Domiciliary care is the formal name for care delivered in someone's own home. If you have heard it called home care, care visits, care at home or a care package, those all describe the same thing. The word simply means "relating to the home".
It is the most common form of paid care in the UK by a considerable margin, and for most people it is the first paid help they ever arrange.
What a visit actually involves
A domiciliary care visit is a scheduled call by a trained carer, usually lasting between thirty minutes and an hour, though longer calls are common where more is needed.
Within that time a carer might help someone wash and dress, support them to the toilet, manage continence, prompt or administer medication, prepare a meal and sit while it is eaten, do a little light housework, and check that the person is well before they leave.
The last part matters more than it sounds. A carer who comes four times a day is the person most likely to notice that someone is eating less, is more confused than usual, or has a chest that sounds wrong — often days before anybody else would.
How the hours are arranged
Most packages fall into a familiar shape. A single morning call to get someone up, washed and started on the day. Two calls, morning and bedtime. Three, adding lunch. Four, adding a teatime visit.
Beyond four calls a day the arithmetic starts to change, and live-in care — where a carer lives in the home — often becomes both better and no more expensive.
At the other end, some people need very little: one visit a week to help with a bath, or a companionship call where the point is the conversation rather than the task.
What it is not
Domiciliary care is not nursing. Carers are not nurses, and district nursing — wound care, injections, catheter changes — comes through the NHS, free of charge, and runs alongside a care package rather than instead of it.
Where clinical tasks are needed at home on an ongoing basis, that is complex care, which is delivered by carers trained and competency-signed against that individual's specific protocols under nurse supervision.
It is also not a cleaning service. Light domestic work around the person is normal; a carer is not there to clean the house.
Domiciliary care against a care home
The obvious difference is the building. The less obvious ones matter more.
Care at home keeps someone's routine, their possessions, their neighbours and their independence, and it scales gradually — you can add a call at a time over years. A care home is a single large step, usually irreversible once a house is sold, but it puts staff in the building around the clock without anything having to be arranged.
We have written that comparison out properly in home care or a care home, including where the costs actually cross over.
Who arranges it, and who pays
You can arrange domiciliary care privately by contacting a provider directly. No referral is needed and no assessment by anybody else has to happen first.
Alternatively, your local council must carry out a care needs assessment for anyone who appears to need care and support. It is free and not means tested, and it establishes what help is needed. A separate financial assessment then decides who pays. We have set out the funding routes, including the money most people miss, in who pays for home care.
What good looks like
Whoever provides it, a few things separate a good domiciliary service from a poor one:
- The same carers. Continuity is not a comfort, it is a safety mechanism. A carer who knows somebody notices change.
- Honest timings. A fifteen-minute call cannot deliver personal care with any dignity. A provider that tells you so is worth more than one that agrees to anything.
- Travel time paid. Where carers are not paid between calls, the time comes out of the visits.
- Somebody who answers at night. Care does not stop at five o'clock, and neither should the phone.
- A published CQC rating. Every registered provider has an inspection report at cqc.org.uk. Read it.
Getting started
An assessment at home costs nothing and takes about an hour. A decent provider will tell you honestly what they think is needed — including when that is less than you asked for, or when what you actually need is a district nurse, an occupational therapist or a conversation with the council rather than a care package at all.
