Domiciliary care: what it is, what it covers and how to arrange it

That wording comes from the NHS guide to help at home from a paid carer and the Care Quality Commission's guidance for homecare agencies. Our guide to what the care words mean goes through the rest of the vocabulary a family meets in the first few weeks, from reablement to a care package, and the A to Z of care terms is there for anything else on a form.

The word is wider than it first sounds. In a council letter, domiciliary care can mean visits from an agency the council has a contract with. In law the service is defined by where the care happens and what it involves, so overnight care and live-in care given in somebody's own home are domiciliary care too. An agency that supplies live-in carers to give personal care registers with the Care Quality Commission in the same way as one that sends carers for an hour at a time.

The word also has a name in each part of the UK. In Scotland the Care Inspectorate registers care at home services. In Wales, Care Inspectorate Wales registers domiciliary support services. In Northern Ireland the Regulation and Quality Improvement Authority registers domiciliary care agencies. The help in the house is the same in all four nations, and how home care is regulated sets out who checks what in each of them.

The tasks on the left match the help the NHS lists for a paid carer at home, and the first five fall within what the law calls personal care. The 2014 regulations define personal care as physical help with eating or drinking, going to the toilet, washing or bathing, dressing, oral care, and the care of skin, hair and nails, or prompting and supervising somebody through those tasks where they cannot decide to do them alone. That definition matters because an organisation providing personal care in somebody's home in England has to be registered before it starts work.

Nursing is a separate service. The Care Act 2014 stops a council meeting somebody's needs with a service the NHS is required to provide, which is why a nurse who comes to dress a leg ulcer is arranged through the GP surgery and does not appear on a care bill. Some carers will take on a delegated health task once a nurse has trained them for that person, and delegated healthcare tasks explains how that works.

Medicines are worth settling before the first visit. A carer can remind your relative to take tablets and can often do more than that once it has been agreed and written down, and whether a private carer can give medication sets out where the lines are. What a carer can do in an hour shows how the tasks fit into a visit, and shopping, cooking and cleaning covers the household jobs families are unsure about asking for.

It is fine to start with fewer visits and add more as you learn what is needed. How many visits a week your parent needs works the hours out from the tasks rather than from a guess. Length matters as much as number. NICE guidance on home care says visits shorter than half an hour should be made only where the care worker is known to the person, the visit is part of a wider package of support, and there is enough time for a specific, limited task or a check that the person is safe and well. Why 15 and 30 minute calls fail explains why an hour is the visit to book for personal care.

As the hours go up, the arrangement that makes sense changes. Past roughly 35 hours of visits a week, live-in care usually costs less than the visits and covers the hours between them, and when live-in care becomes cheaper than visits works through the two side by side. Where the worry is the nights, waking night or sleeping night explains the difference between the two kinds of overnight care.

The figures on these cards are what carers on PrimeCarers charge, with our fee included. What domiciliary care costs compares them with agency prices over a week, a month and a year, and covers who can help pay.

After a hospital stay, care at home often begins as reablement: short-term support to help somebody do things for themselves again. The regulations say a council must not charge for intermediate care and reablement for the first six weeks, although support often finishes sooner than that. Reablement and the free six weeks explains how to ask for it and what to arrange before it stops, because ordinary charging applies to any care that continues afterwards.

Domiciliary care also helps the family member doing most of the caring. If you are that person, a regular visit or a few days of cover can be what lets you keep going, and you are entitled to a carer's assessment of your own from the council. What respite care is covers the ways to arrange a break.

Care at home is not always the right answer. When somebody needs help at any hour and nobody can be there, or the house cannot be adapted, a care home may suit them better. Care at home or a care home sets the two side by side.

The first two routes go through a registered agency, so the Care Quality Commission inspects the organisation and you can read its rating before you agree to anything. The agency employs the carers, plans the rota, arranges cover when somebody is off sick and has a complaints procedure it must follow. Part of the agency's hourly price pays for that organisation.

The third route is the one PrimeCarers is part of, and the difference in status matters. PrimeCarers is an introductory service, not a care agency or a care provider, and it holds no CQC registration. The regulations exclude the introduction of carers to an individual by somebody having no ongoing role in the direction or control of the service. The carer you choose is self-employed and works for you, and the Care Quality Commission's guidance on introductory agencies explains where that line sits.

That has consequences you should weigh before choosing. With a carer you engage directly, you agree the visits, the times and the rate with that person, and nobody supplies a replacement automatically if they are ill or on holiday, so it is worth agreeing at the start how cover will work. When your carer is ill or on holiday covers the options, and if you would like help with scheduling and holiday cover, the managed service sets out the paid options PrimeCarers offers. In return you choose who comes, you can keep the same person, and the hourly rate is lower than an agency's.

Agency or private carer and private carers compared with agency carers go through the two private routes point by point, and the four ways to arrange care, compared adds franchises and managed agencies to the picture.

1. 1

   Ask for a care needs assessment

   Free, and open to everybody

   Ring or write to adult social care at the council where your relative lives. The Care Act says the duty to assess applies whatever the council thinks of the person's needs or their money, so having savings is no reason to be turned away.
2. 2

   The council decides whether the needs are eligible

   Against national rules

   It checks what it found against the national eligibility criteria. If the needs are eligible, the council has to make sure they are met, and it writes a care and support plan saying how.
3. 3

   A financial assessment works out what your relative pays

   After the needs assessment

   In England in 2026/27, somebody with more than £23,250 in savings and capital pays the full cost. Below £14,250, savings are left out of the sum. The value of the home is not counted for care at home.
4. 4

   A personal budget sets out the money

   What the council pays and what you pay

   The personal budget states what meeting the needs will cost, how much your relative contributes and how much the council pays.
5. 5

   Choose how the care is arranged

   Council-arranged or a direct payment

   The council can arrange visits from an agency it contracts with. Or you can ask for a direct payment and arrange the care yourself, including with a self-employed carer you choose.

The council's financial assessment also protects some of your relative's income. For care at home, the charging rules for 2026/27 set a minimum income guarantee, which for a single person over Pension Credit age is £241.45 a week. The council cannot take your relative's income below that figure when it works out their contribution. Local authority funding explains the whole process and the care needs assessment covers what happens on the day.

A direct payment is worth asking about if you want to choose the carer. The council pays the money to your relative, or to someone acting for them, and the family arranges the care. Direct payments explains how to ask, what the money can pay for and the records the council will want back.

Two other kinds of help do not depend on the council. Attendance Allowance is not means-tested, so what your relative earns or has in savings does not affect it, and Attendance Allowance explains who can claim it. Where somebody's needs are mainly health needs, the NHS may pay for the whole package through NHS continuing healthcare.

Before a carer's profile appears on PrimeCarers, we check their identity and their right to work in the UK, check that they hold an enhanced DBS certificate (or a PVG in Scotland or Access NI in Northern Ireland) issued within the last 2 years, and interview them online. Carers are also insured while they work on visits booked through PrimeCarers. How carers are checked explains each step, and what our fees include sets out how the hourly rate is made up.

The contract you sign is between you and the carer. PrimeCarers provides it and processes the payments, but does not set the commercial terms between you. Bank holidays are charged at one and a half times the carer's rate and Christmas Day at twice. Travel time and mileage are charged only where you have agreed them in advance in writing. Notice for live-in care is 7 days once the carer has worked 168 hours, and 48 hours before that.

An agency gives you a different set of protections, and some families value them more. The agency is answerable for the carer, has to follow its complaints procedure, and arranges replacement staff itself. How to arrange home care takes either route step by step, and how quickly home care can start covers the timing.

When you are ready, you can search for carers near your relative and compare their rates, reviews and availability.

If you are looking for a registered agency, the Care Quality Commission's directory lists every registered homecare agency by postcode, with its rating and latest report. If you would rather choose a self-employed carer, the county pages show carers working in your relative's area, and what care costs where you live puts a figure on a week of care in that area.