Chapter 8 Choosing home care services

(Publication: Guide to Care at Home 2008-2009)

What you need to know about home care services

Do you just need your home cleaned?

Most of the home care organisations listed in the Guide to Care at Home and online offer packages of care rather than separate care services. Some cleaning companies are listed but, if you are only looking for help to clean your home, you may find the Yellow Pages useful (see under ‘Cleaning Services - Domestic’) or the small ads in your local paper. Ask for references before you employ a cleaner.

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Who can provide help in your home?

Help from the Adult Services Department

The Adult Services Department will assist people who qualify for their help to identify which resources and support can be put into place to enable them where possible to retain or maintain their independence. Help at home will only be arranged for people who need a great deal of support, for example, people who need help with their personal care and people who have just come out of hospital. Care may also be available to prevent people going into hospital. Initial help may come from the Adult Services Department, with ongoing long term care being provided by other service providers - see Chapter 1.

Help from privately-run and voluntary organisations

If Adult Services can't provide the help you need there are many care service providers in Hampshire, Portsmouth and Southampton that you can buy from. See Home Care services listed in the Guide for the range of care services they offer.

How much does care cost?

As you will appreciate, different kinds of care cost different amounts - for example, weekday domestic help will cost less than nursing care at night. There may also be premiums for very specialist care, for weekend care, and also for travel if you live in a remote part of the county - and some agencies will not provide less than two hours of some kinds of help.

If help is provided by adult services, and you have been assessed as needing to contribute towards the cost of your care, there is a set hourly charge. See chapter 6 for more details.

For care provided by privare organsiations, such as those listed in this Guide, you could expect to pay from around £8.25-£10.50 an hour for domestic help during the day. The cost of personal care is around £12-£15 an hour during the week with a higher weekend rate in some areas. Rates vary widely around the county according to local circumstances.

You should check the cost of care when you discuss buying care from the organisations listed in the Guide and online.

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Standards of care

Who sets the standards for organisations which provide care at home?

Every organisation that wishes to provide personal or nursing care services to people in their own homes has to be registered and inspected to ensure that it meets national care standards.

For explanations of what is covered by the terms personal care and nursing care see Home Care services listed in the Guide.

The Commission for Social Care Inspection (CSCI) is responsible for the registration and inspection of Domiciliary Care Agencies – which offer personal care and Nurses Agencies – which offer care from qualified nurses.

After they are registered, agencies are inspected at least once a year to check that they are complying with National Minimum Standards as set by the government. You can read Inspection Reports on the CSCI website at www.csci.org.uk or order a printed copy of a report by phoning 0870 240 7535.

Your local CSCI office
Commission for Social Care Inspection, The Oast, Hermitage Court, Hermitage Lane, Maidstone, Kent, ME16 9NT
tel 01622 724950
email: enquiries.southeast@csci.gsi.gov.uk

Employers’ Associations

Some home care organisations listed belong to local or national associations and this is indicated in the lists in the Guide and online. For more details about their standards/codes of practice contact:

Hampshire Domiciliary Care Association (HDCA)
tel 01730 710396
United Kingdom Home Care Association (UKHCA)
tel 020 8288 1551

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Non registered services

If you do not need either personal or nursing care, you may wish to contact organisations that offer other home care services. At present these services do not have to be registered or inspected. They include domestic help, shopping, transport/drivers, companion/social, sitting services, gardening and meals. Some are run by voluntary agencies such as Age Concern, others by private businesses.

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Home care services listed in the Guide

The list of organisations uses eleven separate categories of help so that you can find the organisation that offers what you need. A general description of what each category can include is given here, but when you contact any organisation you should check exactly what they can offer and whether they can provide it in your home area. As many organisations find it difficult to recruit staff, they may not always be able to cover the areas that they have told us about.

Domestic help includes tasks such as cleaning, washing up, laundry, ironing and window cleaning. Most of the organisations listed offer domestic help only as part of a care package.

If house cleaning is what you need, then the Yellow Pages lists companies under ‘Cleaning Services - Domestic’. You should ask for references before you employ a cleaner.

Shopping covers shopping, going on errands, collecting pensions, benefits or prescriptions.

Personal care is help with such things as getting up, going to bed, dressing, undressing, washing, bathing, personal hygiene, eating and drinking, using the toilet, managing incontinence, tooth and denture care. It also includes help with health related tasks (such as dealing with pressure sores or catheter or stoma care) that are done under the guidance of a doctor or community nurse. Personal care does not need to be carried out by trained nurses. All organisations offering personal care have to be registered with the Commission for Social Care Inspection (CSCI) - see Standards of Care.

Nursing care is given by qualified nurses, and can include tasks such as changing dressings or giving injections as well as general nursing care. All organisations offering nursing care have to be registered with CSCI - see Standards of Care.

Transport/drivers are organisations that can provide transport and drivers to take people for example, to hospital appointments, shops, church or to social functions.

Companion/social This category can include spending time with someone to help them learn new skills or skills for a particular task, for example to build their confidence in writing letters or making phone calls. It can also include going out with them so that they can take part in social, leisure, educational, religious or cultural activities.

Live-in help can be anything from a few days help in an emergency to long-term help. If personal or nursing care is included, organisations offering live-in help need to be registered with CSCI - see Standards of Care.

‘Sitting services’ allow carers to have a short break. Organisations offering this service can provide someone who will spend time in the carer’s home looking after the person they care for so that the carer can have some free time.

Night Care can be provided as both sleeping or waking night care. When you contact an organisation you should make clear what kind of care you need. If it involves any personal or nursing care, then the organisations needs to be registered with CSCI - see Standards of Care.

Gardening help offered by organisations listed here will probably include cutting grass and weeding. If you want more than this you should look in the Yellow Pages for organisations offering a full range of gardening services.

Meals This category can include the preparation of meals, provision of ready-cooked meals, advice about diet and help with preparing meals.

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Choosing a home care service

When you contact an organisation providing care at home you want to be sure that it offers a high quality service, with trained staff who can provide the care you need. You should be specific about the kind of help you want, and do not hesitate to ask questions - see ‘Questions to ask’.

It is important that you know exactly what to expect, how much you will be paying and what for, and that you have confidence that the people who will be visiting your home are capable of providing what you need.

If you have a sight or hearing impairment, ask whether home care staff have had training in caring for people with a sensory impairment.

If the organisation does not need to be registered - see Standards of Care - you might ask the manager for references from satisfied clients.

Ask to see the organisation’s brochure and a copy of any code of conduct that they have for their staff.

You may find that help from more than one organisation may be necessary to provide everything you need.

You can use the area lists on pages 74-80 to find which organisations operate near you. However, as many organisations find it difficult to recruit staff, they may not always be able to cover the areas that they have told us about.

The section starting on page 81 gives a detailed A-Z list of Home Care services listed in the Guide. you can contact.

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Questions to ask when choosing a Home Care Service

First discussions

Will you visit me in my own home to discuss what help I need?
Can I have a relative or friend with me when we discuss what help I need?
What happens if the care I need changes?

Staff

Have all your carers been interviewed and their references checked?
How else are they screened?
What training will my carer have had?
What qualifications will my carer have?
Will nursing care always be given by a qualified nurse?
Have all staff giving personal or nursing care had police checks? Staff need to be checked by the Criminal Records Bureau (CRB) and against the Protection of Vulnerable Adults (POVA) register (or POCA where working with children is involved).

Supervision

How do you supervise the work your carers do?
How do you check that they are doing what has been agreed?

Emergencies

What help can you provide in an emergency?
Who do I contact in an emergency?

Confidentiality

Who will have details about me and my care?
What personal information do I have to provide?

Handling money

What records do you ask your carers to keep if they are handling my money (for example, if he or she is doing shopping for me or collecting my pension)?

Charges

How much will my care cost?
Do you charge different rates for help at different times (for example, in the evening and at weekends)?
Is anything charged as an extra?
Will I get written confirmation of the cost of my care before it starts?
Will I be notified in advance about any changes in charges?
How do I pay you (for example, do you bill me each week)?

Insurance

Do you have public and employer liability insurance?
Do you have insurance covering losses arising from dishonesty?
Can I see confirmation in writing of your insurance cover?
What household insurance do I need (in case a worker injures him or herself, or household items get broken)?

Equipment

Do I have to provide any equipment?
What equipment do your carers provide?

Complaints

What can I do if I don't get on with my carer?
How do I make a complaint?
What do I do if I am not satisfied with the way my complaint is dealt with?
Do you have a formal complaints procedure?

Changes/cancellations

How much notice do I have to give if I need to cancel help?
Is there a charge if I have to cancel help at short notice?
Will you tell me in advance if my carer cannot come at the usual time?
Will you tell me in advance if a different carer will be coming?
Will you tell me in advance if you have to cancel my help at any time?
What notice do I have to give if I want to cancel services altogether?

Adult Services