What Is Home Care? Types of Support, Funding & How to Choose a Provider (UK Guide)

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 actually looks like day to day

• the different types of support available

• how funding and assessments work

• how to choose a provider without feeling overwhelmed

You’ll also see real-life examples, so you can picture how it might work for your situation.

Why home care exists – and who it really helps

If you’ve never needed care before, it can be hard to know where the line is between “coping” and “needing help”. Home care sits in that messy middle ground.

It exists for situations like:

• An older person who can still make a cup of tea but can’t safely get in and out of the bath.

• Someone with early dementia who’s fine in familiar surroundings but gets confused managing medication.

• A person leaving hospital after a fall or surgery who needs support to rebuild strength and confidence.

• Adults with disabilities who can do many things but need help with specific tasks, like transfers, personal care or cooking.

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 (physical, sensory, learning)

• People with dementia at various stages

• Those recovering after hospital stays

• People nearing end of life who want to be at home with family

A key idea is “least restrictive support”: giving just enough help to stay safe and well, without unnecessarily taking away independence.

Main types of home care in the UK (with scenarios)

Home care isn’t one package; it’s a set of building blocks you can combine. Understanding these helps you avoid both under- and over-buying care.

1. Personal care (the “hands-on” support with daily living)

Personal care covers the intimate, everyday tasks that become difficult when mobility, strength or balance change.

It usually includes:

• Washing, bathing and showering
  Not just basic hygiene but also making sure the person is warm, safe and unhurried. A carer might help someone step into a shower with a grab rail, use a shower seat, dry properly to avoid skin problems, and check for pressure sores.

• Dressing and undressing
  Buttons and zips become surprisingly hard when you have arthritis or a tremor. A carer will help choose weather-appropriate clothing, make sure compression stockings are on correctly, and preserve dignity.

• Toileting and continence support
  This might involve helping someone to and from the toilet, changing pads, or managing catheters in a way that preserves dignity and reduces embarrassment.

• Mobility and transfers
  Helping someone move from bed to chair, or chair to toilet, sometimes using equipment like hoists or slide sheets. Good technique prevents injuries for both the person and the carer.

• Eating and drinking (nutritional support)
  Preparing simple meals, cutting up food, and making sure someone actually eats and drinks enough. Dehydration and malnutrition are very common reasons older people end up in hospital.

• Medication prompts
  For some people, remembering tablets is the hardest part. A carer might prompt, observe and record that medication has been taken.

Example:

Tom is 79 and has Parkinson’s. He can still hold a conversation and walk short distances with his frame, but mornings are tough. A carer comes for an hour each morning to help him wash, dress, shave, take his medication and prepare breakfast. Tom spends the rest of the day independently, and his daughter doesn’t have to rush over before work.

Personal care is usually the backbone of a care package. Other types of support are often built around it.

2. Companionship and social support (not “just a chat”)

Loneliness can be as harmful to health as smoking or obesity. For many people, especially those who have lost a partner or friends, the biggest risk is isolation – not a particular disease.

Companionship care might look like:

• Regular visits for conversation and company
  A carer might share a cup of tea, listen to stories, or help someone keep up with hobbies. This gives structure to the week and something to look forward to.

• Support getting out of the house
  Going for a walk, visiting the library, attending a day centre, or going to a faith community. For someone who can’t go out alone, this keeps them connected to real life.

• Help with appointments and errands
  Going along to GP appointments, the bank, or the hairdresser. This makes staying involved in the wider world far easier.

• Monitoring mood and wellbeing
  A companion can notice changes – more confusion, low mood, breathlessness – and flag concerns before they escalate into a crisis.

Example:

Eileen’s children live far away and work full time. She’s 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 also notices that Eileen’s memory seems worse and helps the family arrange a GP appointment, which leads to a dementia diagnosis and early support.

Companionship might sound “soft”, but in reality it’s a vital prevention tool – especially for mental health.

3. Practical and household support (keeping home liveable)

Sometimes the problem isn’t personal care but the sheer effort of running a home.

Practical support might include:

• Cleaning and tidying
  Vacuuming, changing bedding, wiping surfaces, doing laundry. A clean environment reduces infection risk and falls.

• Cooking and food preparation
  Preparing meals in advance, making sure food is in date and stored safely, checking the fridge isn’t empty.

• Shopping and prescriptions
  Doing the weekly shop, picking up prescriptions, and ensuring essential items (toilet paper, cleaning products) are available.

• Paperwork and bills
  Helping someone open post, understand letters from the council or NHS, or set up direct debits.

This kind of help is sometimes provided by domestic services rather than regulated care, but it often sits alongside personal care in a full package.

4. Specialist and complex care (when needs go beyond basics)

Some conditions require home carers with additional training.

Common examples include:

• Dementia care
  Carers are trained in communication strategies (not arguing, using reassurance), managing “sundowning”, keeping routines predictable, and reducing risks like wandering or leaving the cooker on.

• Neurological conditions (Parkinson’s, MS, MND)
  Here, carers learn specific techniques for safe movement, swallowing difficulties, fatigue management and symptom monitoring.

• Learning disability and autism support
  Carers might support independent living skills, communication preferences, sensory needs and behaviour that challenges.

• Clinical tasks
  In some cases (and with proper training and supervision), carers may help with PEG feeding, catheter care, oxygen use or complex medication regimes – usually under the direction of community nurses.

Example:

Rahul, in his early 40s, has advanced MS and uses a wheelchair. He has a tailored package including morning and evening personal care, help with transfers using a hoist, and support to get to a local disability sports group once a week. His carers are trained in pressure care and manual handling to keep him safe.

Specialist care is where the difference between a general domestic agency and a CQC-regulated home care provider really matters.

5. Reablement and post-hospital home care

After a hospital stay, many people can manage at home again with a bit of time-limited support.

Reablement aims to:

• rebuild confidence (e.g. after a fall or operation)

• help people relearn daily tasks

• reduce long-term care needs

This support is often provided by local authority or NHS reablement teams and may be free for a set period (for example, up to 6 weeks in many areas).

Example:

Sandra has a hip replacement. Instead of going to a rehab unit, she goes home with a 4-week reablement package. Carers help her 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.

6. Palliative and end-of-life care at home

Some people, when facing a terminal illness, choose to spend their last months at home.

Home-based palliative care typically includes:

• personal care with extra sensitivity and respect

• managing symptoms like pain, breathlessness or nausea

• support for family carers (who may be exhausted, frightened or grieving)

• coordination with GP, district nurses and hospice teams

The aim is comfort and dignity, not “doing everything possible at all costs”. Many families find that even a few hours of home care a day makes an enormous difference to their ability to cope.

7. Live-in care (24-hour support without leaving home)

Live-in care places a carer in the home, often sleeping in a separate room but available if needed overnight.

It suits people who:

• need frequent or unpredictable support

• are at high risk of falls or confusion

• strongly wish to avoid a care home

• have a partner or spouse they don’t want to be separated from

The costs are higher than hourly visits but can be comparable to care home fees, especially if a couple both need support.

Who actually provides home care? NHS, council or private?

This is where families often get stuck because several systems overlap.

NHS

• Funds healthcare needs (district nurses, some therapy, palliative care, Continuing Healthcare in certain cases).

• Does not normally fund routine “social care” tasks like washing and dressing.

Local authority (council)

• Responsible for assessing social care needs.

• May arrange and fund home care if you meet eligibility criteria and have low/moderate means (your finances are under certain thresholds).

• Contracts home care agencies to deliver the care.

Private/self-funded

• You pay a home care provider directly for some or all of the care.

• Often used when someone is above financial thresholds, needs more hours than the council will fund, or wants more flexibility (longer visits, same carers, specific times).

In reality, many people end up with a mix: some care paid for by the council, some privately topped up, plus NHS nurses for healthcare tasks.

How funding and assessments work (in plain English)

1. Care needs assessment (local authority)

You can ask your local council for a care needs assessment. It’s free and available to anyone who seems to need support, regardless of their finances.

In the assessment, a social worker or assessor will:

• talk to you (and your family if you want)

• ask what you struggle with day to day

• look at safety risks (falls, medication, nutrition, isolation)

• consider your wishes (for example, staying at home vs moving somewhere else)

They then decide if you meet national eligibility criteria for support (for example, if without support you’d be at significant risk to health or wellbeing).

2. Financial assessment (means test)

If you’re eligible for support, the council will normally conduct a financial assessment to see how much, if anything, you must contribute.

In England (at time of writing), broadly:

• Above £23,250 in savings – you typically pay the full cost (“self-funding”).

• Between £14,250 and £23,250 – you contribute part of the cost.

• Below £14,250 – the council covers more, though your income may still be taken into account.

For home care, your main home is usually not counted as capital, unlike in some care home funding calculations. (The rules differ in Scotland, Wales and Northern Ireland, but the principle of means-testing is similar.)

3. NHS Continuing Healthcare (CHC)

Some people with complex, primarily health-related needs can get their care funded entirely by the NHS under Continuing Healthcare. The criteria are quite strict and based on the nature, intensity, complexity and unpredictability of needs. Families sometimes find this assessment process challenging and may need advocacy.

4. Benefits that can help cover home care

Don’t overlook benefits – they’re often what makes home care financially possible:

• Attendance Allowance (for people of State Pension age with care needs)

• Personal Independence Payment (PIP) (for under State Pension age)

• Carer’s Allowance (for someone providing regular unpaid care)

• Pension Credit (top-up for low-income pensioners)

These are designed to help with the extra costs of disability or caring, including paying for home care.

How much does home care cost in the UK?

Costs vary by region and provider, but as a rough guide:

• Hourly domiciliary care: £20–£30 per hour, sometimes more in London or very rural areas.

• Live-in care: often £900–£1,600 per week, depending on complexity.

• More complex dementia or specialist packages may be higher.

People often start with a small package — for example, 3 x 30-minute visits per week — and then adjust as needs change.

How to choose a home care provider (without losing your mind)

Choosing a provider is part research project, part gut feeling. Here’s a way to make it structured but still human.

Step 1: Clarify what you actually need help with

Before you speak to any provider, list:

• tasks that are difficult now (e.g. showering, stairs, cooking, shopping)

• times of day when things are hardest (e.g. mornings, evenings)

• what must not change (e.g. walking the dog daily, staying in own bedroom)

This helps you avoid “we’ll take whatever you can offer” and instead ask for support that meaningfully improves life.

Step 2: Check regulation and quality ratings

In England, home care agencies must be regulated by the Care Quality Commission (CQC). You can look up a provider’s rating and inspection reports here:
https://www.cqc.org.uk/

You’ll see ratings like:

• Outstanding – rare but excellent

• Good – generally very reliable

• Requires Improvement – may have issues; read the report carefully

• Inadequate – red flag

Don’t just look at the overall rating; read why they got it. For example, a provider might be “Good” overall but “Outstanding” in caring, which is a strong sign.

In Scotland, Wales and Northern Ireland, equivalent national regulators play a similar role.

Step 3: Ask detailed questions (and listen to how they answer)

When speaking with providers, go beyond price and availability. Consider questions like:

• “How do you match carers to clients?”
  A thoughtful answer might include considering personality, interests, language, and gender preferences.

• “Will we see the same carers regularly?”
  Continuity is vital, especially for dementia or anxious people. High turnover can be very unsettling.

• “What’s your minimum visit length?”
  Extremely short 15-minute visits can feel rushed and unsafe for personal care; many families prefer longer slots.

• “How do you handle emergencies or last-minute changes?”
  This reveals how robust and responsive the organisation is.

• “What training do your carers receive – especially around dementia, mental health, or moving and handling?”
  Quality training is a good predictor of good care.

You’re not just buying hours; you’re buying reliability and trust.

Step 4: Notice the “soft” factors

Beyond regulations and policies, pay attention to things like:

• Do they speak respectfully about clients and families?

• Do they listen properly, or rush you off the phone?

• Are they honest when they can’t meet a need, instead of over-promising?

• Do they acknowledge the emotional side of this decision?

For many families, these soft factors matter more in the long run than a slightly lower hourly rate.

Step 5: Start small and review regularly

It’s often wise to start with a modest package — for example:

• a morning visit 3 times a week for personal care

• plus one companionship visit

• plus a weekly “big shop” support

After a month, review: is this enough? Too much? Are the times right? Good providers will adjust the care plan with you, not treat it as fixed in stone.

When home care might not be enough

Home care is flexible, but there are situations where it may no longer be safe or sustainable:

• the person needs two carers for most tasks, most of the day

• there are frequent night-time issues (wandering, falls, distress)

• the home environment cannot be made safe enough

• family carers are completely exhausted despite support

• the person themselves feels unsafe or isolated

At that point, live-in care or residential care may be the next step. It’s often easier to discuss these options early, before a crisis forced decision.

Where mental health and GP care fit in

Home care is only one piece of the support picture. Many people receiving home care also need:

• a registered GP to coordinate medical treatments and referrals
  👉 See: How GP Registration Works in the UK
  https://allhealthandcare.co.uk/resources/how-gp-registration-works-in-the-uk

• access to mental health support, especially for older adults, carers and people with long-term conditions
  👉 See: How to Access Mental Health Services in the UK (NHS vs Private)
  https://allhealthandcare.co.uk/resources/how-to-access-mental-health-services-in-uk

The best outcomes often come when GP, mental health services, home care providers and family all communicate, rather than working in isolation.

What to do next – a simple action plan

If you’re reading this because you think you or a loved one might need home care, here’s a straightforward starting point:

1. Write down what’s getting difficult – be specific (e.g. “getting in/out of bath”, “stairs after 4pm”).

2. Request a care needs assessment from your local council (it’s free).

3. Check eligibility for benefits like Attendance Allowance or PIP to help with costs.

4. Shortlist 3–5 home care providers, checking their regulator ratings and reading inspection reports.

5. Arrange meetings or home visits to discuss a potential care plan.

6. Start with a trial period and review together after a few weeks.

You don’t need to have everything figured out at once. Home care is often a journey, not a single decision