s safeguarding team, and call 999 in an emergency.

Changing provider can be unsettling, so try to plan the handover, and make sure the new provider has the care plan and medicines information.

Taking the next step

You do not have to find the perfect provider on the first call. Start with a clear idea of what your relative needs, check the basics, ask the questions in this guide, and compare more than one option. It is fine to take your time, and fine to say no.

If you would like to talk to us, Proritas Healthcare offers a free, no-obligation consultation to discuss the support you or your relative may need, including routines, preferences and medical needs. You can book a free consultation, contact us, see our care services, or read our complaints procedure and safeguarding statement first. We are happy for you to bring this checklist, and to compare us with other providers. Whether we are the right fit depends on your relative’s needs and wishes.

Frequently asked questions

How do I find a reliable home care provider?

Start by listing what your relative needs and prefers, then shortlist two or three providers from CQC information, recommendations from friends, your GP or hospital team, a local Age UK, or your council’s list of approved agencies. Check registration, read the latest report, ask the same questions of each, and get prices and a contract in writing.

What questions should I ask a home care agency?

Ask about CQC registration, recruitment and DBS checks, training and supervision, how care is assessed and reviewed, how carers are matched, how visit times and delays are handled, what happens with missed visits or complaints, and every charge, including extras. The NHS also suggests asking about experience with similar needs and how to contact the agency out of hours.

Should I choose a CQC-registered provider?

Yes, if the service includes personal care, because providers of personal care in England must register with the CQC. The NHS says all homecare agencies must register. Registration is a legal requirement rather than a quality guarantee, so also read the latest report and ask your own questions.

How can I check a care provider’s inspection history?

Search for the provider on the CQC website and open its latest report. Check the date, the rating if it has one, and what inspectors said about safety, effectiveness, caring, responsiveness and leadership. Not every provider has a rating, for example if it is new or has not been inspected yet, so ask the provider how it assures quality.

What should a home care assessment include?

It should cover health, medicines, mobility, daily routines, preferences, home safety and risks, and the person’s own goals. It should involve the person receiving care, produce a written care plan, and set a date for review. Be wary of a quote given without any discussion of needs.

What happens if a carer misses a visit?

It depends on the provider, so ask before you sign. A good provider will explain how it finds cover, how quickly it contacts you, how it records and reviews missed visits, and how to complain. If the problem recurs, raise it formally, then use the complaints procedure and, if needed, the Local Government and Social Care Ombudsman.

Can I change home care providers if I am unhappy?

Generally yes, but check the notice period and other terms in your agreement first. Raise your concerns with the provider and use its complaints procedure. If the council arranges or pays for care, speak to the council before changing.

Who can I complain to about a home care provider?

Start with the provider, then use its formal complaints procedure. If you are unhappy with the outcome, you can ask the Local Government and Social Care Ombudsman to look at it. The CQC does not handle individual complaints, but it can use the information to look further into a service. If you suspect abuse or neglect, contact the local council’s safeguarding team.

Does the cheapest provider mean worse care?

Not necessarily, and the most expensive is not automatically best. Compare the full cost, including minimum visit lengths, travel, evening and weekend rates and cancellation terms, alongside the quality questions in this guide. Ask each provider to cost the same example week.

Do I need a care needs assessment from the council first?

You do not need one to arrange care privately, but it can help. The NHS says anyone can ask for a free assessment, and if the council finds eligible needs, it may arrange or contribute to care after a financial assessment. If you are not eligible, the council should still give advice about local help.

Can the person receiving care choose their own provider?

Often yes, particularly if they are paying privately or receive a direct payment. If the council arranges the care, ask what choice you have. Wherever possible, the person should be involved in the decision, and their preferences should be recorded in the care plan.