What a carer can do in one hour

The list a carer works down is not the same as the list a family writes. A carer does medication and personal care first because those are the jobs with a consequence attached, then food, then the house, then company, then the errands. When the time runs out it runs out at the bottom of that list, which is why the housework is what gets dropped and why the conversation is the first casualty of a short visit.

Medication is the one job in that hour with no give in it at all: our guide to medication at home explains what a carer can give, what has to be signed for and what needs a district nurse instead.

That is a good hour, and it is a real one. What it does not include is the washing up from yesterday, a load of laundry, a change of bedding, or fifteen minutes sitting down together. Families are often surprised by that, and the surprise is a useful one: it usually means either the visit should be 90 minutes, or the housework should move into a longer weekly visit of its own. Both are covered in the standard home care visits.

The fifteen minutes of company in the second hour do more work than they look like they do. Somebody who has had a proper conversation eats better, moves more and rings their daughter less often in a panic. It is also when a carer picks things up: the letter from the hospital that has not been opened, the bruise on the arm, the fact that the same jumper has been worn four days running. That is the case for companionship care as part of a visit rather than as a separate thing you buy later.

Six hours at about £18 an hour is £108, against £120 if you booked the same six hours as short visits at the usual rate. Carers advertise the lower figure because one long booking is worth more to them than six scattered hours: no travelling between calls, no gaps they cannot fill, and a day they can plan around. Not every carer offers it, and the rate is theirs to set, so ask when you message them.

A half day is what most families need when they say they need respite. Four hours on a Wednesday afternoon, every week, is enough for a family carer to see a friend, go to their own GP or sleep. It is a different thing from booking a week off, which is covered in respite care, and it costs £72 to £100 a session.

Three things stretch a visit and none of them are anybody's fault. A bad night means a bed to strip and a full wash rather than a wipe. A confused morning means every step has to be explained twice, and hurrying makes it worse rather than better. And pain, especially first thing, turns a two-minute transfer into a ten-minute one. If a visit is running over most days rather than occasionally, that is telling you something: the visit is the wrong length, rather than the carer being slow.

The one that comes up most often is cleaning. A carer will wash up after the meal they cooked, wipe the surfaces and change a bed. Booking a carer to deep clean a house at £20 an hour is expensive and means the personal care gets rushed, and a separate cleaner costs less. Where exactly the line falls, and what to write in the care plan, is set out in shopping, cooking and cleaning: what counts as care and in our guide to personal care.

1. 1

   Write down what has to happen

   5 minutes

   Write it in order, from the front door to the front door. Be specific: "helped to the toilet, washed at the sink, dressed, tablets, porridge, dishes done" rather than "morning help".
2. 2

   Put the minutes from the chart above against each one

   2 minutes

   Use the planner at the top of this page. Add nine minutes for arriving and leaving, and add 18 more on the days there is a shower.
3. 3

   Round up to the next half hour

   1 minute

   Seventy minutes is a 90-minute visit, not an hour you hope stretches. Visits on PrimeCarers are booked in half hours with a one-hour minimum, so the rounding is small.
4. 4

   Book it, then change it after a fortnight

   Week two

   Ask your carer whether the length is right. They will know within three visits, and adjusting is a message rather than a contract change. If the visits are creeping up towards 35 hours a week, look at live-in care instead.

Booking length and booking frequency are separate decisions, and it is worth making them separately. Two hours three times a week does more for someone lonely than an hour six times a week, and the reverse is true for someone who needs medication at fixed times. If cost is the constraint, the hourly cost guide shows what each pattern comes to, and weekend and evening rates covers the days that are priced differently.