How quickly home care can start, and what decides the wait

The routes differ in who is doing the waiting. Arranging care yourself needs nobody's approval. A council package follows an order of steps set by law, and after a hospital stay the ward and the council arrange things on their own timetable. Home care covers what the care itself involves, and how to arrange home care takes the whole process in order, from the first worry to the first fortnight.

If your relative is unsafe today, go straight to emergency care at home, which sets out the urgent help available on PrimeCarers and how it works. This page is about the ordinary shape of the wait.

The step that sets the pace is the second one. A carer who is free at the times you need can reply, speak to you and start within a few days. One who is free on Tuesdays but not Thursdays cannot, however good they are, so be clear about which times are fixed and which could move. How many visits a week your parent needs turns a list of tasks into days and hours, which is the thing a carer needs to know first.

Before a profile appears, we check the carer's identity, right to work and an enhanced DBS on the Update Service, and interview them online. We do not check qualifications, training or references, which sit on the profile for you to follow up. Carers are insured while they work. How carers are checked sets out each check.

1. 1

   Ask for a care needs assessment

   Anyone can ask

   Ring adult social care at the council where your relative lives. The gov.uk council lookup finds the right team. Paragraph 6.29 of the statutory guidance says an assessment should be carried out over an appropriate and reasonable timescale, taking into account the urgency of needs, and that the council should tell your relative an indicative timescale. Ask for that date and write it down.
2. 2

   The assessment and the eligibility decision

   In that order

   A social worker or occupational therapist goes through an ordinary day with your relative. The council cannot decide whether the needs are eligible until the assessment is finished, except where it is meeting urgent needs.
3. 3

   The care and support plan

   No set timescale

   Paragraph 10.84 of the Care and Support statutory guidance says there is no defined timescale for the plan, but that it should be completed in a timely fashion and that planning should not unduly delay needs being met. If it is dragging, quote that sentence back.
4. 4

   A provider with room

   Where the wait can grow

   The council then needs a provider with carers free at the times in the plan. Where local providers are full, this is the step that holds everything up, and it is the one a family has least control over.

There is a way around the last step. Once the council has agreed to meet your relative's needs, section 31 of the Care Act lets your relative take the money as a direct payment and use it to pay for care they choose, instead of waiting for a provider on the council's list. A family who has already found a carer with the right hours can ask about this rather than wait. Direct payments explains how it works, and the care needs assessment goes through the assessment day and the three tests the council applies.

When the council can act before it assessesSection titled When%20the%20council%20can%20act%20before%20it%20assesses

Section 19(3) of the Care Act says a council may meet needs which appear to it to be urgent without having yet carried out a needs assessment or a financial assessment, or made an eligibility decision. Paragraph 6.26 of the guidance goes further. Where somebody with urgent needs approaches the council, it should provide an immediate response and meet their needs, and it gives the examples of a condition that deteriorates rapidly and an accident. The assessment follows afterwards.

This is a power, not a duty, and the council judges whether needs are urgent. Describe the danger rather than the difficulty: your relative fell twice this week and cannot get up alone, or has had no hot meal since Friday, or has been found outside at night. Ask for the duty social worker, and ask what they will put in place while the assessment is arranged.

Discharge and reablementSection titled Discharge%20and%20reablement

Under the hospital discharge and community support guidance, the expectation is that people go home, with short-term support arranged around them, and that their long-term needs are assessed once they have had a chance to recover. The requirement for a long-term assessment before somebody could leave hospital was removed by the Health and Care Act 2022. That is why this route can be the fastest: nobody waits for a full care package before your relative leaves.

The help is usually reablement or intermediate care: a short spell of visits to help your relative get back to washing, dressing and getting about on their own. The NHS page on reablement says it usually lasts no more than six weeks, depending on progress. It is free for that period, and it is time-limited, so the question of what happens after it ends is worth raising in the first week rather than the last. Reablement, the free six weeks covers what it involves, and hospital discharge explained sets out the discharge pathways and who to ask for on the ward.

Ask the ward for the discharge team early, and tell them what the house is like and who is at home. If the date comes before anything is in place, discharge is tomorrow and there is no care covers what to do next.

NHS continuing healthcare, and the fast trackSection titled NHS%20continuing%20healthcare%2C%20and%20the%20fast%20track

NHS continuing healthcare is a package of care funded entirely by the NHS for somebody whose needs are mainly health needs. The standard route runs through a checklist and a full assessment, and the National Framework says the decision should, in most cases, take no more than 28 calendar days. NHS continuing healthcare explains who qualifies.

The fast track is separate, and it is only for somebody whose condition is deteriorating rapidly and may be entering a terminal phase. A doctor or nurse responsible for their care completes one form, the local NHS board must accept a properly completed form and act on it immediately, and the framework says commissioning the care should not usually take longer than 48 hours. Fast-track continuing healthcare goes through the form and the conversation with the doctor.

Why a regular early-morning carer is the hardest thing to arrange quicklySection titled Why%20a%20regular%20early-morning%20carer%20is%20the%20hardest%20thing%20to%20arrange%20quickly

The morning visit covers getting up, washed, dressed, fed and given tablets. For somebody who cannot manage those alone it cannot wait until the afternoon, so everybody who needs that help needs it in roughly the same two hours, somewhere around seven to nine. A carer can only be in one house at a time, so their early mornings are the first part of their week to fill, and the last part to come free.

Asking for the same carer at a fixed early time, every day of the week, is the hardest version of that. It needs one person with the same free slot seven days running, which is rarer than a free afternoon or a free Tuesday. Continuity matters, and the same carer every visit is worth working towards, but this is the part of the week with the least spare capacity.

A few things widen the choice. A window of an hour, 7.30 to 8.30 rather than 7.30 exactly, lets more carers fit you in. Two carers sharing the week, one on weekdays and one at weekends, is easier to find than one carer for all seven mornings, and it gives you cover when one of them is away. If the morning is hard because nights are unsettled, overnight care or a live-in carer may suit your relative better than an early visit, and live-in care starts at £1,050 a week. The morning, lunch and tucking-in calls sets out what each visit covers.