Paying for private support at home
All people with a need for care and support are entitled to request an assessment from their local council. However if you have, for example, a lot of savings or a high level of income, then you may know before you even undergo this assessment that you will not be eligible for financial support from the council towards the cost of your care.
Alternatively you may find that, following an assessment from your council, your care needs are not high enough to meet the criteria for receiving council-funded support.
Or you may simply prefer to make your own arrangements - this will give you greater flexibility and choice over your support.
In all these circumstances you may decide that you want to make private arrangements for the support you receive.
If you do arrange support privately then you should remember that, regardless of your financial circumstances, you may be entitled to state disability benefits which could help to meet the costs of support at home.
Paying a personal care assistant directly gives you greater control over the kind of care provided. However you need to be aware that you will act as their employer, which has certain practical, legal and financial implications, including:
- recruiting the care worker, and checking references, DBS and right to work
- drawing up a contract of employment and agreeing the hours of work
- paying income tax and national insurance
- arranging insurance cover in case of accidents
- arranging alternative care whilst the personal assistant is on holiday or ill, or if they resign.
Her Majesty Revenue and Customs (HMRC) provide advice on tax arrangements if you employ a personal care assistant.
Being the Boss is a peer support website run by people with disabilities who aim to share knowledge, support and information around employing personal assistants.
Skills for Care have a website Employing Personal Assistants which has a useful toolkit of leaflets, template documents and other documents
Which? Later Life Care has advice on employing a private carer
You can also opt to book care through a home care agency . Using an agency may mean you have less control over who the carer is, and is usually more expensive, but has the advantage that the agency will take care of most of the tax paperwork and payroll, and will arrange cover if your usual assistant is not available.
Home care agencies will provide trained care workers or, when required, nurses who can come to your home to assist with tasks such as:
- shopping, cleaning, laundry, ironing
- personal care such as washing, bathing, dressing, going to the toilet, and managing any problems with incontinence
- meal preparation
- taking medication
- treating ongoing health problems which require specialist nursing input (including receiving injections, changing dressings and bandages)
- going out in the local community
Agencies will charge different amounts depending on the type of care required. Personal care and nursing care is sometimes more expensive than, for example, help with cleaning your home because the carers require additional training.
Some agencies will offer specialist support for people with particular needs, for example people with learning disabilities, people with dementia or mental health problems, or people with brain injuries.
Depending on your needs and your financial situation you can choose to have a care worker visit you once or twice per week, or one or more times per day, or you can arrange for someone to be with you 24 hours a day.
Home care agencies in your area
You can find details of agencies that may be able to help you in our Services and Products section. Do a search using the words 'domiciliary care' in the search box at the top of this page for an extensive list of local home care agencies.
Using the Care Quality Commission website
Home care agencies are run by a variety of organisations, including private firms, charities and voluntary sector organisations, and local councils. They are registered and regulated in England by the Care Quality Commission (CQC). The CQC visits them regularly and writes a report about the agency which you can see on its website; this report will tell you what the agency does well, and about any areas where they need to improve their standards.
You can use the Care Quality Commission (CQC) website to search for home care agencies in your area, to see what types of support they offer, and to see if they have an up-to-date and good inspection report.
The CQC have produced a leaflet about the standard of care you should expect in your home. Click here to download the leaflet.
Using the NHS website
The NHS website also allows you to search for home care agencies in your area, to see what other people have said about them, and to rate them yourself based on your experiences.
The At Home Service from Age UK
The At Home Service from Age UK offers a range of personally tailored packages of care and support for older people in the Kensington and Chelsea, Hammersmith & Fulham and Westminster areas.
If you employ someone to provide care and support for you, either privately or using a personal budget, then a change in the law means that, as an employer, you may need to make pension arrangements for them.
If your care is provided by an agency, and it pays your personal assistant's national insurance contributions, the agency is the employer and you don't need to do anything.
If you employ your personal assistant directly, you will only need to automatically enrol them in a pension scheme if they meet certain criteria, which are based on their age and how much you pay them.
The Pensions Regulator has information for people who receive care and support explaining what they need to do, and when, to arrange pensions for people whom they employ.
The HomeCareDirect website aims to help people to take control over their care at home, whether through a personal budget, personal health budget, direct payment or for people who pay for their care privately.
The following websites provide independent advice on all aspects of paying for support in your home:-
- The NHS website
- The Which website
The Society of Later Life Advisers (SOLLA) provide a database of financial advisors who specialise in giving advice on finances in later life, enabling you to plan ahead or to make the most of your money once you reach retirement and older age. All advisors on the database have to prove that they meet appropriate criteria and have the right qualifications before they are accredited by SOLLA.
If you are struggling to manage your money and pay for things by yourself then Pay Your Way offers a guide on safe ways in which you can allow other people to pay for things on your behalf, whilst still staying in control of your finances.
If you would like to receive independent advice on accessing care and support, benefits, legal issues, housing, your rights as a carer,and a range of other issues, then you can contact the Westminster CAB