Home care, often called care at home or domiciliary care, is support provided to you or a loved one in your own home rather than in a care home or hospital. It can be as light-touch as someone popping in for a chat and to heat up a meal, or as intensive as round-the-clock live-in care for someone with complex needs.
For many families in the UK, home care is the compromise that lets a person stay in the place they know best, surrounded by their belongings, routines and community, while getting the practical and personal help they now need.
This guide explains what home care looks like day to day, the different types of support available, how funding and assessments work, and how to choose a provider without feeling overwhelmed.
Why home care exists and who it helps
If you have never needed care before, it can be hard to know where the line is between “coping” and “needing help”. Home care often sits in that middle ground.
It exists for situations like:
- an older person who can still make a cup of tea but cannot safely get in and out of the bath
- someone with early dementia who feels settled at home but gets confused with medication
- a person leaving hospital after a fall or surgery who needs support to rebuild strength and confidence
- an adult with a disability who needs help with specific tasks such as transfers, personal care or cooking
- a family carer who is becoming exhausted and needs regular support to keep the arrangement safe
Home care is most often used by:
- older adults who want to stay at home as long as possible
- people with disabilities or long-term conditions, including physical, sensory and learning disabilities
- people with dementia at different stages
- people recovering after hospital stays
- people nearing the end of life who want to remain at home with family
A key idea is least restrictive support: giving enough help to stay safe and well, without unnecessarily taking away independence.
Main types of home care in the UK
Home care is not one fixed package. It is a set of building blocks that can be combined depending on what the person needs. Understanding the main types helps families avoid both under-buying and over-buying care.
1. Personal care
Personal care is hands-on support with daily living. It covers the intimate tasks that can become difficult when mobility, strength, memory or balance changes.
It usually includes:
- Washing, bathing and showering — helping someone wash safely, use a shower chair or grab rail, dry properly and avoid skin problems.
- Dressing and undressing — helping with buttons, zips, compression stockings, weather-appropriate clothing and dignity.
- Toileting and continence support — helping someone get to the toilet, change pads or manage continence needs discreetly.
- Mobility and transfers — helping someone move from bed to chair, chair to toilet, or use equipment such as hoists or slide sheets safely.
- Eating and drinking support — preparing simple meals, cutting up food, encouraging fluids and reducing the risk of dehydration or malnutrition.
- Medication prompts — reminding, observing and recording that medication has been taken where this is part of the care plan.
Example:
Tom is 79 and has Parkinson’s. He can still hold a conversation and walk short distances with his frame, but mornings are difficult. A carer visits for an hour each morning to help him wash, dress, shave, take medication and prepare breakfast. Tom spends much of the rest of the day independently, and his daughter no longer has to rush over before work.
Personal care is often the backbone of a home care package. Other support is usually built around it.
2. Companionship and social support
Companionship care is sometimes dismissed as “just a chat”, but isolation can have a serious effect on physical and mental health. For some older people, especially those who have lost a partner or live far from family, the biggest risk is not a single medical condition but loneliness, low mood and gradual withdrawal.
Companionship care might include:
- Regular conversation and company — sharing a cup of tea, listening, playing cards or supporting hobbies.
- Help getting out of the house — going for a walk, visiting a library, attending a day centre, going to a faith group or meeting friends.
- Support with appointments and errands — accompanying someone to the GP, pharmacy, bank, hairdresser or local shops.
- Monitoring wellbeing — noticing changes such as confusion, breathlessness, poor appetite, low mood or increased falls risk.
Example:
Eileen’s children live far away and work full time. She is physically fairly fit but lonely. A carer visits twice a week to play cards, go for a short walk and check she has food in the house. The carer later notices Eileen’s memory seems worse and helps the family arrange a GP appointment.
If mood, anxiety or carer stress are becoming part of the picture, our guide to how to access mental health services in the UK explains where support may come from.
3. Practical and household support
Sometimes the main problem is not personal care, but the effort of keeping a home safe, clean and manageable.
Practical support might include:
- Cleaning and tidying — vacuuming, changing bedding, wiping surfaces, laundry and keeping walkways clear to reduce falls risk.
- Cooking and food preparation — preparing meals, checking food is in date, batch cooking or making sure the fridge is not empty.
- Shopping and prescriptions — doing the weekly shop, collecting prescriptions and making sure essentials are available.
- Paperwork and bills — helping someone open post, understand letters or manage simple admin tasks.
Some practical help is provided by domestic services rather than regulated care providers. However, when it is part of a wider support plan involving personal care, medication prompts or vulnerability, it often sits within a regulated home care package.
4. Specialist and complex home care
Some conditions require carers with additional training, closer supervision and more detailed care plans.
Common examples include:
- Dementia care — supporting routines, communication, reassurance, sundowning, wandering risks, nutrition, personal care and distress.
- Neurological conditions — including Parkinson’s, MS and MND, where carers may need training in movement, fatigue, swallowing risks and symptom monitoring.
- Learning disability and autism support — supporting independence, communication preferences, sensory needs and behaviour that challenges.
- Clinical or delegated tasks — such as catheter care, PEG feeding, oxygen support or complex medication routines, where appropriate training and supervision are in place.
Example:
Rahul, in his early 40s, has advanced MS and uses a wheelchair. His package includes morning and evening personal care, help with transfers using a hoist, and support to attend a local disability sports group once a week. His carers are trained in pressure care and moving and handling.
This is where the difference between a general domestic service and a regulated home care provider matters. For dementia-specific support, you may also find our guide to dementia care options in the UK useful, even if the aim is to keep someone at home for as long as possible.
5. Reablement and post-hospital home care
After a hospital stay, many people can manage at home again with time-limited support. This is often called reablement.
Reablement aims to:
- rebuild confidence after a fall, illness or operation
- help people relearn daily tasks
- reduce long-term care needs
- avoid unnecessary admission to a care home
This support is often provided by local authority or NHS reablement teams and may be free for a limited period, commonly up to 6 weeks depending on the area and circumstances.
Example:
Sandra has a hip replacement. Instead of going to a rehab unit, she goes home with a 4-week reablement package. Carers help with washing, mobility exercises and meal preparation while she regains strength. After 4 weeks, she no longer needs daily visits and only uses occasional help with heavy cleaning.
If you are trying to arrange support after discharge, our guide to choosing care after a hospital stay may help you compare short-term care, home care and residential options.
6. Palliative and end-of-life care at home
Some people with a terminal illness choose to spend their last months, weeks or days at home. Home-based palliative care focuses on comfort, dignity and support for both the person and their family.
It may include:
- personal care delivered with extra sensitivity
- support with pain, breathlessness, nausea or fatigue
- help for family carers who may be exhausted or frightened
- coordination with the GP, district nurses, hospice teams and community palliative care services
The aim is not to “do everything possible at all costs”, but to support comfort, choice and dignity. Even a few hours of care per day can make a major difference to whether a family feels able to cope at home.
7. Live-in care
Live-in care places a carer in the home, usually with their own room, so support is available throughout the day and sometimes overnight depending on the arrangement.
It may suit people who:
- need frequent or unpredictable support
- are at high risk of falls or confusion
- want to avoid moving into a care home
- have a spouse or partner they do not want to be separated from
- need more continuity than short daily visits can provide
Live-in care costs more than hourly visits, but it can sometimes be comparable to care home fees, especially if a couple both need support. For a wider comparison, see our guide to the cost of live-in care vs care homes in the UK.
Who provides home care: NHS, council or private?
Families often get confused because several systems overlap.
NHS support
The NHS funds healthcare needs. This may include district nursing, community therapy, some palliative care, rehabilitation and NHS Continuing Healthcare in certain cases. The NHS does not usually fund routine social care tasks such as washing, dressing, meal preparation or companionship unless the person meets specific healthcare funding criteria.
Local authority support
Your local council is responsible for assessing social care needs. If you meet eligibility criteria and qualify financially, the council may arrange and fund some or all of your home care. This usually involves a care needs assessment followed by a financial assessment.
For a fuller breakdown, see our guide to how social care funding works in the UK.
Private or self-funded care
You may pay a home care provider directly for some or all of the support. This is common when someone is above the financial thresholds, wants more hours than the council will fund, wants longer visits, or needs more flexibility around timing and choice of carers.
In reality, many people end up with a mixture: council-funded visits, privately paid top-up hours, NHS nurses for health tasks, and unpaid support from family or friends.
How funding and assessments work
1. Care needs assessment
You can ask your local council for a care needs assessment. It is free and available to anyone who appears to need support, regardless of income or savings.
During the assessment, a social worker or assessor may ask about:
- what the person struggles with day to day
- washing, dressing, eating, toileting and mobility
- falls risk, medication, nutrition and isolation
- memory, confusion or mental health concerns
- support already provided by family or friends
- what the person wants, including staying at home if possible
The council then decides whether the person meets national eligibility criteria for support.
2. Financial assessment
If the person is eligible for support, the council will usually carry out a financial assessment to decide how much they must contribute.
In England, broadly:
- Above £23,250 in savings: you usually pay the full cost of care.
- Between £14,250 and £23,250: you usually contribute part of the cost.
- Below £14,250: the council may cover more, although income can still be taken into account.
For home care, the main home is usually not counted as capital if the person continues living there. This is different from many care home funding situations. Rules differ across England, Scotland, Wales and Northern Ireland, so local advice is important.
3. NHS Continuing Healthcare
Some people with complex, primarily health-related needs may qualify for NHS Continuing Healthcare, often shortened to CHC. This can fund a full package of care, including care at home, but the criteria are strict and based on the nature, intensity, complexity and unpredictability of the person’s needs.
Families often find CHC assessments difficult to understand. Our guide to NHS Continuing Healthcare explains how the process works and why some people qualify while others do not.
4. Benefits that can help pay for home care
Benefits can make home care more affordable and are often overlooked.
- Attendance Allowance — for people over State Pension age who need help or supervision because of illness or disability.
- Personal Independence Payment — for people under State Pension age with long-term health or disability-related needs.
- Carer’s Allowance — for someone providing regular unpaid care, if eligibility criteria are met.
- Pension Credit — extra money for people over State Pension age on a low income.
These benefits are designed to help with the extra costs of disability, illness or caring, including paying for home care or respite support.
How much does home care cost in the UK?
Costs vary by region, provider, visit length and complexity. As a rough guide:
- Hourly domiciliary care: often around £20–£30 per hour, sometimes more in London or very rural areas.
- Live-in care: often around £900–£1,600+ per week, depending on needs and provider.
- Specialist dementia, night care or complex care: often higher due to training, staffing and supervision needs.
People often start with a small package, such as a few 30-minute or 60-minute visits per week, and then adjust as needs change. If care needs increase significantly, it may be worth comparing home care with residential options. Our guide to care homes in the UK explains the main types, costs and ratings.
How to choose a home care provider
Choosing a provider is part research project, part gut feeling. The aim is to find support that is safe, reliable, kind and realistic for the person’s needs.
Step 1: Clarify what help is actually needed
Before speaking to providers, write down:
- tasks that are difficult now, such as showering, stairs, cooking, shopping or medication
- times of day when things are hardest, such as mornings, evenings or overnight
- risks, such as falls, wandering, confusion, poor nutrition or carer exhaustion
- what matters most to the person, such as staying in their own bedroom, keeping a pet, or going outside daily
This helps you ask for support that actually improves daily life, rather than accepting a generic care package.
Step 2: Check regulation and quality reports
In England, home care agencies that provide personal care must be regulated by the Care Quality Commission. You can look up a provider’s rating and inspection report on the CQC website.
Ratings include:
- Outstanding — rare and excellent
- Good — generally reassuring
- Requires Improvement — read the report carefully
- Inadequate — a serious warning sign
Do not only look at the overall rating. Read why the provider received it. For example, a provider may be rated Good overall but have stronger or weaker findings in safety, caring, leadership or responsiveness.
Scotland, Wales and Northern Ireland have their own care regulators, but the principle is similar: check registration, inspection findings and any enforcement action.
Step 3: Ask detailed questions
When speaking with providers, go beyond price and availability. Useful questions include:
- How do you match carers to clients? Look for answers about personality, language, interests, gender preference and specialist experience.
- Will we see the same carers regularly? Continuity is especially important for dementia, anxiety, autism or people who dislike change.
- What is your minimum visit length? Very short visits can feel rushed and may be unsafe for personal care.
- How do you handle emergencies or last-minute changes? This shows how robust the organisation is.
- What training do carers receive? Ask specifically about dementia, moving and handling, medication, safeguarding, continence, nutrition and mental health.
- How do family members receive updates? Some providers use care notes, apps or regular calls.
- What happens if the usual carer is off sick? A good provider should have a clear contingency plan.
You are not just buying hours. You are buying reliability, communication and trust.
Step 4: Notice the soft factors
Beyond ratings and policies, pay attention to how the provider behaves.
- Do they speak respectfully about clients and families?
- Do they listen properly, or rush you off the phone?
- Are they honest when they cannot meet a need?
- Do they acknowledge the emotional side of arranging care?
- Do they involve the person receiving care, not just the family?
For many families, these softer factors matter more in the long run than a slightly lower hourly rate.
Step 5: Start small and review regularly
It is often sensible to start with a modest package, for example:
- a morning visit 3 times per week for personal care
- one companionship visit
- weekly shopping or meal preparation support
After a few weeks, review whether the support is enough, too much, or happening at the wrong times. Good providers will adjust the care plan rather than treating it as fixed.
When home care might not be enough
Home care is flexible, but there are situations where it may no longer be safe or sustainable.
Warning signs include:
- the person needs two carers for most tasks, most of the day
- there are frequent night-time issues such as wandering, falls or distress
- the home environment cannot be made safe enough
- family carers are exhausted despite support
- the person feels unsafe, frightened or isolated
- missed medication, poor nutrition or repeated hospital admissions continue despite care
At that point, live-in care, respite care or residential care may need to be discussed. It is usually better to have these conversations early rather than waiting for a crisis. If you are unsure whether the situation has reached that stage, our guide to signs it may be time for a care home may help.
If you are comparing providers or visiting homes, you may also find these guides useful: how to choose a care home in the UK, care home visit checklist and care home red flags families should not ignore.
Where GP and mental health care fit in
Home care is only one part of the support picture. Many people receiving home care also need a registered GP to coordinate medication, referrals, long-term condition reviews and urgent medical concerns. If the person has recently moved or is not currently registered, see our guide to how GP registration works in the UK.
Mental health also matters. Older adults, disabled adults, people with dementia, unpaid carers and people recovering after illness can all experience anxiety, depression, grief or burnout. The best outcomes often come when the GP, home care provider, mental health services and family communicate rather than working in isolation.
What to do next
If you think you or a loved one may need home care, start with these steps:
- Write down what is getting difficult, such as washing, stairs, meals, medication, loneliness or night-time safety.
- Request a care needs assessment from the local council. It is free.
- Check benefits such as Attendance Allowance, PIP, Pension Credit or Carer’s Allowance.
- Shortlist 3–5 providers and check regulator ratings and inspection reports.
- Ask detailed questions about carers, training, continuity, visit length and emergency cover.
- Start with a trial period and review the care plan after a few weeks.
You do not need to have everything figured out at once. Home care is often a journey rather than a single decision, and the right package may change as needs change.
FAQ: home care in the UK
What is the difference between home care and domiciliary care?
They usually mean the same thing. Domiciliary care is the formal term for care provided in someone’s own home. Home care is the more commonly used phrase.
Is home care only for older people?
No. Home care can support older adults, disabled adults, people with long-term conditions, people recovering after hospital stays, people with dementia and people approaching the end of life.
Can the council pay for home care?
Yes, if the person meets care eligibility criteria and qualifies financially after a means test. The process usually starts with a care needs assessment from the local authority.
Is home care free in the UK?
Not usually. Some short-term reablement may be free for a limited period, and some people qualify for council-funded care or NHS Continuing Healthcare. Many people pay some or all of the cost themselves.
Does the NHS pay for home care?
The NHS usually funds healthcare tasks rather than routine social care. It may fund care at home through NHS Continuing Healthcare if the person has complex, primarily health-related needs and meets the criteria.
How many hours of home care do people usually need?
It varies widely. Some people need a few short visits per week for meals or companionship. Others need several visits per day, overnight support or live-in care. A needs assessment can help estimate the right level of support.
Can home carers give medication?
Home carers may prompt, assist or administer medication depending on the care plan, provider policy, training and the type of medication. More complex medication tasks may need district nurses or specialist oversight.
How do I know if a home care provider is safe?
Check whether the provider is properly regulated, read inspection reports, ask about staff training and continuity, and pay attention to how they communicate. In England, use the CQC website to check regulated providers.
What if my parent refuses home care?
This is common. It may help to start small, frame care as practical help rather than loss of independence, involve the person in choosing the carer, and focus on what matters to them. If this is becoming a serious issue, read our guide on what to do if a parent refuses care.
When should we consider a care home instead?
A care home may need to be considered if the person is unsafe at home despite support, needs frequent help day and night, has repeated falls, is severely isolated, or family carers can no longer cope safely. Home care and care homes are not opposites; they are different options for different stages and needs.
Final takeaway
Home care can help someone stay in familiar surroundings while receiving practical, personal and emotional support. The right package depends on the person’s needs, risks, preferences, funding situation and family support.
Start by identifying what is becoming difficult, request a care needs assessment, check funding options, and compare providers carefully. Good home care should protect safety and dignity without taking away more independence than necessary.
