Domiciliary Care in Exeter

What domiciliary care in Exeter actually means

If you have recently had a conversation with a social worker, a discharge coordinator or somebody at Devon County Council, you have probably heard the phrase domiciliary care. It is not a special kind of care. It is any care delivered in the place where you live, as opposed to a care home, a nursing home or a hospital. Help with washing and dressing at home is domiciliary care. So is somebody coming in to make lunch and prompt the tablets. Most families call it home care, and they are right to.

The reason the word matters is that it decides how care is arranged and paid for. When the council assesses somebody as needing support at home, they will talk about domiciliary care, and they will offer one of two routes to get it.

The two ways domiciliary care is usually arranged

The first route is that the council, or you, engage a company. The company employs carers, holds a registration with the Care Quality Commission, runs a rota, and sends whoever is available. That is the model most people picture when they hear the word, and it suits a lot of families, particularly where needs are high or where cover for absence matters more than continuity.

The second route is that you engage a person directly. The council calls this a personal assistant. You choose the individual, agree the hours and the tasks, and direct the care yourself. Because the carer works under your direction rather than for a company, the arrangement sits outside CQC registration. It is a recognised and long-established way of arranging care, and it is how I work. The trade-off is simple and I do not hide it. You get one known person, and you take on the job of planning for their absence.

Direct payments from Devon County Council

If the council has assessed you and agreed that you are eligible for support, you can usually ask for a direct payment rather than a council-arranged provider. A direct payment is a sum of money paid to you, or to somebody managing it on your behalf, to arrange your own care. Spending it on a self-employed carer is one of the most common uses.

The council may ask to see that whoever you engage is insured and DBS checked, and may want a record of hours. I keep those records anyway, and I bring the documents to the first visit. If you are not sure whether you would qualify, the starting point is a needs assessment from the council's adult social care team, which you or a family member can ask for. I will happily talk it through, though I cannot apply on your behalf.

Paying privately

Many families pay for domiciliary care themselves, either because they do not qualify for council support or because they would rather not wait for an assessment. That is entirely straightforward here. An agreed hourly rate, a written agreement, and an invoice. My usual arrangement is a minimum term of three months, paid in advance, and that is open for discussion at the first visit. There is no registration fee.

What I do, and what I do not

I provide personal care, medication support, meals, help getting out, light housework and company, at agreed times, any day of the week. I do not provide nursing, so injections, dressings and clinical tasks come from the district nursing service. I do not provide overnight or live-in care. I do not do two-person moving and handling alone. And because I work by myself, I cannot provide a replacement when I am ill or away. Before we start, I help you plan for that, and the plan goes in writing with everything else.

Checking an independent carer

Whoever you engage, ask to see three things. An enhanced DBS certificate, ideally with the adults barred list check and, better still, on the DBS Update Service so you can verify it online. An insurance schedule covering public liability and professional indemnity. And training certificates for moving and handling, safeguarding, medication and first aid. I bring all three to the first visit without being asked. If somebody cannot produce them, keep looking.