Domiciliary care is professional care and support delivered in a person's own home. Also known as home care, it includes help with personal tasks, household tasks, and companionship. In the UK, it is regulated by the CQC under the Care Act 2014 and costs £26–38 per hour on average, with council funding available if you meet the eligibility criteria.
This guide covers England only. Scotland, Wales, and Northern Ireland have different care funding systems.
Last updated: March 2026.
For many families, domiciliary care is the first step in getting outside help — and for good reason. It allows your parent or loved one to stay in familiar surroundings, maintain their routines, and retain a degree of independence that residential care cannot always match. But it is not the right solution for everyone, and understanding what domiciliary care actually involves, what it costs, and where its limits lie is essential before committing.
This guide covers everything UK families need to know: the types of care available, who it suits, how much you should expect to pay, how to arrange it through the council or privately, and how to recognise when home care is no longer enough.
What Domiciliary Care Actually Includes
The term "domiciliary care" covers a broad range of services. Not all providers offer every type, so it is worth understanding the categories before you start looking.
Personal care
This is the most common form of domiciliary care and the type most people think of first. It includes:
- Washing and bathing — helping your parent get in and out of the bath or shower safely, or providing a bed bath if mobility is very limited
- Dressing and undressing — assistance with clothing, fastenings, and compression stockings
- Toileting and continence care — help using the toilet, managing incontinence pads, and catheter care
- Medication management — prompting, administering, or supervising prescribed medications
- Mobility support — help getting in and out of bed, transferring to a chair, and moving around the house safely
- Eating and drinking — assistance with meals, cutting food, and ensuring adequate fluid intake
Personal care tasks require trained carers who understand manual handling, infection control, and dignity in care. A good provider will tailor the approach to your parent's preferences — not impose a rigid routine.
Household support
Household tasks are often bundled with personal care visits, though some families arrange them separately. These typically include:
- Meal preparation and cooking
- Light housework — vacuuming, dusting, laundry
- Shopping — either accompanying your parent or doing it on their behalf
- Managing post and paperwork
- Ensuring the home is safe — checking smoke alarms, clearing trip hazards
Household support on its own does not count as "regulated activity" under CQC rules, so some providers offering only cleaning or shopping may not be CQC-registered. If your parent also needs personal care, always choose a registered provider.
Companionship
Loneliness is a serious health risk for older adults, and companionship visits exist to address it. A carer might:
- Sit and talk, play cards, or watch television together
- Accompany your parent on a walk or to a local group
- Help maintain hobbies — gardening, reading, puzzles
- Provide reassurance and emotional support
These visits are particularly valuable for people who live alone and have limited social contact. They are not a luxury — isolation is linked to increased risk of depression, cognitive decline, and earlier mortality.
Specialist care
Some domiciliary care providers offer specialist services for more complex needs:
- Dementia care — structured routines, redirection techniques, and environment management for people living with Alzheimer's or other forms of dementia
- Palliative and end-of-life care — supporting someone to remain at home during their final months or weeks, often in coordination with district nurses and hospice teams
- Reablement — short-term, intensive support (usually 6–12 weeks) to help someone regain independence after a hospital stay or illness
- Complex clinical care — PEG feeding, stoma care, or ventilator management, delivered by specially trained carers under nursing supervision
Specialist care typically costs more and requires carers with additional qualifications. Not every agency provides it, so check before you commit.
What domiciliary care does NOT cover
It is equally important to understand the boundaries:
- Nursing care — domiciliary carers are not nurses. Tasks like wound dressing, injections, and clinical assessments are provided by district nurses through the NHS, not by your home care agency
- 24/7 supervision — standard visiting care provides set hours. If your parent needs someone present at all times, you will need live-in care or residential care
- Emergency response — carers are not paramedics. If your parent falls between visits or has a medical emergency, they will need to call 999 or use a telecare alarm
- Major household maintenance — plumbing, electrical work, and structural repairs are not part of a care package
Understanding these boundaries early prevents frustration later. If your parent's needs cross into nursing territory, speak to your GP about district nurse referrals or consider whether a care home with nursing might be more appropriate.
What Types of Domiciliary Care Are Available?
Domiciliary care is not one-size-fits-all. The right type depends on how much support your parent needs and when they need it.
| Type | What it involves | Typical cost (2026) | Best for |
|---|---|---|---|
| Hourly visiting care | Carer visits 1–4 times daily for 30–60 minutes each | £26–38 per hour | Moderate needs — personal care, medication, meals |
| Live-in care | Carer lives in your parent's home full-time | £1,200–1,500 per week | High-dependency needs where your parent wants to stay at home |
| Night sleeping care | Carer sleeps in the home overnight, available if needed | Around £210 per night | Reassurance overnight; someone present in case of a fall or confusion |
| Night waking care | Carer stays awake through the night providing active support | Around £260 per night | Frequent night-time needs — repositioning, toileting, wandering |
| Respite home care | Temporary increase in care hours to give family carers a break | Varies (usually hourly rate) | Family carer holiday, illness, or burnout prevention |
Hourly visiting care is by far the most common arrangement. Most families start with one or two visits per day and increase as needs change. The minimum visit length is usually 30 minutes, though some councils still commission 15-minute visits for medication-only calls.
Live-in care is the main alternative to a care home for people who need round-the-clock support. At £1,200–1,500 per week, it is comparable to or slightly more than the average care home fee — but your parent stays in their own home. It works best when the home has a spare bedroom for the carer. For a full breakdown of what live-in care involves and costs, see our complete guide to live-in care.
Night care is often the tipping point. If your parent needs active support through the night, the cost of waking night care alone can exceed £1,800 per week — at which point a care home may become the more practical and affordable option.
Worked Scenario: How Domiciliary Care Scales
To understand how care builds up, let's trace a common 18-month trajectory for an elderly parent living alone.
Stage 1: The Start (1 Visit / Day)
- Need: Medication prompt and breakfast prep in the morning.
- Time: 30 minutes.
- Cost (at £28/hr): £14/day = £98/week.
- This is highly sustainable and prevents early crises.
Stage 2: The Middle (3 Visits / Day)
- Need: Morning (wash/dress/breakfast), Lunch (hot meal prep), Evening (pajamas/bed prep).
- Time: 45 mins morning, 30 mins lunch, 30 mins evening.
- Cost (at £28/hr): £49/day = £343/week (£1,486/month).
- The family claims Attendance Allowance (£114.60/week) which covers a third of the cost.
Stage 3: The Limit (4 Visits / Day + Night Risk)
- Need: 4 visits (including tea time) + mobility has declined, meaning two carers are needed to safely operate a hoist for transfers. Plus, she now needs help toileting at night but only has day visits.
- Time: 4 visits per day x 2 carers = 8 billed visits.
- Cost: Approx £120/day = £840/week.
- At £840/week for daytime care, plus the high risk of a night-time fall when no carer is present, the family must now seriously consider whether a residential care home provides better safety and value.
Who Is Domiciliary Care Suitable For?
Domiciliary care works well for a wide range of people, but it is not suitable for everyone. Understanding the fit before you arrange care saves time, money, and distress.
Domiciliary care is typically a good fit for:
- Older adults who need help with daily tasks but are otherwise safe at home — getting dressed, preparing meals, taking medication on time
- People recovering from hospital stays — reablement packages of 6–12 weeks can restore confidence and independence after a fall, surgery, or illness
- Those living with long-term conditions — Parkinson's, multiple sclerosis, stroke recovery, or arthritis, where support needs are predictable and manageable
- People in the early to mid stages of dementia — structured visits, medication prompts, and companionship can maintain quality of life at home for months or years
- Adults with physical disabilities — where personal care and mobility support enable independent living
- People who want to remain at home — for many older adults, staying in their own home is the single most important factor in their wellbeing
When domiciliary care is NOT suitable:
Not every situation can be managed at home, and recognising this early is important. Domiciliary care may not be enough if your parent:
- Needs supervision between visits (frequent falls, leaving the cooker on, wandering outside)
- Has advanced dementia with severe confusion, aggression, or sundowning that creates safety risks
- Requires nursing-level clinical care that cannot be delivered by visiting district nurses alone
- Lives in a home that is physically unsuitable — steep stairs with no stairlift, no downstairs bathroom, poor heating
- Is profoundly isolated and the loneliness is worsening despite companionship visits
In these situations, a care home or nursing home may provide a safer, more sociable environment. That does not mean domiciliary care has failed — it means needs have changed.
How Much Does Domiciliary Care Cost?
Cost is usually the first question families ask, and the answer is not always straightforward. Prices vary by region, provider, and the complexity of care required.
Average hourly rates in 2026:
- England average: £26–38 per hour
- London and the South East: £30–42 per hour (10–15% above national average)
- North of England, Wales, and rural areas: £22–30 per hour
The Homecare Association publishes an annual minimum price for sustainable home care delivery. For 2026, this stands at £34.42 per hour — the rate below which providers struggle to pay carers fairly, maintain training standards, and remain financially viable. If an agency quotes significantly below this figure, ask how they achieve it.
What drives the cost:
- Time of day — evening and weekend visits typically cost 10–20% more
- Specialist care — dementia or complex clinical care attracts a premium
- Visit length — shorter visits (30 minutes) cost more per hour than longer ones due to travel time
- Rural locations — travel time between clients increases the effective cost
- Bank holidays — expect to pay 1.5x to 2x the standard rate
Putting it in context:
A typical care package of three 45-minute visits per day, seven days a week, costs approximately £1,000–1,400 per month at standard rates. By comparison, the average care home fee in England is around £1,000–1,500 per week. Domiciliary care is often more affordable for low-to-moderate needs, but the cost equation shifts once you need more than about 15–20 hours of care per week.
How to Get Domiciliary Care
Arranging domiciliary care in the UK follows a reasonably standard process, whether you go through your local council or arrange it privately.
Step 1: Request a care needs assessment (free)
Contact your local council's adult social care team and ask for a care needs assessment. This is a legal right under the Care Act 2014 — the council cannot refuse. The assessment is free regardless of your financial situation.
During the assessment, a social worker or assessor will:
- Visit your parent at home (or in hospital if they are about to be discharged)
- Discuss their daily routine, what they can and cannot manage, and what matters most to them
- Identify eligible needs under the national eligibility criteria
- Recommend the type and level of care that would meet those needs
The assessment should take into account your parent's wishes, their physical and mental health, and any risks to their safety or wellbeing. If you are a family carer, you are also entitled to a carer's assessment to evaluate the impact on your own health and wellbeing.
Step 2: Financial assessment
If the needs assessment confirms your parent is eligible for care, the council will carry out a financial assessment (sometimes called a means test) to determine how much they should contribute towards the cost.
The thresholds for 2026 in England are:
- Capital below £14,250: The council pays for care; your parent contributes from income only
- Capital between £14,250 and £23,250: Partial council funding; your parent pays a contribution based on a "tariff income" calculation
- Capital above £23,250: Self-funded; the council will not contribute, but must still arrange care if asked
For domiciliary care specifically, the value of your parent's home is not included in the financial assessment — unlike care home funding, where the property is usually counted after 12 weeks. This is an important distinction and one reason some families choose to maximise home care before considering residential options.
For a detailed breakdown of funding thresholds, see our guide to care home funding eligibility. The means test rules are the same for domiciliary care and residential care.
Step 3: Council-arranged or privately arranged care
Once the assessment is complete, you have two options:
Council-arranged care. The council selects a provider from its approved list and manages the care package. You (or your parent) may have limited choice over which agency is used, but the council handles contracts, quality monitoring, and complaints.
Privately arranged care. You find and hire a care agency yourself. This gives you more control over who provides care and when, but you are responsible for vetting the provider, agreeing terms, and managing the relationship. If your parent is council-funded, they can request a direct payment — a cash amount from the council to purchase care independently.
Many self-funding families go straight to private providers without involving the council at all. This is perfectly fine, but be aware that skipping the needs assessment means you lose the safety net of council support if your parent's savings run out later.
Step 4: Care plan
Whether arranged through the council or privately, a good provider will create a care plan before care begins. This should include:
- What tasks will be carried out at each visit
- Preferred times and routines
- Medication details
- Emergency contacts and procedures
- Your parent's preferences, likes, and dislikes
- Goals — what the care is trying to achieve (not just tasks to complete)
Review the care plan regularly. Needs change, and the plan should change with them.
Who Pays for Domiciliary Care?
Funding for domiciliary care comes from several possible sources. Most families use a combination.
Council-funded care (capital below £23,250)
If your parent's savings and investments fall below the upper threshold, the council will contribute towards the cost. The amount depends on the financial assessment. Your parent will still pay something from their income (usually pension and benefits), but the council covers the rest.
Partially funded care (capital £14,250–£23,250)
In this band, the council assumes your parent can afford to contribute £1 per week for every £250 of capital above £14,250. This "tariff income" is added to their actual income to calculate their contribution.
Self-funded care (capital above £23,250)
If your parent has savings, investments, or other capital above £23,250, they are expected to pay for their own care in full. The council must still carry out a needs assessment if requested, and must arrange care if asked — but will not contribute financially.
Direct payments
If your parent qualifies for council-funded care, they can request a direct payment instead of council-arranged services. The council pays a set amount into their bank account, and they use it to hire care workers or an agency of their choice. This provides more flexibility and control.
Attendance Allowance
Attendance Allowance is a non-means-tested benefit for people aged 65 and over who need help with personal care. It is worth up to £114.60 per week (higher rate, 2026) and is not affected by savings, income, or other benefits. It can be used towards domiciliary care costs and does not need to be declared in the council's financial assessment.
If your parent is not already claiming Attendance Allowance, apply as soon as possible. It takes 6–10 weeks to process and is not backdated to before the application date. Our guide to care home funding eligibility explains the interaction between Attendance Allowance and other funding sources in more detail.
NHS Continuing Healthcare (CHC)
If your parent has a "primary health need" — meaning their care needs are mainly driven by a health condition rather than social care needs — they may qualify for NHS Continuing Healthcare. This covers the full cost of care, whether delivered at home or in a care home, and is entirely free. CHC is assessed through a multi-disciplinary team and uses a standardised decision support tool. Eligibility is strict, but it is worth pursuing if your parent has complex medical needs.
Not sure which funding routes apply to your situation? Our Funding Guide provides a personalised breakdown of every option available to you, based on your specific circumstances.
How to Choose a Domiciliary Care Provider
Choosing the right provider is one of the most important decisions you will make. A poor choice leads to missed visits, inconsistent carers, and deteriorating wellbeing. Here is what to look for.
Check the CQC rating
All domiciliary care providers in England must be registered with the Care Quality Commission (CQC). Each provider is inspected and rated on five key questions: safe, effective, caring, responsive, and well-led. Ratings range from Outstanding to Inadequate.
As a minimum, look for providers rated Good or above. Check the date of the last inspection — a rating from three or more years ago may not reflect the current quality. Read the full inspection report, not just the headline rating. Pay particular attention to the "Safe" and "Responsive" sections.
Ask about staff checks and training
Every carer entering your parent's home should have:
- A current DBS (Disclosure and Barring Service) check — this is non-negotiable
- Mandatory training in moving and handling, medication management, safeguarding, infection control, and first aid
- Specialist training relevant to your parent's needs — dementia awareness, end-of-life care, or condition-specific knowledge
Ask the provider how they recruit, vet, and train their staff. A good agency will be transparent and specific. Vague answers are a warning sign.
Consistency of carers
One of the biggest complaints about domiciliary care is the "revolving door" of different carers. Your parent should not have to explain their routine, preferences, and medical history to a new face every week.
Ask the provider:
- How many different carers will visit my parent in a typical week?
- Is there a regular team assigned?
- What happens when a regular carer is on holiday or off sick?
- Can we meet the carers before care begins?
The best providers assign a small, consistent team — ideally two or three regular carers who know your parent well.
Look for professional membership
Membership of the United Kingdom Homecare Association (UKHCA) is a positive signal. UKHCA members commit to a code of practice covering employment standards, quality of care, and ethical business practices. It is not a guarantee of quality, but it indicates a provider that takes professional standards seriously.
Other practical questions to ask:
- What is the minimum visit length? (Anything under 30 minutes is a red flag for personal care)
- What happens if a carer is running late or cannot attend?
- How do you handle complaints?
- Can I see a sample care plan?
- What are your fees, and how much notice do you need to change the care package?
- Do you have capacity to increase hours if needs change?
When Is Domiciliary Care No Longer Enough?
This is the question nobody wants to face. You arranged home care to keep your parent safe and comfortable in their own home, and for a while it worked. But needs change, and there comes a point where domiciliary care — however good — cannot provide what your parent requires.
Signs that home care may no longer be meeting needs:
- Frequent falls or safety incidents between visits — if your parent is falling when no one is there, the gaps between visits are too long
- Needing more than 3–4 care visits per day — at this level, the cost of domiciliary care often approaches or exceeds care home fees, and there are still significant hours without supervision
- Night-time needs — if your parent regularly needs help during the night, adding waking night care pushes costs well above £2,000 per week
- Wandering, confusion, or behaviour that creates risk — particularly in mid-to-advanced dementia, where the home environment itself becomes unsafe
- Increasing social isolation — if your parent spends most of the day alone despite companionship visits, a care home may offer a more sociable and stimulating environment
- Carer burnout in the family — if you or other family members are filling the gaps between professional visits and your own health is suffering, the current arrangement is not sustainable
- The home is no longer suitable — stairs that cannot be managed, a bathroom that cannot be adapted, or heating and maintenance issues that make the environment unsafe
The cost tipping point
A useful rule of thumb: once domiciliary care costs exceed around £1,000–1,200 per week, it is worth comparing the total cost with local care home fees. At that point, a care home may offer better value — not because it is cheaper per hour, but because it provides 24/7 staffing, meals, social activities, and building maintenance in a single fee.
A Critical Check (The MSIF Benchmark): If your home care quotes are reaching £1,000+ per week, you must check what a care home actually costs in your specific area. Do not rely on national averages. RightCareHome provides Market Sustainability and Improvement Fund (MSIF) data—the exact rates your local council pays care homes. In many Northern and Midlands councils, the official MSIF rate for a 24/7 residential care home is actually lower than £900/week. Paying £1,100/week for just a few hours of home care a day when full 24/7 residential care costs less is a financial drain you need to be aware of.
Making the transition
Recognising that home care is no longer enough is not a failure. It is a sign that your parent's needs have grown beyond what can be safely managed at home — and that is a reflection of their condition, not your caregiving.
If you are starting to consider residential care, a respite or trial stay can help both you and your parent experience a care home environment before making a permanent commitment. For guidance on timing, our article on when the right time might be addresses the emotional and practical factors that families weigh. You may also find our home care vs care home comparison helpful for weighing the two options side by side.
If you would like help identifying care homes that match your parent's specific needs, location, and budget, or determining exactly what your council pays (MSIF data), our Funding Calculator provides a data-driven starting point.
Get Your Custom Funding Action Plan
Summary
Domiciliary care is a valuable option for families who want to keep a loved one safe and supported at home. It covers everything from personal care and medication management to companionship and specialist support for conditions like dementia.
The key facts to remember:
- Cost: £26–38 per hour for visiting care; £1,200–1,500 per week for live-in care
- Funding: Council funding available if capital is below £23,250; Attendance Allowance (up to £114.60/week) available to all regardless of savings
- How to arrange: Request a free care needs assessment from your local council, even if you plan to arrange care privately
- Regulation: Always choose a CQC-registered provider rated Good or above
- Limits: Domiciliary care has boundaries — when needs outgrow what can be delivered at home, a care home may be the safer and more sustainable choice
The most important thing is to plan ahead. Do not wait for a crisis to start researching your options. Whether your parent ultimately stays at home or moves to residential care, understanding the landscape early gives you more choice, better outcomes, and less stress when the time comes to act.
Terminology: Domiciliary Care, Home Care, Care at Home
These terms all describe the same thing — professional care delivered in a person's own home. "Domiciliary care" is the formal term used by the CQC and in legislation. "Home care" and "care at home" are the everyday equivalents. If you see these terms used interchangeably, they mean the same service.
Two related terms that are not the same: reablement is a short-term programme (typically 6-12 weeks) provided free by the council to help someone regain independence after illness or a hospital stay. Intermediate care is a time-limited NHS service bridging hospital and home. Neither is ongoing domiciliary care, though both may lead to it.
Sources
- CQC — Care Quality Commission — provider registration, inspection ratings, and regulation of domiciliary care
- Care Act 2014 — legal framework for needs assessments, eligibility, and funding
- Skills for Care — The state of the adult social care sector and workforce — workforce data and training standards
- GOV.UK — Care and support statutory guidance — detailed guidance on means testing and local authority duties