What a sitting service is, and how to get one

The reason to know these words is that the same service has three names depending on who you are talking to. The council may call it replacement care, the charity may call it a carers break, and the leaflet in the GP surgery may call it sitting. Ask for all three and you will find more than if you ask for one.

Sitting sits at the small end of a family of things that all do the same job, which is giving the person doing the caring some time back. A few hours a week is sitting. A whole day is day care, and a week or a fortnight is respite care. If you are reading this because you are exhausted rather than because you have an appointment, read when to consider respite care as well, and the signs of carer burnout.

The pattern most families end up with is a free scheme for the regular weekly slot and a paid carer for everything the scheme cannot cover: the evening appointment, the weekend away, the fortnight when your own back gives out. There is no reason to pick one route and stick to it.

The row that catches people out is the waiting time. A free scheme takes weeks to start, and often an assessment first, which is entirely reasonable when what you need is a regular Tuesday afternoon from next month. It is no use at all when the appointment is on Thursday. So start the free application now, because it costs nothing and the list only moves if you are on it, and book what you need for this month separately.

Say the same thing to each of them: who you look after, what you do for them, how many hours a week that takes, and what you would use the time for. Carers services are used to that conversation and it is what their forms ask for anyway. If you have never registered as a carer with the GP surgery, do that on the same call, because it puts you on the list for the flu jab, for carer health checks and, in many areas, for the sitting schemes themselves.

Two things worth knowing before you ring. The first is that a lot of schemes want a carer's assessment done before they will allocate hours, and that assessment is free, is your right, and does not depend on the person you care for having had one. The second is that in many areas the local hospice offers sitting, including night sitting, for people receiving palliative care, and families often do not ask because they think a hospice is only for the last few days of life. That is not what a hospice is for.

There is a sensible reason for every one of those. A volunteer is not trained, not supervised for care tasks, and not insured for them, and a scheme worker is employed under a job description that says company and supervision. Asking a sitter to help your mother onto the toilet puts them in a position they are not allowed to be in, however willing they are.

So work out what the two or three hours need to contain. If the answer is that somebody sits with Dad while you go out, a free scheme is a good fit and you should chase one. If the answer is that Mum needs the toilet twice in that time, or her tablets at two o'clock, or lunch cooking, you need a carer, and pretending otherwise makes for an uncomfortable afternoon for everybody. Our guide to what carers can do with medication sets out the line on tablets specifically.

The last difference is not about tasks. A free sitter is a favour, and favours are hard to use often. Families find they will not ring to change a day, will not ask for an extra hour, and will not say when something has not gone well. A carer you are paying is a working arrangement, and most people find it easier to be straightforward about what they need. Neither one is better than the other. They are simply different, and the one worth having is the one you will use.

Four hours once a week, the highlighted row, is what most families book first: an afternoon that is properly yours, every week, at £72 to £100. It is the smallest amount of paid help that changes anything, and it is the size of break that people keep taking rather than cancelling.

Nights are priced differently, because a night is a shift rather than a run of hours. A sleeping night, where the carer goes to bed in the house and gets up if needed, is £130 to £145. A waking night, where they stay awake, is £150 to £160. If the reason you cannot cope is that you are up three times a night, that is the number to look at rather than any daytime figure. Overnight care sets out both, and short-term night care after hospital covers the version families book for a fortnight.

1. 1

   Ring your local carers centre today

   20 minutes, free

   Search for your council area plus the words carers centre. Ask what sitting, carers break or replacement care schemes run locally, and ask them to refer you. While you are on the phone, ask about a carer's assessment.
2. 2

   Ask the council for a carer's assessment

   Free, your right

   It is a separate assessment from the one for the person you look after, and you can have it even if they refuse theirs. It is what unlocks funded replacement care, and it takes your own health seriously for once.
3. 3

   Decide what the hours have to contain

   10 minutes

   Write down the day, the length, and the tasks. If the list is only company and safety, a free scheme fits. If it includes the toilet, tablets or a meal, you are booking a carer.
4. 4

   Find two or three carers and talk to them

   This week

   Search by postcode, read the profiles and reviews, and message the ones who look right. Every carer on PrimeCarers is interviewed online, and we check their identity, their right to work and an enhanced DBS before they appear. Carers are insured while they work. Tell them plainly that this is so you can get out of the house.
5. 5

   Start small and keep it in the diary

   Week 1

   Book one block a week, on the same day. Stay in the house the first time if the person you care for is anxious, then go out for an hour, then go out properly. Add hours once it is working rather than starting big.

There are two practical things worth adding. Tell the person you care for what is happening and why, in ordinary words, rather than presenting the sitter as a visitor. People work out what is going on, and being managed feels worse than being asked. Our guide to getting someone to accept care is useful here, and if there is dementia in the picture, the dementia care guide covers how to introduce a new face.

And keep the same person if you can. A sitter who has been three times knows where the tea is, what programme is on at two, and what your mother is like on a bad day. That knowledge is most of the value, which is why the same carer every visit matters more here than almost anywhere else. If the few hours turn into something bigger, how many visits a week your parent needs works the whole week out, and companionship care covers the version that is about the person rather than about you.