Shopping, cooking, cleaning: what counts as care

Two things tend to surprise people once they have worked through all twenty. The first is how much housework already sits in the care column. Nobody has to negotiate for the washing up, the bed, a load of laundry or a wiped-down bathroom; those are part of any decent visit and no carer will bill you for them separately. The second is how short the domestic help column turns out to be. Families usually arrive at this question braced for a long list of refusals, and find five items, every one of them a job somebody else does better and for less money.

The third column, the one in the middle, is where the useful conversation lives. It is also the one families skip, because each job in it feels too small to raise. Raising it is exactly the point: seven small unspoken assumptions are what turn into a bad feeling by March.

The reason this matters is not fussiness about job titles. It is that the hour is finite. If a carer arrives for a one-hour morning call and spends twenty minutes hoovering, your mother gets forty minutes of care instead of sixty, and the wash gets rushed. Families who work out the three groups in advance nearly always end up buying the same number of hours and getting more care inside them.

There is one more reason. Carers on PrimeCarers are self-employed and set their own rates and their own limits, so what you are doing here is preparing a short conversation rather than reading out a rule book. Some carers love shopping and will happily take on the dog. Others would rather not drive at all. Both are fine, and both are easier to find out in the first phone call than in week three.

Two hours is the visit length most families settle on once they have tried an hour, and this is why. An hour covers the person. Two hours covers the person and leaves the house working as well. The what a carer can do in an hour guide walks through the shorter version, and minimum visit length explains why nothing under an hour is worth booking.

If your budget only stretches to one hour, spend it on the person and let the house wait. A good carer will still get the plates washed and a wash on, because those happen alongside the meal rather than instead of it. What they will not be able to do in sixty minutes is the shop, the bed linen and a walk to the postbox as well. Trying to fit all of it into an hour is how a visit turns into a rush, and a rushed visit is the one your mother will tell you she did not enjoy without being able to say why.

Two of these deserve a word on their own. The first is the food shop. It is one of the most useful things a carer can take off a family, and it is also where money goes missing in badly run arrangements, so handle it properly from day one. Give the carer a prepaid shopping card loaded with a set amount, or your relative's own card with a receipt filed after every trip. Never share a PIN, never let cash change hands for the carer's own time, and keep the receipts somewhere a second family member can see them. The comparison of carer shopping cards sets out the options.

The second is the dog. Families are often embarrassed to raise it, and they should not be. For a lot of people living alone the dog is the reason they get up, get dressed and leave the house, so keeping the dog going is keeping the person going. Feeding and letting out takes a minute and no carer will make a fuss. A 30-minute walk is half a visit, so book it as half a visit.

The last one on the right is a different kind of line from the others. Cleaning an oven is a question of what you are paying for. Wound care, injections, PEG feeds and anything else that counts as a regulated clinical task is a question of law and training, and it belongs to a district nurse or a carer with specific training and a written delegation from a nurse. What carers are not allowed to do covers that boundary in full, and medication administration covers the one families ask about most.

The shopping itself is paid for by your relative, the same as it always was. What you are buying from the carer is the time and the trip. If the carer uses their own car, add mileage at 45p a mile; if they walk or take your relative's car, there is nothing extra. Cleaning products, bin bags and washing powder come out of the household budget too, so keep a small float or add them to the shopping list rather than expecting the carer to buy them.

There is nothing else added on: no agency fee on top, no charge for the care plan, no minimum contract, and no premium because the visit involved cooking rather than washing. The rate is the carer's own and it is the same for every kind of hour, which is one of the reasons families find it easier to plan. You pay after the visit has happened, through the platform, so there is no cash in the house and there is a record of every visit and every pound.

If the list of jobs is getting long enough that you are booking three or four visits a day plus a shopping visit and a cleaning visit, do the sum before you commit. Past about 35 hours a week, live-in care costs about the same and covers the housework, the cooking and the nights as part of the arrangement. How many visits a week does my parent need has an estimator that shows you where you are, and do live-in carers do housework answers the same question for the live-in version.

1. 1

   Write down every job, in order of the day

   10 minutes

   Walk through a normal Tuesday in your head, from getting up to going to bed, and write down everything that has to happen. Do not filter it yet. Add the weekly jobs at the bottom: the shop, the bins, the bed, the appointments.
2. 2

   Sort them into the three groups

   Use the sorter above

   Care, agree it first, domestic help. Anything in the third group needs a different person, and it is worth pricing a cleaner now so you can see the difference. A cleaner is usually about half a carer's hourly rate.
3. 3

   Go through the middle group with the carer

   First phone call

   Read the list out. Ask what they are happy to take on, how long they think each one takes, and what they would drop if a visit ran short. A carer who says no to two of them is being straight with you, and that is the carer you want.
4. 4

   Put it in the care plan and review it

   Week 1 and week 3

   Name the job, the day and roughly how long it should take. Then look again after a fortnight: some jobs turn out to take half the time, and some turn out to matter far more than you thought. A care plan that is never changed is usually one that nobody reads.

Most families write this list feeling as though they are asking too much, and most carers read it feeling relieved that somebody has finally written it down. Being specific is not the same as being demanding. The vaguest arrangements are the ones that end in resentment, because the carer is guessing and the family is disappointed about something they never said out loud. Building a good relationship with your carer and the care plan guide both go further on this.