How do you choose a home care agency?
Start by looking up the agency's latest inspection report from the regulator for your part of the UK — the Care Quality Commission in England, the Care Inspectorate in Scotland, Care Inspectorate Wales, or RQIA in Northern Ireland. It's free, it's public, and it tells you more than any brochure. After that, ask the same short list of questions of every agency on your shortlist, and the right one usually becomes obvious.
Start with the regulator
Any home care agency that provides personal care — help with washing, dressing, medication, getting in and out of bed — has to be registered with an independent regulator, and that regulator publishes a report on each one it registers. Which body it is depends on where the person lives, and the reports don't all look the same, so it helps to know what you're reading before you start.
| Where the person lives | Regulator | What the report gives you | Where to check |
|---|---|---|---|
| England | Care Quality Commission (CQC) | A rating: Outstanding, Good, Requires improvement or Inadequate | cqc.org.uk |
| Scotland | Care Inspectorate | Grades from 1 (unsatisfactory) to 6 (excellent) across several themes | careinspectorate.com |
| Wales | Care Inspectorate Wales (CIW) | A written inspection report, with no star or number rating | careinspectorate.wales |
| Northern Ireland | RQIA | An inspection report judged on safe, effective, compassionate and well-led care | rqia.org.uk |
Sources: Care Quality Commission ratings and care directory (cqc.org.uk, directory updated monthly); Care Inspectorate Scotland six-point grading scale, 1 unsatisfactory to 6 excellent (careinspectorate.com); Care Inspectorate Wales inspection reporting under the Regulation and Inspection of Social Care (Wales) Act 2016 (careinspectorate.wales); RQIA registration and inspection of domiciliary care agencies (rqia.org.uk). All checked October 2026.
A registered agency will give you its registration details happily. If a provider can't or won't say who regulates it, treat that as a reason to pause. There is one gap worth knowing about: in England, an introductory agency that only matches you with a self-employed carer, and doesn't direct the care itself, may not be CQC-registered, because it isn't carrying out the regulated activity. That can be a perfectly good way to arrange care — but it means the inspection report you'd normally lean on won't exist, so more of the checking falls to you.
What a CQC rating actually tells you
For agencies in England, the CQC judges every service against five plain questions: is it safe, is it effective, is it caring, is it responsive, and is it well-led? The overall rating — Outstanding, Good, Requires improvement or Inadequate — is built from those. Good means the service meets the standards expected of it, which is where most agencies sit. Requires improvement means concerns have been found and the agency has been told to put them right; Inadequate means serious failings, and the agency may face enforcement action.
Two things matter when you read one. First, look at the date. A rating can be a couple of years old, and because the CQC has a backlog of inspections, a good number of agencies are still carrying an older judgement or none at all — so a missing rating isn't proof of a problem on its own, it just means you check more yourself. Second, open the full report rather than stopping at the headline word. An agency rated Good overall can still be Requires improvement on one of the five questions, and if that question is Safe, that's exactly the detail you want before you trust someone with medication or helping the person move around.
An agency, or a carer you employ yourself?
There are two broad routes, and neither is better in the abstract. A fully managed agency sends employed carers, arranges cover when someone is off sick or on holiday, carries its own insurance, runs the background checks and supervises the work. You pay more for that, and you usually have less say over exactly who turns up on the day. Employing a carer yourself, or using an introductory agency to find a self-employed one, tends to cost less and can give you the same familiar face at every visit — but the cover when they're away, the insurance, and often the employment responsibilities become yours to handle.
Which one fits comes down to how much the family can realistically take on, and how much continuity matters to the person being cared for. It's the first real decision to make, because it shapes everything else about how the care is arranged.
The questions worth asking every agency
Ask the same handful of questions of each agency on your list and the differences show up quickly. Write the answers down as you go — it's easy to muddle two providers up after a morning of phone calls.
- Will the same carer, or a small regular team, visit — and what happens when they're on holiday or off sick?
- Are your carers employed and background-checked (a DBS or Access NI check), and what training do they have before working on their own?
- Can you show me a written care plan, and how often is it reviewed as things change?
- If more hours are needed later, can you increase the care without us having to move to another agency?
- How are the costs worked out — do evenings, weekends and bank holidays cost more, and are there travel or other charges on top?
- What is your cancellation policy, and are we refunded if the person goes into hospital?
- How do we raise a concern, and who do we reach out of hours?
Good providers answer these without hesitating, because they've been asked them many times before. Hesitation, vagueness about cost, or a reluctance to put the care plan in writing all tell you something.
Where a social worker fits in
Before you start ringing round, it's worth asking the council for a free care needs assessment. A social worker or assessor looks at what the person can and can't manage and writes down what support would help, and they can often point you towards agencies in the area. Anyone can ask for an assessment, and it's worth having even if you expect to pay privately, because it gives you a clear description of the hours and the type of care to ask each agency for. Our guide to paying for care at home explains how to request one and how council funding, benefits and NHS funding work, and the cost of home care page shows the hourly and weekly rates to expect.
In this section
These pages take the choices in turn — weighing an agency against a private carer, comparing care at home with a care home, and getting the right people involved — so you can decide with your eyes open.
Common questions
If you already know care is needed, tell us what's needed and where, and home care providers covering that postcode will contact you. It's free and there's no obligation.