There may come a time when it is helpful to get some paid care support. Maybe the person you care for needs extra support after an illness. Or perhaps you are getting older yourself, and are less able to do some of the physical tasks involved in caring. Getting paid help is not always an easy decision to make. As well as the costs involved, it might feel strange to have someone take on some of the personal care you may have been doing yourself.
It can be a big adjustment – both for you and the person you care for. But it can be hugely helpful in making your caring role more manageable and less stressful.
This information will help you to navigate the first steps in accessing paid care. The help we refer to in this section is personal care (like washing, dressing and eating), rather than home help (like laundry, washing up or gardening).
Identify what someone might need more help with at home
This is the first step to identifying what type of care would be most helpful. They are free and can be arranged through the adult social services department of your local council.
They are different from a carer’s assessment (which focuses on your needs as a carer). You could arrange for one at the same time.
Care needs assessments are usually scheduled annually, but you can request one at any time. Both the NHS and Age UK have helpful information about what to expect and how to prepare for one.
After the care needs assessment, the person you care for will receive a care and support plan.
This will clarify what support is needed, and might include help with:
- Personal care.
- Bathing and dressing.
- Eating and drinking.
- Preparing meals.
- Managing medications and collecting prescriptions.
- Shopping.
- Specialist support for a condition.
- Companionship.
Funding care
Most people have to pay for social care – or at least contribute towards it. It can feel overwhelming when you start looking at costs, but there is advice available, such as the Money helper tool. You can also speak to a specialist care fees advisor.
If the council finds the person you care for to be eligible for care and support at home, they will then carry out a means test (or financial test). This will take into account the income and savings of the person you care for.
The means test does not take into account the value of someone’s property, unless they are moving into a care home.
If the person you care for has:
- £14,250 in total, they will be entitled to the maximum funding available.
- Between £14,250 and £23,250, they will be entitled to some funding.
- £23,250 in total, they won’t be entitled for funding and will be a ‘self-funder’.
You can read more information in ‘Getting local council funding for care costs’.
Direct payments
If the council does provide funding towards care, it’s called a ‘personal budget’. You can either choose for the council to manage this budget (and they will arrange care) or you can request direct payments (and arrange the care yourself). It’s also possible to have a combination of the two.
You can read more in our ‘Personal budgets and direct payments’ guide.
NHS continuing healthcare
If the person you care for has long-term complex health needs they may qualify for free care which is arranged and funded by the NHS.
Speak to your healthcare provider, doctor or social worker if you think the person might be eligible for this and they will arrange for an assessment.
How to access care
Access care through the local council
The process for accessing support through the local council will differ depending on where the person you care for lives. But essentially, after a care needs assessment, the local authority will provide a care plan. You can then choose for them to arrange the care and manage any funding that’s been allocated.
Arrange care yourself
Here you have two main options:
- Getting care through an agency: The agency supplies their own professional care staff and manages the service. An advantage of this is that if a carer is ill or on holiday, another professional carer will step in. This option can be more expensive, though more straightforward than hiring someone direct. It can be helpful to ask for recommendations from people you know.
- Employing a private carer: This is likely to mean taking on the responsibilities of an employer, such as paying national insurance and pension contributions.
A benefit of employing a carer direct is that you’ll be able to choose someone who is a good personality fit, rather than being allocated someone through an agency. It’s worth noting however that UK care regulators don’t monitor care organised in this way.
Whichever route you choose, meeting with different providers and carers will help you to make an informed decision.
Our ‘Arranging help at home’ guide has lots of information which applies to personal care as well as home care. Or visit the Which? website which has checklists of questions to ask prospective agencies or carers.
Becoming an employer
If you are employing an individual, rather than going through an agency, you could technically be their employer and that brings certain legal requirements, such as paying sick leave and pension contributions. We include a lot of information about this on our ‘Arranging help at home’ page. Scroll down to the ‘Should you employ your own help at home’ section. It might take time to find the ‘right’ carer. Ask all the questions you need beforehand, check references, and, if possible, take time to make your decision.
It’s also important to include the person you care for when choosing a paid carer, to whatever extent is possible. This can help them to feel more comfortable with their new caring arrangements. You can read more ideas to help the person you care to make decisions about their future here.
Here are a few key questions to ask before deciding on which carer to employ:
- Can the person you care for afford the cost? Are they eligible for any financial support and if so, how much?
- Does the carer offer the hours and times you need?
- Does the carer have experience in looking after someone with similar needs to the person you care for?
- What training has the carer received? Are their qualifications up to date?
- What needs or preferences does the person you care for have about who cares for them?
Helping someone to prepare for involving paid carers
When the person you care for doesn’t want paid care
It can be upsetting if the person you care for doesn’t want paid care. You might feel guilty about involving other carers, or frustrated if the person can’t understand why extra support is important.
It can be helpful to involve them in any decisions about their care, as far as possible. It may also be useful for another family member or friend speak with them. Sometimes hearing information from a different point of view can make all the difference.
Care plans, emergency care plans and
advanced care plans
A care plan is really helpful when there are both paid carers and family members involved in caring. This plan or log allows people to keep track of the care that’s been carried out (for example what breakfast they’ve had / what medication has been given). Some carers will have their own systems, but this care plan template can be a useful starting point.
It is also important to have an emergency care plan in place, which includes all the information someone would need if stepping in as a carer in an emergency. We detail all the information you need to include in our guide ‘Planning for emergencies as a carer’. Share this with any carer who is involved in caring for the person.
Also make the care company or paid carer aware of an advance care plan if you have one. This contains the person’s wishes, needs and preferences around their care in the future, if they are ever unable to verbalise them.
Communicating preferences and boundaries with a care agency
Understandably, the person you care for might feel wary of having someone new care for them. Talking to them about any fears, and their care preferences, can help them to feel more comfortable about the situation.
Those preferences might include:
- Religious beliefs which may affect care (for example, not wanting physical contact from a carer of a different gender, types of medical care).
- Personal preferences (not wanting to be showered by someone of a different gender or wanting to go to bed at a particular time).
- Things that they want to do themselves (if they can do them safely).
You can share these with the agency by:
- Setting up a meeting before care provision begins.
- Creating and sharing a one-page profile under the headings: what people appreciate about me, what’s important to me and how best to support me.
- Writing down a regular routine to share with the carers.