Using a care agency

Care agencies can provide care workers who:

• visit your home on a schedule
• or live in your home

Visiting care workers could come to your home:

• once a day or more often 
• several times a week
• infrequently
• when you need them

Live-in care workers usually provide care every day. This might be from a person who works 12 hours a day or 2 or more care workers who share a rota to give 24-hour support.

Both visiting and live-in care workers give similar support like helping with:

• food shopping, cooking and washing-up
• bathing and getting dressed
• housework like vacuuming and laundry
• using the toilet
• collecting prescriptions and taking medication 
• budgeting and managing finances 
• medical appointments 
• tasks like writing birthday cards and feeding pets 

Some care workers may also provide company.

Your care worker should have training to help support you if you have complex care needs. If you are having problems with your care worker meeting your needs, you can raise the issue with the agency.

Who your care worker is will depend on the support you need.

If you have flexible care, you are likely to get different care workers each time you use the agency.

If you have an ongoing contract for care support, you can ask the agency for the same care worker or workers. They might not be able to guarantee this.

A care agency might allocate a care worker to you because they are the best person to meet your needs. Your care worker may change if a new client joins the agency and needs the care worker’s specialist skills. The care agency should tell you in advance, so you know before the change happens. If possible, you should be allowed to meet them in advance.

You might have different care workers due to their working arrangements. For example, their rota might change weekly, or they are on holiday, training or sick leave. You should get a rota in advance, so you know who is providing your care and when.

Sometimes your care worker may be unavailable at short notice or has a planned absence like a holiday. The care agency will provide a suitable replacement for you if your contract covers set times or dates. The agency should tell you there will be a change, so you know who to expect.

If you employ someone, you might need cover when they are off work, for example if they are sick or on holiday. This would be back-up support, and the care agency does not have to provide cover at short notice if you are not signed up to them. If you can contact the care agency and give them advance notice, they will have more time to find someone to support you.

If are unable to get cover and are left vulnerable, you can ask your local council safeguarding team for support. They might be able to meet some of your most urgent needs at short notice.

You can find care agencies through:

• your local authority’s adult social care services 
• Homecare Association
• National homecare providers (NHS)
• Housing Care services directory
• CHS Healthcare
• Care Quality Commission (CQC) for England
• Care Inspectorate Wales (CIW)  for Wales

You can check the quality of the agency by:

• visiting the care agency
• reading reports on the Care Quality Commission (CQC) and Care Inspectorate Wales (CIW) websites

You can also ask your local council for a list of care agencies in your area within your budget. You can also ask for a list of agencies that accept direct payments.

There are things you can do to decide if a care agency will meet your needs.

• Make a list of what is important to you and ask if they can meet your needs.
• Ask questions about the agency’s track record. For example, what percentage of care workers were on time for visits last year?
• Look at the regulator’s inspection through Care Quality Commission (CQC) for England or Care Inspectorate Wales (CIW).

The care agency will assess how they can meet your needs. This assessment will also be an opportunity for you to ask questions. You can ask about anything, for example:

• health and safety
• how many people might do your care
• what tasks a care worker would do
• if they meet your specific preferences, for example if you want to eat your breakfast before bathing

Your care agency might be paid in different ways, depending on who is paying for your care and how.

If you are paying for your own care, you will pay the care agency directly. This could be a monthly invoice you pay by a set date.

If you use a care agency, your local authority or the NHS may pay for your care.

For example, if you have used your personal budget to pay a personal assistant, the local authority may pay the care agency directly.

You can ask your local authority to use your personal budget to:

• pay the care agency
• give you the money (direct payments) to pay the care agency

If the NHS is paying for your care, you can ask them:

• to pay the care agency (a third-party budget)
• how to access your personal health budget so you can pay the care agency

Managing a personal budget

Direct payments

If all or part of your care is paid by social services or the NHS, you will have had an assessment. The assessment looks at your needs and the required support to meet them. 

After an assessment, you will receive a report, which includes a care plan. You should be allowed to say if you agree or disagree with the report. Social service or the NHS will share the report with the care agency.

The care agency will also do their own assessment of your needs. The agency may want to review your care plan if they feel you:

• need less support
• need more support which will have to be paid for

If this happens, you can contact social services or the NHS and ask them to do another needs assessment. If your new care plan does not change, you can:

• ask the care agency to support you in line with the care plan
• pay for any additional support yourself
• find another agency that will meet the needs of the care plan

Getting a social care needs assessment

Financial assessment for social care

It is important to get reliable care that meets your needs from people you are comfortable with. There are things you can do if you are having problems with your care worker. You can:

• speak to the care worker
• raise the issue by speaking to the care agency manager or a supervisor
• follow a complaints procedure

Types of problems

If your care worker is turning up late or not turning up at all, you can raise the issue with the care agency. If the problem continues, follow the complaints procedure.

If your care worker is refusing to follow your care plan, you can raise this with the care agency.

If the problem continues, follow the complaints procedure.

If your care worker is bullying or discriminating against you, you can make a formal complaint.

Raising an issue

You should have a contact at the care agency who is a supervisor or manager. You can speak to them about any problems.

You can ask them what steps they will take to address the issue and what you can do if you continue to have problems with your care worker. This includes dealing with the problem through the complaints procedure.

Complaints procedures

You have the right to raise issues and complain about your care. Care agencies should have a complaints procedure. They should give you a copy when you have your assessment. You can ask for a copy at any time.

The procedure will list the steps you take to make informal and formal complaints. The procedure might ask you to speak to your care worker yourself or contact the agency in writing by:

• emailing
• filling in a paper or online form
• writing a letter

If these are not accessible to you, the care agency should provide reasonable adjustments and another way to contact them.

When the problems are serious, you can make a formal complaint.

Each care agency will have their own process. The complaints procedure should describe this.

If you are unhappy with the outcome of your complaint, you can escalate the problem.

Escalating problems

Support with your complaint

If social services or the NHS are providing your care package, you can ask them to help with your complaint.

Having problems with your care worker can be upsetting. You can ask family and friends for support.  You can also speak to our helpline for advice.

Scope helpline

Your care agency should take any concerns or complaints seriously, investigate them and respond to them in good time.

There are things you can do if you have complained to the care agency about the care you have received and are unhappy with their response.

If social services or the NHS are providing your care package, they have a responsibility to investigate. Share details about your complaint and the agency’s response.

If you are paying for your own care, you can still contact social services and the NHS to inform them about the care agency. They should be interested in the performance of providers.

Complaining to the ombudsman

You can make a complaint to the ombudsman if you are unhappy with the response from the care agency, social services or the NHS:

• Local Government and Social Care Ombudsman (England)
• Public Service Ombudsman (Wales)

Informing service regulators

You can also inform the service regulator for:

• Care Quality Commission (CQC) for England
• or Care Inspectorate Wales (CIW)

They will not become involved in your individual complaint, but they do want to know about your experience. It can help them decide when, where and what to inspect.

The CQC may also use what you have shared during inspections. If your complaint is a serious safeguarding matter, they may act immediately.