How to arrange home care, from the first worry to the first visit

A lot of the worry in the first fortnight comes from not knowing which route you are on. A daughter who rings on Monday and hears the assessment will be in six weeks can think nothing may happen until then. The council route decides whether the state pays towards the care, and puts in writing what your relative needs. It does not decide whether care may start. Home care covers what care at home involves once it is running.

Turn the list into a week rather than a wish: two hours on a Tuesday morning is something a carer can plan around. How many visits a week your parent needs turns tasks into hours, and the care plan guide covers what a plan should contain.

1. 1

   Ring adult social care at the right council

   Ten minutes

   Adult social care sits with the county council or unitary authority where your relative lives, not where you live. The gov.uk lookup takes you to the right team.
2. 2

   Ask for a care needs assessment, in those words

   The phrase that matters

   Give the name, address and date of birth, say why you are worried, and ask for a care needs assessment under the Care Act. Naming it puts you in the right queue.
3. 3

   Say so if savings have already been raised

   Section 9(3)

   The Care Act says the assessment happens regardless of the level of the adult’s needs or the level of their financial resources. Money is looked at separately, afterwards.
4. 4

   Ask for a carer’s assessment for yourself in the same call

   A separate right

   If you are the one doing the caring, you have your own right to be assessed, whether or not your relative accepts help. What a carer’s assessment is explains what it covers.
5. 5

   Ask for a date, and write down who gave it to you

   There is no legal limit

   The statutory guidance asks for an assessment over an appropriate and reasonable timescale, and for the council to give an indicative one. Ring back if the date passes.

Your relative has to agree to be assessed, and a refusal is not permanent. Where it comes from pride or a fear of losing the house, how to get someone to accept care covers the conversation before the phone call. What a care needs assessment is, and how to ask for one goes through the day itself and the three tests the council applies.

The assessment looks wider than paid visits. A council has to consider whether equipment, an adaptation or something in the community would help instead, so it sometimes ends in a handrail or a key safe rather than in hours. Home adaptations that reduce the need for care covers that.

For care at home the value of the house your relative lives in is left out of the capital calculation, so the home is not in the sum the way it would be for a permanent care home place. Councils are not obliged to charge for care outside a care home at all, so what somebody pays in the next county is no guide. Local authority funding works through the financial assessment and self-funding your care covers the position above the limit.

Four sources of help sit outside the council's calculation and are worth chasing in parallel.

Ask about a direct payment as well. Where the council has agreed to meet some of the cost, section 31 of the Care Act lets the money be paid to your relative, or to somebody they nominate, instead of the council arranging the care. That is the point at which a family can choose the carer rather than take whichever provider holds the council's contract. What care costs where you live prices a week in your relative's area.

Over about 35 hours a week the sums change again. Three visits a day plus the weekly shopping comes to 30 or 40 hours, and at that point live-in care costs less than the visits and covers the nights. The hourly cost of care at home sets the figures out in full.

A home care agency has to be registered with the Care Quality Commission before it starts work, because personal care given in somebody's home is a regulated activity. An introductory service with no continuing part in directing the care sits outside that registration, and so does a carer your relative engages directly. PrimeCarers is an introductory service and holds no CQC registration. How home care is regulated explains what that changes, and the CQC directory lets you read the inspection report for any agency you are considering.

Trust what you hear on the phone more than what you read on a page. Ask what happens when the carer is ill or away, because cover is easy to forget until you need it.

If the arrangement is not working, say so early and say what is wrong. A carer would far rather be told in week one that the mornings are twenty minutes too late than find out in month three. Where it cannot be put right, notice is 48 hours for hourly care, and cancellations and late-running visits covers what is then payable.

Free help with the arguing exists. Age UK advises on getting care arranged, Carers UK is the charity for family carers, and Citizens Advice covers benefits and the complaints route.

If the council will not be paying, carers on PrimeCarers set their own rates, which run from £18 to £25 an hour with our fee included, against £28 to £35 from an agency. You can search carers near your relative and compare their rates, reviews and availability before you have heard back.