Private domiciliary care: paying for care at home yourself

If the term is new, what domiciliary care is and what it covers explains it first. In short, a carer visits at agreed times to help with things like washing, dressing, meals and medication prompts, and then leaves. Paying for it privately changes four things.

The right to an assessment is set out in section 9 of the Care Act 2014, which says the duty applies whatever the council thinks of the person's needs or their financial resources. The NHS guidance on homecare suggests having one even when you pay, because it gives you a written account of what help is needed. You do not have to wait for it to start care. The care needs assessment explains what happens on the day.

There is one more option worth knowing about. If your relative has savings above the upper limit, which is £23,250 in England, they can still ask the council to arrange their care at home, and section 18 of the Care Act says the council must do so if their needs are eligible. They pay the full cost, and the statutory guidance allows the council to add an arrangement fee that covers only its own costs of setting the care up. Self-funding your care covers that route and what happens if savings run down, and Attendance Allowance explains how to claim a benefit that is paid whatever your relative has saved.

A home care agency in England has to be registered with the Care Quality Commission, which inspects it and publishes a rating you can read on the CQC website. The agency employs its carers, plans the rota and sends a replacement when somebody is ill. The regulations require it to run a complaints system, and if you are not happy with its answer, the Local Government and Social Care Ombudsman can look at complaints about care arranged privately with a registered provider. Part of the agency's hourly price pays for that organisation, and the carer who comes may change from week to week.

The second route is the one PrimeCarers is part of, so it is worth being clear about what we are. PrimeCarers is an introductory service, not a care agency or a care provider, and it holds no CQC registration. The carer you choose is self-employed and works for you, and the CQC's guidance on introductory agencies explains why that kind of service sits outside registration. Self-employed carers and the CQC goes into the detail.

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. For visits booked through PrimeCarers, we arrange insurance cover where the carer does not have their own, subject to the policy terms, so check it covers the work you agree. We do not check qualifications, training or references. A profile can show reviews from PrimeCarers bookings and references the carer has collected from past families and employers, and neither is verified by us, so ask the carer about their skills and training and follow up the references that matter to you.

What you take on in return for choosing the person and paying a lower rate is more of the organising. You agree the visits with the carer, and nobody sends a replacement automatically if they are ill or on holiday. The contract lets the carer send a substitute they arrange, and you can object on reasonable grounds, but it is better to agree at the start how cover will work. When your carer is ill or on holiday sets out the options. If you would like help with that side, the optional Managed service adds 5% and includes help with scheduling and holiday cover, bookings handled for you by WhatsApp, email or phone, and a monthly review with you and the carer. The Fully Managed service, at 10%, is for live-in care only.

Agency or private carer goes through the two routes point by point, and how to choose a domiciliary care provider has the questions to ask an agency or a carer before you agree to anything.

The carer sets their own rate, and it is on their profile before you speak to them. Rates vary with the area, the carer's experience and the kind of help needed. The figure on the profile already includes our fee, and there is no deposit or joining fee. You pay by card through PrimeCarers after the visits have happened. Our pricing shows how the hourly rate is made up.

An agency's hourly price covers the carer's wages and the agency's own costs: its office, its managers, its rota and the cover it provides. It is a fair price for those things if you want them. If you would rather choose the person and do some of the organising yourself, the self-employed route costs less for the same hours.

What domiciliary care costs works through one to four visits a day and compares visits with live-in care and a care home. If you are not yet sure how many hours your relative needs, how many visits a week your parent needs builds the week up from the tasks. Past about 35 hours a week, live-in care on PrimeCarers, from £1,050 a week, starts to cost less than visits.

The contract on PrimeCarers is between you and the carer. PrimeCarers provides it and processes the payments, but does not set the commercial terms between you, and it charges nothing itself if you cancel. If you and the carer disagree, the contract asks you both to try to settle it in good faith, with non-binding mediation before anything more formal. PrimeCarers can help the two of you talk but does not decide the outcome. The full wording is in the client and carer contract.

The contract also says the carer is self-employed and responsible for their own tax and National Insurance. That is different from employing somebody yourself as a personal assistant, which makes you an employer with duties such as payroll and holiday pay. Can I employ a private carer? explains the difference. For cancellations in more detail, read deposits, cancellation and notice, and for bank holiday and weekend rates, weekend, evening and bank holiday rates.

1. 1

   Write down what your relative needs

   Today

   List the times of day that are hard and the tasks that need doing, such as getting up and dressed, meals, tablets and getting to bed. If you would like the council's view, ask for a needs assessment at the same time. You do not have to wait for it.
2. 2

   Decide which route suits you

   Agency or self-employed carer

   If you want somebody else to organise the carers and the cover, look at registered agencies on the CQC website and read their latest reports. If you would rather choose the person and pay less an hour, search for self-employed carers.
3. 3

   Compare carers and talk to two or three

   Free

   Search by postcode and compare rates, reviews and availability. Message the carers you like, describe the visits, and ask about their experience and training. A phone or video call tells you a lot.
4. 4

   Agree the visits and the cover

   Before the first visit

   Settle the days, times and tasks with the carer, and what will happen if they are ill or away. Read the notice and cancellation terms so nothing comes as a surprise.
5. 5

   Choose how much help you want with the arranging

   Optional

   The basic service is included in the carer's rate. If you would like PrimeCarers to handle bookings and help with scheduling and holiday cover, the Managed service adds 5%.

A sensible place to begin is the hardest part of the day, adding visits once you see how it goes. Because the arrangement is with one person rather than a package, adding a lunch visit or changing a time is a conversation with the carer. Hiring a carer, start to finish covers each step in more detail, and private carers brings together everything about working with a self-employed carer. When you are ready, find a carer near your relative.