How to arrange home care in London: a family's step-by-step guide

Arranging care for a parent or partner usually starts in a moment nobody planned for — a fall, a hospital stay, or the slow realisation that things at home aren't working any more. Here is the path through it, step by step.

1. Start with a needs assessment

Every adult in England who appears to need care is entitled to a free care needs assessment from their local council's adult social care team, under the Care Act 2014. You can request one whether or not you expect the council to pay for anything. An assessor looks at what the person can and can't manage — washing, dressing, meals, medication, getting about — and writes up what support would help.

You can request an assessment through your local council's website (search "[your borough] adult social care assessment") or by phone. If the person is in hospital, ask the ward about discharge planning — an assessment can be arranged before they come home.

2. Understand who pays

After the needs assessment comes a financial assessment (means test). In England, broadly:

• If the person has savings and assets above the upper capital limit, they pay for their own care ("self-funding").
• Below that limit, the council contributes on a sliding scale.
• The value of their home is not counted while they still live in it and only need care at home.

If the council does fund some care, ask about direct payments — money paid to you or the person needing care so you can choose your own care agency, rather than the council choosing one for you. Many of our clients use direct payments.

Some people with significant, complex health needs qualify for NHS Continuing Healthcare, which is not means-tested. It has a strict eligibility process, but it's always worth asking the GP or district nurse whether an assessment is appropriate.

3. Choose a care agency

Every home care agency in England must be registered with the Care Quality Commission (CQC), the independent regulator. Check any agency you're considering on cqc.org.uk — you'll see their inspection history and overall rating (Outstanding, Good, Requires Improvement, or Inadequate).

Beyond the rating, ask:

• Will we get a small, consistent team of carers, or someone different each day?
• How are carers vetted and trained? (Enhanced DBS checks, verified references and refreshed mandatory training should be the baseline.)
• What happens if a carer is ill or on holiday?
• How is the care plan reviewed as needs change?
• Can we reach a real person out of hours?

4. The care plan

A good agency visits you at home before care starts, and builds the plan around the person's actual routines — when they like to get up, how they take their tea, what independence they want to keep. The plan should be written down, shared with you, and reviewed regularly.

5. Starting care

Expect an introduction to the carer before or at the first visit, clear timesheets or visit logs, and regular contact from the agency's office. If something isn't right, say so early — a good agency wants to hear it.

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Bright London Care is a CQC-registered home care agency rated Good, supporting families across every London borough. If you're at the start of this journey and just want to talk it through, call us on 020 8214 1321 — no obligation, no pressure.