Nikki Porges, registered nurse in the Health at Hand team

Health care at home

Ageing Well

24 September 2019

Receiving health care services at home may be the best option for many older people.

This will enable you or your family member to remain in their home and maintain independence, dignity and confidence. Once a care needs assessment has been carried out  the local authority social services department will be able to offer various kinds of help and support at home.

Services that you or your family member may require as a result of the care needs assessment, may include home care services, meals on wheels, laundry services, special equipment or minor adaptations to the home.

The various services available are covered by different pieces of legislation. Some stipulate that local authorities have a duty to provide these; others only give them the power to do so. Therefore there are variations between different services and the different local authorities that provide them.

The following list is not exhaustive; however it gives some examples of the types of services available:

Equipment and adaptations to the home

  • Grab rails in the bathroom
  • Special taps
  • Wheelchairs and walking aids
  • Amplifiers for telephone and television

(Aids may also be loaned from the British Red Cross, Age UK, or the Women’s Royal voluntary Service, for example)

Home help

  • Help with practical tasks such as shopping and housework

Home care services

Help with personal needs such as washing and dressing.


  • Meal preparation in the home
  • Delivery of meals or frozen foods to the home


If your care needs are due to a health condition you may be entitled to NHS funded health care and your local health care provider will be able to tell you more about this or your GP.

It is at Local Authorities’ discretion how much they charge for any care service that is provided at home. Generally speaking, charges for all care services received at home must be reasonable. If you receive care at home you should receive information on how the charges are calculated and how they can be reviewed. Since April 2003 local authorities in England and Wales have to comply with government guidance on charging policies.  In Scotland and Northern Ireland, home care services are often means tested and the calculation of charges will take into account your savings, income and living expenses.

If you or your relative requires support with activities of daily living i.e. showering, food preparation and housework, you could choose to receive your care from a domiciliary care agency rather than a nursing agency. However the level of care will be a crucial factor in deciding which agency to use. In England all nurses agencies and agencies supplying domiciliary care workers have to be registered with the Care Quality Commission.

You may find the following questions helpful when deciding on which domiciliary care agency to use:

  • How does the agency work out its charges
  • Do the charges vary depending on whether care is required during the day or at night
  • Do different charges apply over weekends and bank holidays
  • Are there any additional charges, for example for any equipment needed or for the carers travel expenses
  • Are the charges a set weekly fee inclusive of weekends and public holidays.

Arranging the care

  • How is the initial meeting arranged – will there be a home visit to discuss your care needs and the home environment
  • Will there be a discussion about choices and preferences in putting together the care programme (this can also be referred to as a care package)
  • Will the care programme have some flexibility so that changes in circumstances can be managed effectively
  • Who will make decisions about any significant changes to the care programme
  • How often will the care needs be assessed to ensure the care package remains appropriate to your needs.

Dealing with care staff

  • How will different carers be introduced to their clients
  • Do carers carry means of identification on them at all times
  • Will you be notified if there are any staff changes or another member of staff is covering the regular carer
  • Do all carers have appropriate professional qualifications and receive ongoing professional training
  • How does the agency supervise and monitor individual carers performance
  • Are there specific procedures for carers who need to handle your money so possible misunderstandings can be avoided.

Useful links

Should you require further guidance you might find the links below useful:

Independent Age

Homecare - Age UK

Arranging care - Age UK


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