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Home Care, Nursing & Companion Services

The Independent Option

Almost all Home Care and Home Nursing services will be available from independent, voluntary or private, agencies in your area. Many agencies provide both Home Care and Home Nursing services. However, recruitment levels are not all that they should be – and agencies may not, therefore, always be able to provide a service for you.

With the exception of some specialist organisations which provide volunteers to ‘sit’ with people whose family carer needs some time off, there is likely to be a charge for services. A comprehensive regional listing of Care Agencies is provided (see below).

You could, of course, employ your own staff to provide the support you need. This might seem a daunting task, but there may be some help available with the recruitment and with the responsibilities of being an employer. This help may be obtained from either the independent Care Agencies, or from organisations run by people with disabilities themselves who assist and promote independent living. A listing of some of these Independent Support Organisations is provided.



How to choose a Home Care or Nursing Agency

Home Care agencies providing domociliary care are registered The Care Quality Commission (CQC).

The majority of agencies we have listed are members of the United Kingdom Home Care Association (UKHCA), set up in 1989 to identify and promote high standards. All members have to go through a vetting system. The UKHCA can be contacted by calling 020 8288 1551.

Alternatively, or in addition, you could consult your local Social Services department, or look in the Yellow Pages. Do not be put off if there does not appear to be an agency in your immediate vicinity. Many agencies cover a wide area and are not confined to specific local or health authority boundaries.

Telephone a few organisations. Ask them to send you their brochure and price list, which should include Terms and Conditions of Business. Ask about any specific services you want, such as night care, live-in care, home nursing etc.

Most agencies will offer to visit you to discuss your needs in more detail. Establish that you are under no obligation and that there would be no charge for such a visit. For an extensive ‘check list’ of key questions which should be useful to apply at a first meeting, click here.





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Live-in Services

Having someone to live in your home is probably the most economical and satisfactory means of obtaining help – particularly if you need a lot of support, or if more than one person in the household needs assistance. In return for a basic weekly wage, accommodation and food you will get nearly full time assistance.

Live-in care can be for short periods, perhaps when a family member is on holiday, or immediately after discharge from hospital, or it can continue over the longer term.

There are basically two models for providing live-in help:

(i) The agency provides a rota of care workers or companions, each one staying for one or two weeks, with the guarantee of someone to take their place. Usually the same workers return regularly.

(ii) The agency introduces one care worker/companion who stays as long as she/he is needed and so long as you are both happy with the arrangement.

Some people prefer the former arrangement and enjoy getting to know a small number of care workers who return regularly. The system is also likely to be less expensive, because workers will not need to have as much time off when they are staying for a shorter period. However, the latter scheme provides better continuity of care if that is your priority.

Whichever type of service you choose, you will need to provide a comfortable bedroom and access to a television (preferably in the bedroom). Live-in workers should be treated as a member of the family, but they should also have some formal time off each day. Agencies will have their own terms for live-in workers, but they will be bound by the European Working Time and the Minimum Wage Regulations.

In summary, live-in workers should be able to provide a full range of domestic and personal support, although they would not normally be expected to do heavy cleaning tasks.

Many Home Care or Nursing Agencies provide live-in services as well as their normal daily or hourly care services. There are, however, some agencies which specifically provide live in care and supply their services on a national basis.

There is also potential for an ‘au pair’ arrangement – to meet the needs of an older person who needs little personal assistance, but who needs some domestic support and companionship. Normally, ‘au pairs’ are young people who come from abroad to learn English. They must have adequate time off to attend English classes and to participate in some social life. They would receive a modest wage, accommodation and food.

If you are interested in such an arrangement, contact an ‘au pair’ agency. You will find such agencies in Yellow Pages.

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Homeshare Services

Homeshare is a fairly new concept and is, as yet, only available in a few places in the UK. A listing of organisers is provided below. Homeshare is a reciprocal arrangement whereby a householder offers accommodation in return for a specified amount of companionship and support.

For schemes to work satisfactorily, they need to be properly set up and managed, providing support and training for both householder and helper. The aim should be to ensure that there is equality of expectation on both sides.

Normally, householders are in their 80’s and 90’s with needs varying from simple companionship to more complex support requirements. Homeshares must be aged 25 years or over and be working or studying during the day. A minimal commitment of six months is usually required of the homesharer.

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Employing Your Own Staff

If you have someone who could advise and support you, your choice might be to recruit your own home care staff.

Issues which need to be considered are:

Advertising for staff
What you are looking for will dictate where and how you advertise. If you are seeking someone to provide support for a few hours each week or on a daily basis, consider advertising in a local newspaper, on newsagents’ boards, or in a local Church magazine.

If you are looking for live-in help, a national newspaper, magazine, or one of the papers which are aimed at young people travelling and working in the UK, are more likely to be productive.

A Home Care agency in your area might help you to recruit your own staff and advise you on what to expect. It would also be able to provide cover if your employee is unavailable for any reason.

Never give your own address in any advertisement. Wherever possible a Box Number for a newspaper advertisement is safest, or a friend might agree that replies could be sent to his/her address and forwarded to you. Alternatively, your telephone number will enable an applicant to make direct contact with you.


Interviewing applicants
It is essential to interview anyone whom you are thinking of employing. Get a friend to do this with you if possible. Think about the questions you want to ask beforehand and be clear about what you want from the arrangement, particularly regarding the specific tasks you will need done. Decide how much you can offer to pay, how much time off (for a live-in staff) you will give, and so on. Candidates may ask you to pay their travelling expenses for coming to an interview.


You should get at least two references, one of which should be from the candidate’s last employer and neither should be from a friend or family member. Preferably, you should ask for names and addresses and write for the references yourself – or ask a friend to do this for you. If you are presented with ‘open’ references, be sure to telephone and check that they are genuine.


Being an employer
If you are employing someone regularly, or on a live in basis, you will need to operate a domestic PAYE scheme. This is not difficult, but you will need some help to set it up. You will then be deducting tax and the employee’s National Insurance contribution from his/her wages and adding to it your employer’s NI contribution. Every month you will need to send this accrued sum to the Inland Revenue.

In addition to accounting for tax and NI payments, you will also have to provide 4 weeks’ paid leave each year. This would be pro rata, so that the pay which your worker receives on their holiday weeks would be the average of the pay they had received from you during the previous 13 weeks. Staff cannot go on paid leave unless you have agreed that the timing is convenient for you.

If you are intending to employ a live in worker, you will need to observe the regulations which limit the number of hours anyone can work without a break and the requirements for time off.

You will also need to check that your household insurance covers your potential liabilities as an employer of someone who is working in your home. If one of your requirements is that your employee should drive your car, you must also make sure that the car insurance covers all drivers (and don’t forget that you also need to make sure that he/she has a valid driving licence).

All of this may sound rather daunting. However, many people have found direct employment a very satisfactory way of providing themselves with the assistance they need. You can specify exactly what you want and you can remain in full control of the situation. You should not, however, choose this route unless there is another responsible adult who is aware of the situation and on whom you can call if there are problems. You will also need to think about how you will get the help you need if your worker is off sick or on holiday.


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