Finding quality live-in homecare

As we grow older, we may reach a point at which we can no longer fully support ourselves without help. Finding the most appropriate way to obtain the care needed in order to maintain a desirable quality of life can be a difficult decision. We investigate.

How to choose a good homecare provider, by Chris Miller, The Good Care Group 

Research by Age UK reveals that the majority of people wish to remain in their own homes, living independently for as long as possible, yet many people still regard relocation to a residential nursing or care home as the only option for full-time care in later years. Moving to the often unsettling and unfamiliar surroundings of a residential care home can be upsetting, depressing and even frightening.  

Unfortunately, many people purchase care in a crisis, brought about by a major change in their lives such as: 

  • Death of a spouse
  • Change in circumstances of family carer
  • Deterioration in health
  • Acute incident/accident or hospital admission
  • Respite care to relieve a family care giver
  • Re-ablement/rehabilitation to aid recovery following acute event 

Decision-making in a crisis is invariably hurried with little time allowed to review various options. There are issues around the wishes of the individual, their capacity to make a decision and whether it is in their best interest. The consequences of getting it wrong can be long reaching.  

One care option is live-in care. There are many benefits of staying in your own home with a live-in carer, such as:  

  • Being surrounded by our memories, belongings, beloved pets and community ties. This can be very beneficial as we age
  • One to one personalised care, something more difficult to achieve in institutional settings
  • Retaining independence
  • Avoiding a traumatic move at a time in life when change can be unsettling
  • Couples can stay together as loving partners
  • Continued participation in local activities
  • Maintaining assets and capital appreciation   
In some situations the Oddfellows' Convalescence Benefit can be used to contribute towards short term live-in care for members. This is likely to be a more costly option, but could be invaluable, for instance to allow a full time carer to have a couple of days’ break. Mary Atkinson, Head of Care and Welfare, the Oddfellows

With live-in care at home, there are also many questions to ask as the standard and quality can vary greatly.

Q: Fully managed service or introductions agency?
Some live-in care providers offer a fully managed service. They employ the carers and take full accountability for the service provided. There should be a care manager, regular reviews, an accessible complaints procedure and a quality assurance process. 

Other live-in care providers operate as an introductions agency, but do not manage the service. Instead, they take a commission and the client pays and manages the carer directly. There is no requirement to conduct background checks, provide training or undertake regular reviews. The client must manage any concerns they have with the carer directly. 

Q: Regulated or not?
All care providers are regulated and must be registered with the Care Quality Commission in England, the Care Inspectorate in Scotland and the Care and Social Services Inspectorate in Wales. However, care agencies that do not employ their staff, or offer a managed service, are not regulated. 

This means that these agencies are not externally regulated and do not have to meet the same quality standards. You can find out whether a provider is registered with the regulator by using the CQC, CI or CSSIW websites. If they are regulated, you can also access their latest inspection report.  

Q: Recruitment and training  

  • How does the provider recruit staff?
  • What checks do they undertake?
  • Do they interview all staff beforehand and validate their skills and experience?
  • How do they match carers with clients?
  • What training does the care provider offer its staff?
  • Does the care provider have the internal expertise needed to deliver specialist or complex care?  

Unregulated agencies, who do not employ their staff, are not able to offer training. Even amongst regulated agencies, training standards can vary. All registered care providers should provide regular learning opportunities for staff and should ensure that their workforce has the skills, knowledge and experience to deliver the service.  

Q: Quality assurance and expertise
At home care involves carers working alone with vulnerable people. This comes with risks and any reputable care provider will have a rigorous quality assurance and risk management strategy in place. 

  • How does the provider monitor quality?
  • What is the complaints policy?
  • How often do they visit the clients and are these visits sometimes unannounced?
  • What approach do they take to the handling of clients’ finances, for example if shopping is required?
  • How well are staff trained, supervised and developed?
  • Are they registered with external kite-mark organisations such as the UK Home Care Association?
  • Is the provider an award winner of industry quality awards and accolade programmes?  

Q: Carer continuity, engagement and retention
Live-in care is a demanding role and avoiding carer burn-out is critical for both safety and to ensure consistency of carers.  

  • What are the staff turnover rates and how does the care provider seek to retain good carers?
  • What rota patterns does the provider operate and how are carer breaks handled?
  • How does the provider look after its staff, ensuring that they feel valued?
  • A motivated and engaged workforce is more likely to provide a high quality service and to stay with the client for the long term.  

Q: Number of carers
How a live-in care package is staffed can vary from one provider to the next. Some will identify one live-in carer who will remain in the house indefinitely until they choose to move on. This tends to occur more with agency models. Others may operate a rota where each carer works for a set period of time, for example six weeks, and then another carer will replace them at that point. The third option is that a team of two dedicated carers are identified from the outset, who will provide cover by working shifts opposite one another. Having a sustainable staffing solution in place is very important if you are to ensure long term continuity of the carers.  

The Good Care Group ( is a national provider of professional, multi award-winning 24 hour live-in care services allowing people to continue to live safely and happily in their own home, maintaining dignity and independence, with tailored support as required. In addition to general care and support, they also have specialist services for complex conditions such as Dementia, Parkinson’s, MS and Stroke rehabilitation. As well as providing permanent care placements, The Good Care Group can also offer periods of short term respite care following hospital discharge, in an emergency or if your primary family carer needs to take a break or holiday. For further information call 08000 234220.