Ask the Registered Manager: Choosing the Right Home Care

Kim Hillier, Registered Manager at Bloomfield Care in Newbury, West Berkshire, answers five questions families often ask when they're weighing up care for someone they love.

What happens when someone receiving care at home needs more support?

One of the biggest benefits of having consistent carers is that they get to know each person well: their routines, their preferences, their needs and what is "normal" for them. That familiarity means carers can spot changes in someone's health, wellbeing or behaviour that might otherwise go unnoticed.

When we notice a change, we arrange a review with the person and, where appropriate, the people they've chosen to represent them. Together we talk through what has changed, agree any extra support that's needed and update the care plan, so the care continues to meet their needs, wishes and the outcomes that matter to them.

That's why continuity of care is so important to safe, effective, person-centred care, and why we work hard to provide a consistent team of carers who know you, understand your care plan and can recognise when something isn't quite right.

How can families tell whether a home care company is well managed?

Choosing a home care provider is a big decision, and you should feel confident that the company you choose is well managed, organised and committed to high-quality, person-centred care.

Read independent reviews. One of the best ways to judge a provider is to hear from people who have used the service. Websites such as homecare.co.uk carry feedback from clients and families on the quality of care, the reliability of carers, communication and the overall experience.

Talk to the managers. The management team should be able to explain clearly how care is delivered, how carers are recruited and trained, how quality is checked, and what happens when there's a concern or someone's needs change. A well-run service answers these questions confidently and can show that good processes are in place.

Expect openness. Clients and families should be able to see relevant care records, such as care plans and visit notes, where appropriate and in line with the person's consent and data protection rules. It keeps you informed and reassures you that visits are happening and needs are being met.

Notice how responsive they are. Do you hear from them regularly? How do they handle feedback or a complaint? A well-managed provider welcomes questions, listens and shows that it is always looking to improve.

What is the difference between a care agency and hiring a private carer?

Both can provide high-quality, person-centred care, but there are some important differences to think about.

A private carer can offer a very personal, one-to-one experience. Over time a close professional relationship can develop, with real familiarity, companionship and trust, which can be very reassuring for someone being cared for at home.

Because a private carer works independently, though, cover can be a problem. If they're unwell, have a family emergency or take annual leave, there may be nobody else available, and the family may have to arrange alternative care themselves. Private carers working directly for an individual generally don't have to register with the Care Quality Commission (CQC), although this depends on how the care is arranged. Families should make sure the right training, experience, references and DBS checks are in place, and if you employ the carer directly, some employer responsibilities may fall to you or your representative.

A care agency gives you the reassurance of a wider team and an established management structure. A good agency still aims to provide a small, consistent team of carers who get to know the person's routines, preferences and needs, while having other carers ready to step in during sickness, holidays or emergencies.

Agencies providing regulated personal care in England must be registered with the CQC and are responsible for meeting its standards of safety, quality and governance. They're also responsible for making sure carers have the right training, competency checks and recruitment checks, including DBS checks.

An agency also brings support beyond the individual carer: a management team, an out-of-hours on-call service, regular care reviews and quality monitoring. It can usually respond more flexibly when needs change, whether that means more visits, different visit times or extra support.

In short, a private carer offers one familiar person, while a good care agency aims to give you that same personal relationship with the added security of a wider team, professional oversight and back-up when you need it.

Can someone with significant care needs stay at home instead of moving into a care home?

Yes, absolutely. Having significant or increasing care needs doesn't automatically mean someone has to move into a care home. With the right support, many people can carry on living safely and comfortably at home, even as their needs become more complex.

We believe everyone should have the chance to stay in the place they call home, surrounded by familiar belongings, memories and routines, wherever that can be done safely and in line with their wishes.

As needs grow, visiting care may no longer give enough support. This is where live-in care can be a real alternative to a care home. With Bloomfield Care's live-in service, a dedicated carer lives in the person's home, providing support through the day, companionship and reassurance, and help with everyday living, including personal care, medication support, mobility, meals and more complex needs.

Live-in care also brings greater continuity. The carer builds a detailed understanding of the person's preferences, routines and changing needs, which can be especially helpful for people living with dementia or anyone who finds changes to their surroundings unsettling.

Every situation is different, so our team carries out a full assessment to make sure live-in care can meet someone's needs safely, looking at mobility, equipment, overnight support and anything else that's needed. Where it helps, live-in care can be combined with visiting carers or other health professionals.

What are the warning signs that a home care package is no longer enough?

As someone's needs change, there may come a point where their current care no longer gives them enough support. Spotting this early is key to keeping them safe and comfortable. Signs to look out for include:

These signs don't automatically mean someone needs to move into a care home. At Bloomfield Care we review care needs regularly and act quickly when things change. Our carers are encouraged to report anything that isn't usual for the person, so we can arrange a review with them, their chosen representatives and any health professionals involved.

That review helps us work out whether extra visits, longer calls, specialist equipment or a move to live-in care could give the extra support needed. Where someone's needs become more clinically complex, we can also work alongside district nurses and other health professionals to see whether they can continue to be cared for safely at home.

If you're facing any of these questions for someone you care about, our Newbury team is happy to talk it through with you.