How to get the same carer every visit

There is a second benefit that families rarely predict. Continuity is worth as much to you as it is to your relative. Knowing the name of the person who will be there at eight tomorrow morning, and being able to text them, is the difference between care you have arranged and care you are still worrying about. Families with one carer tend to stop checking. Families with a rota carry on managing it themselves.

It works the other way round as well. A carer who knows somebody well also knows what is not a problem. They will not ring you at nine at night because your mother was quiet, if quiet on a Thursday is what she has always been. Families with a rota tend to get two kinds of message: nothing at all, or alarm. A carer who knows your mother can tell you which of the two it is, and that judgement is what you wanted in the first place.

Nobody can spot a change without knowing how things were before. That is why care notes matter so much and why they are worth reading, and it is why the most useful question to ask any care provider is not about training or qualifications. It is this: how many different people will my mother see in a month? How to find the best carers and what makes a good carer cover the rest of what to ask.

Two or three ticks and continuity should be near the top of your list when you choose. Five or more and it should be the first question you ask anybody, before price. If dementia is in the picture, the dementia care guide explains why familiarity does so much of the work, and what is sundowning covers the time of day when an unfamiliar face causes the most trouble. If the visits involve washing and the toilet, personal care and privacy and dignity of the elderly are worth reading before the first visit.

An agency employs staff, pays them by the hour and has to cover every client every day. Somebody calls in sick, somebody leaves, a client comes out of hospital and needs three visits a day from Friday, and the rota is rebuilt around whoever is available. The coordinator is doing their best with an impossible puzzle, and the way the puzzle gets solved is by moving carers. Add high staff turnover across the sector and short visits packed back to back, and the same face every day becomes something an agency can aim at rather than something it can promise.

What you get in exchange is real: the agency owns the problem. If nobody turns up, that is their failure to fix, at any hour. That is the actual product you are buying at £28 to £35 an hour, and for some families, particularly with complex needs and no local relatives, it is the right trade.

PrimeCarers works the other way round. Every carer is self-employed, sets their own rate and takes on the clients they choose. You look at profiles, reviews and rates, talk to two or three, and pick one. That carer is the one who comes, because they agreed to those visits with you rather than being assigned them. The trade is the mirror image of the agency's: you get continuity, and you take on the cover problem. The next two sections are about solving it before it happens. Agency or private carer and private carers vs agency carers set out the whole comparison, and moving from agency care to a private carer covers the switch.

The most common reason a private arrangement ends is not the care itself. It is money and hours. A self-employed carer is building a week out of several clients, and a client whose visits move about or get cancelled without notice is the one that gets dropped when a steadier offer comes along. A predictable, properly paid pattern of visits is the single strongest thing you can do to keep the person your mother likes. Cancellations and late-running visits covers the notice periods, and building a positive relationship with your private carer covers the rest.

1. 1

   Get the main carer settled first

   Weeks 1 to 4

   Do not try to arrange two people at once. Choose one carer, agree a regular pattern of visits, write the routine down and let a month pass. You will know quite quickly whether this is the right person, and it is easier to change one carer than two.
2. 2

   Ask your carer who they would recommend

   Week 4

   Carers know other carers locally and they know who is good. A recommendation from the person already doing the job is the best lead you will get, and the two of them will hand over properly because their reputations are linked.
3. 3

   Book the second carer for real visits

   Week 5 onwards

   Give them one regular visit a week, or the Saturday, or the shopping run. A cover carer who has never been to the house is not cover; they are a stranger with a key safe code. One visit a week keeps them current and keeps them willing.
4. 4

   Keep one written routine that both use

   Ongoing

   The same care plan, the same notes and the same folder in the kitchen, covering where things are, how she likes things done, what the medication is and who to ring. Two carers working from one written routine are a small team. Two carers working from memory are really two separate arrangements.
5. 5

   Agree what happens in an emergency

   Before you need it

   Write down who rings whom, in what order, and by when. If neither carer can make a visit, our team will do their best to find vetted cover at short notice, and a plan already on paper makes that far quicker.

Families sometimes resist this because a second carer feels like a step back from the thing they wanted. In fact it works the other way round. The point of the second carer is to protect the first one: the main carer can be ill, take a holiday, go to a wedding and come back to a client who is still theirs. Arrangements with no cover are the ones where a family panics in week nine and books an agency, and the good carer loses the work permanently.

Ask about holidays at the start rather than in June. Most self-employed carers take two to four weeks a year and will tell you the dates months ahead if you ask, which is all the notice you need to arrange cover properly. Illness is the one you cannot plan, which is why the second carer needs to be somebody who has already been to the house.

A hospital stay is the gap families handle worst. Visits stop, the carer loses the income, another client fills the slot, and your mother comes home to nobody. If your relative goes into hospital, tell the carer the same day, agree how you will keep in touch, and if the stay is short consider paying a retainer or keeping one visit a week for the house. When she comes home she will need more care rather than less, and coming home to the person she knows is worth a great deal. Hourly care after a hospital stay covers what that week looks like.

Finally, be realistic about what one carer can cover. If you are heading towards three visits a day plus weekends, you are close to the point where one person cannot hold it alone, and where live-in care from £1,050 a week starts to cost about the same as visits and gives you a single named person for the whole day. Live-in carers work in rotations too, usually two people alternating, so ask about that when you compare.