The short answer
- Support alongside, not instead ofMost of the help is prompting, planning and company rather than lifting and washing, and it leaves the person doing as much of a task as they can.
- One or two people, for the long runA support worker who knows the routine does not need telling it again, and the person does not have to explain themselves to a stranger each week.
- Capacity is judged one decision at a timeThe Mental Capacity Act assumes a person can decide, and requires that they be helped to decide, before anyone decides for them. A relative is not automatically the decision maker.
- Ask the council first, then look at carersA Care Act assessment is free and does not depend on savings. Carers on PrimeCarers charge £18 to £25 an hour with our fee included.
This page is written for whoever is reading it: a parent, a sibling, a friend, or the person the support is for. Where it says the person, read it as yourself if that is who this is about.
What the support does
What support at home looks like when the need is not physical
Care at home is usually described in terms of washing, dressing and lifting. For many adults with a learning disability the difficulty sits elsewhere: in the planning, the paperwork, the getting there, and the confidence to keep doing something week after week.
Prompting rather than doing
The starting point
A routine that holds
Same days, same times
Money, post and appointments
The admin of a life
Shopping and cooking together
Side by side
Keeping a job or a college place
During the day
Friendships and getting out
Evenings and weekends
Some weeks need more than one kind of help. Where washing, dressing or continence are part of it, personal care for disabled adults covers how that is arranged, and where the gap is company, companionship care is the same arrangement for a different purpose. If someone needs a person there day and night, live-in care for a younger adult with a disability sets out how that works, and the disability care pillar has the wider picture.
Before you speak to anyone, write the week down: the day, the time, the task, and what happens now. A social worker will ask for the same thing. Writing a care plan together has a format you can use.
One or two regular people
Why one or two regular people work better than a rota
With an agency rota the person often meets whoever is free that day, which means explaining the same things to people who will not be there next month. Keeping the number of people small is not simply a preference, because it changes how well the support works.
What tends to work
- One main carer, with a second person the household knows for cover
- Meeting somewhere familiar first, with short visits before long ones
- The person taking part in choosing, and having the final say where they can
What tends to cause trouble
- A different face most days, so the routine is explained again each time
- A first visit that starts with personal care, before any trust is there
- Changes sprung on the day, which can undo weeks of settling in
PrimeCarers is an introductory service. We introduce self-employed carers and do not provide, deliver or manage care, so there is no rota here. The family, or the person themselves, chooses the carer and agrees the hours with them. Before a carer appears in a search we check their identity and right to work, run an enhanced DBS check kept on the Update Service, and interview them online. Carers are insured while they work. How we vet every carer sets out what the checks cover.
We do not check qualifications, training or references. What a carer says about supporting people with a learning disability is their own account on their profile, so ask what they have done, for how long, and who with. Questions to ask at interview has a list to work from. We do not provide supported living, so if a staffed house is needed, that is a conversation with the council, and supported living versus care at home sets the two side by side.
Decisions and capacity
The Mental Capacity Act, applied properly
Families can go wrong here with the best of intentions. The Mental Capacity Act 2005 sets out five principles and they run in order, and a learning disability on its own says nothing about whether someone can make a decision.
- 1
Assume the person can decide
Principle oneA person must be assumed to have capacity unless it is established that they lack it, and it cannot be established by their age or appearance, or by a condition that leads others to make unjustified assumptions about them. - 2
Take every practical step to help them decide
Principle twoNobody is to be treated as unable to decide until all practicable steps to help them have been tried. Somebody who can understand an explanation given with simple words or pictures has understood it. - 3
An unwise decision is still their decision
Principle threeA person is not to be treated as unable to decide merely because they make an unwise decision. Disagreeing with a choice is not grounds for taking it over, which is hard for a parent to sit with. - 4
Only then, a best interests decision
Principle fourIf the person cannot make this decision at this time, it must be made in their best interests, taking account of their wishes, feelings, beliefs and values. Somebody may be unable to decide about a tenancy and perfectly able to decide what they eat. - 5
Choose the least restrictive option
Principle fiveBefore anything is done there must be regard to whether the purpose can be achieved in a way less restrictive of the person’s rights and freedom of action.
Easy read information is the practical side of principle two: short sentences, with a picture beside each point. Under the Accessible Information Standard, organisations providing publicly funded NHS care or adult social care must have regard to identifying and meeting people's information and communication needs, so you can ask a GP surgery, a hospital or a council for an easy read version of a letter or a care plan. Mencap is the learning disability charity most people are pointed to first, and it publishes advice in easy read and runs a helpline. A carer can help by reading a letter through with the person rather than answering it for them, and what carers are not allowed to do covers where the line sits on money.
Health checks and hospital
The annual health check and the hospital passport
Two things exist specifically for people with a learning disability, both are free, and both are easy to miss: a yearly appointment, and a document that goes into hospital with the person.
Two things to put in place this month
0 of 6 ticked
Once a year: the annual health check
Before any hospital visit: the hospital passport
Both sit on the NHS website in full: the annual health check and going into hospital, which includes a passport to fill in. A support worker who knows the person is useful at both, because they can say what has changed. If medication is involved, can a private carer give medication? sets out what a carer may do with it.
Asking the council
What a Care Act assessment looks at
Support at home for a disabled adult is usually funded at least in part by the council, and it starts with an assessment. Under section 9 of the Care Act 2014, where it appears that an adult may have needs for care and support, the local authority must assess them, whatever it thinks of the level of need or of their finances.
Looking after yourself
Managing and maintaining nutrition
Planning the week’s meals, shopping, and cooking alongside the person rather than instead of them. For one person that is a prompt and a recipe with pictures. For another it is help with everything hot.
Maintaining personal hygiene
A reminder about a shower, a hair wash and clean clothes, or hands-on help with washing, at the hour of the day the person prefers.
Managing toilet needs
Help with continence products, laundry and getting to the bathroom in time, arranged so that it stays private.
Being appropriately clothed
Choosing clothes for the weather or for a job, keeping the washing going, and replacing what has worn out.
The home itself
Being able to make use of the home safely
Working through the cooker, the front door, the stairs and the bath, and asking the council for equipment or an adaptation where something is not safe.
Maintaining a habitable home environment
Cleaning, bins, bedding and the small jobs that pile up, done together so the skills stay with the person.
A life outside the front door
Developing and maintaining family or other personal relationships
Getting to see friends and family, keeping in touch by phone or message, and going along to a club or a group the person already likes.
Accessing and engaging in work, training, education or volunteering
Getting to a job or a college place and home again, support during the day, and help with the forms and emails that come with both.
Making use of necessary facilities or services in the local community, including public transport and recreational facilities
Learning a bus route with someone the first few times, support at the GP surgery or the bank, and going to the places the person wants to go.
Carrying out any caring responsibilities the adult has for a child
Support with the school run, appointments and the routines of looking after a child, where the person is a parent.
Needs are eligible if they arise from a physical or mental impairment or illness, if the person cannot achieve at least two of those ten outcomes without help or without significant difficulty, and if there is a significant impact on their wellbeing. That is worth reading twice beforehand, because it tells you what to describe: which of the ten are hard, on which days, and what happens when nobody is there.
If needs are eligible, the council must produce a care and support plan and a personal budget, which states what meeting those needs costs, what the person pays after a financial assessment, and what the council pays. That money can be taken as services the council arranges, or as a direct payment. Local authority funding covers how to ask.
Who pays
Direct payments, personal budgets, and what carers charge
There are two questions here and they are easier apart: how much the council contributes, and what an hour of support costs once you are arranging it yourself.
£18-£25
An hour on PrimeCarers, our fee included
About £20 an hour is typical, and the carer sets the rate.
£28-£35
What an agency charges an hour
The same hour in the same home.
£23,250
The upper capital limit in England
Below £14,250 savings are disregarded, though income still counts.
£1,050+
A week for a live-in carer
Overnight support starts from about £130 a night.
PrimeCarers rates, September 2026. Capital limits from the Department of Health and Social Care charging circular for 2026 to 2027.
A direct payment is the council's money paid to the person, or to someone authorised to receive it for them, so they can arrange their own support. It is the main route into choosing your own carer, and direct payments explains how to ask for one. Where that carer works for one person rather than for an agency, what a personal assistant does, and whether to employ one or engage somebody self-employed sets out the two routes and what each asks of you. For how that differs from a personal budget or a personal health budget, personal budgets and personal health budgets sets them side by side. Councils usually ask to see a contract and payment records, and both exist on the platform.
Charging for care at home is means-tested, but there is a floor: the statutory rules say charges must not reduce a person's income below a set weekly amount, the minimum income guarantee, which rises for 2026 to 2027. The detail is in the charging circular. Separately, Access to Work is a government grant that can pay for support at work, including a support worker or a job coach, and it does not affect other benefits.
If whoever is caring now needs a break, respite care covers how one is funded.
Questions
Questions families ask about support at home
This is a common way to use one, and it is a question for your council’s direct payments team, because the rules differ between councils. They usually ask to see a contract and a record of payments, and both exist for arrangements made here. Direct payments explains how to ask for one.
Where he can take part in choosing, he should, and the Mental Capacity Act starts from the assumption that he can. Look at profiles together, meet two or three people somewhere familiar, and let him have the final say. If a decision is one he cannot make even with support, it is made in his best interests, taking account of his wishes and feelings.
We do not check qualifications, training or references, so we cannot tell you that, and there is no way to search by training. What a carer says about their experience is their own account on their profile, so ask them what they have done, for how long and with whom. The checks we run are identity, right to work, an enhanced DBS on the Update Service, and an online interview, and carers are insured while they work. How we vet every carer.
No. We are an introductory service that connects people with self-employed carers, and we do not run a registered service or provide supported living or residential care. Support at home from a carer the person chooses can sit alongside a supported living tenancy, or instead of it.
It depends on which parts of the week are difficult rather than on a diagnosis. Somebody who needs a hand with shopping, cooking and post might use six to ten hours a week, and somebody who also needs support at work and in the evenings will use more. The ten outcomes above are the clearest way to build the number. At £20 an hour, ten hours a week comes to £200.
Start smaller and slower than feels efficient. A first meeting somewhere familiar, then a short visit doing something the person likes rather than a task they resent, then the harder parts of the week once there is some trust. If the answer stays no, that is information rather than failure, and it is worth saying so at the assessment.