Care at home for an adult with a learning disability

This is the care at home part of our family guide to learning disability, which covers the wider picture from health to housing.

With money, a support worker can help the person understand it, but should not hold their bank card or PIN, borrow from them or decide for them. What carers are not allowed to do covers where the line sits. Managing someone's money formally is for a DWP appointee, an attorney or a deputy, not a carer.

At appointments, the person can ask for reasonable adjustments such as a longer slot, a quieter time or a letter in easy read, and reasonable adjustments, the dentist and STOMP goes through what to ask for. For the daytime, work and supported employment and day services and things to do in the day cover the options, and relationships, friendships and dating covers the social side.

Where washing, dressing or continence are part of the week, personal care for disabled adults covers how that is arranged, and where the gap is mainly 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.

Agree with the person where each task sits, perhaps a spoken reminder for getting up and doing it together for the post, and write it down so a second support worker gives the same help. If one worker prompts and another does the task, the person can lose the skill they were building.

The levels can move in both directions. A new job, a house move or an illness can mean more help for a while, and that is a normal part of support rather than a step backwards. Writing a care plan together has a format you can use for the whole week: the day, the time, the task, the level of help and what happens now. A social worker will ask for much the same thing.

1. 1

   Write down what matters to the person

   Before you search

   One page, in their words where possible: what they like and dislike, how they communicate, what a good day looks like, what upsets them and what helps. Add the days and times support is needed.
2. 2

   Read profiles together

   Search by town or postcode

   Look at what each carer says they have done, their rate, their reviews and any references on their profile. There is no way to filter by learning disability experience, so read and ask.
3. 3

   A short message or call first

   Ten minutes

   Ask the questions that would rule someone out before anybody meets: the days, the travel, and whether they have supported an adult with a learning disability before.
4. 4

   Meet somewhere familiar, with the person leading

   The interview

   At home or in a favourite café. Let the person ask their own questions if they want to, and notice who the candidate talks to. If they speak only to the parent and not to the person, take note of it.
5. 5

   Start with short visits doing something enjoyable

   The first weeks

   A walk, a trip to the shops or a favourite activity comes before any personal care or difficult tasks, so that some trust is there first.
6. 6

   Agree the hours, the rate and the routine

   In writing

   The family, or the person, agrees these directly with the carer. Put the level of help for each task in writing too, so it can be handed on.

Questions worth asking at the interview:

• Tell us about someone with a learning disability you have supported. What did a normal week look like?
• How would you help with a task you could do much faster yourself?
• What would you write in your notes after a visit?
• Which days could you do every week for the next year?

Questions to ask at interview has a longer list.

PrimeCarers is an introductory service. We introduce self-employed carers and do not provide, deliver or manage care, so who comes is your choice. Before a carer appears in a search we check their identity and right to work, confirm an accepted criminal-record check (Enhanced DBS issued within the last 2 years, DBS Update Service, Scottish PVG or Access NI), and interview them online. Separately, carers are insured while they work. We do not check qualifications or training, and we do not verify the references a carer shows on their profile, so what a carer says about supporting people with a learning disability is their own account, for you to check at interview. How we vet every carer sets out what the checks cover.

Someone who does Saturday mornings every week can step into a Wednesday when the main support worker is away, and the person already knows them. At interview, ask whether each candidate could cover extra days at short notice, and introduce new people one at a time.

Where more than one relative is involved, the person who set up the PrimeCarers account can invite family from the My Family page. Each joins with their own login and one of four levels of access: Owner, Family Member, View Only or Finance. When a carer accepts a job, the family members on the account are in the conversation with that carer, so a brother and a sister can both read and reply. Visit reminders, visit reports and cancellations go by email to everyone with Owner, Family Member or View Only access, and the reports are kept on the person's profile, where they can be downloaded as a PDF for a social worker or a GP. Sharing care with family on PrimeCarers explains it step by step.

Respite for parents of a disabled adult covers the forms a break can take. Support at home is also one option among several: supported living versus care at home and Shared Lives describe two others that councils arrange. We do not provide either.

The NHS describes annual health checks and going into hospital, and a support worker who knows the person can say what has changed at both. If medication is involved, can a private carer give medication? sets out what a carer may do, and where that includes rescue medication for seizures, epilepsy care at home explains how training and delegation are arranged with the clinical team.

On decisions, section 1 of the Mental Capacity Act sets out the principles and the NHS explains how the Act works. Legal authority to decide for someone comes from a lasting power of attorney they made while they had capacity, or from a deputy appointed by the Court of Protection. Mencap publishes advice in easy read and runs a helpline.

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. So describe which of the ten are hard, on which days, how much prompting each needs, 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. Local authority funding covers how to ask.

Some rules are worth knowing before you ask for one.

• If the person cannot manage it themselves. Where an adult lacks capacity to ask for a direct payment, section 32 of the Care Act lets the council pay an authorised person instead, such as an attorney, a deputy or someone the council considers suitable, who must act in the adult's best interests.
• Paying a relative who lives with them. A direct payment cannot normally pay a close family member living in the same household. Regulation 3 of the Direct Payments Regulations allows it only where the council considers it necessary.
• Records and reviews. The council must review a direct payment within the first six months and then at intervals of no more than twelve, under regulation 7, and will want to know how the money is being spent. Keep the agreement with each carer and the invoices.

Rules differ between councils, so ask the direct payments team before you agree anything, and do not assume a council will say yes. Direct payments explains how to apply. Whether to employ a personal assistant or engage someone self-employed is set out in personal assistants and direct payments, and personal budgets and personal health budgets explains how the budgets differ.

Charging for care at home is means-tested, but charges must not reduce a person's income below a set weekly amount, the minimum income guarantee, set out in the charging circular for 2026 to 2027. Access to Work can pay for a support worker or job coach at work, as Access to Work and care at home explains.

If whoever is caring now needs a break, respite care covers how one is funded.