Long Term Care in Exeter
Are you looking for long term care at home in Exeter that does not keep changing?
An ongoing arrangement with one carer, reviewed as needs change, on terms agreed in writing
Long term care is where the difference between one carer and a rota shows most. Over months and years, the person who visits becomes part of the household. They know the history, the routine and the small signs that something is wrong. That cannot be handed over on a shift sheet.
Free visit, no obligation, and an honest answer about whether I am the right fit.
- Enhanced DBS checked
- Fully insured
- Free home visit
- Same carer, every visit
Long term care in Exeter, done by one person
Most care is arranged in a hurry, after a fall or a diagnosis or a discharge. Long term care is different. It is the arrangement that carries on once the emergency has passed, and it is where families most often become unhappy with what they have. The complaint is almost always the same. Too many different people. Nobody who knows her. A new face every week, and every new face asking the same questions.
The reason I work alone is that continuity is the thing long term care most needs and the thing a rota cannot provide. When the same person visits three times a week for two years, they do not need a care plan to know that she likes the radio on in the kitchen and that Tuesday is the day her son rings. They notice when the radio is off.
How the arrangement starts
It starts the same way every arrangement does. A phone call, then a free visit, then a written agreement. The difference for long term care is what goes into the agreement. As well as the days, times and tasks, we talk about what is likely to change. What happens if mobility gets worse. What happens if memory does. What the family want to be told, and when. None of it is binding, and all of it is useful, because it means the first review is a continuation of a conversation rather than a surprise.
Reviewing as things change
Needs do not stay still. What starts as two mornings a week for a bit of help with the shower often becomes every morning, then mornings and afternoons. Sometimes it goes the other way, after an operation heals or a medication is sorted out. Either way, the agreement is reviewed with you, and changed in writing, before anything on the ground changes.
I will also tell you when I think a review is needed, even if you have not asked. Seeing someone regularly over a long period means I am often the first to notice a slow drift. Eating less. Sleeping more. Confusion that was occasional becoming daily. Families deserve to hear about that early, while there is still time to plan.
Long term care and dementia
Dementia is the condition where long term continuity earns its keep most clearly. A person whose memory is failing can still recognise a voice, a face and a routine long after names have gone. Keeping all three constant, visit after visit, is the most reassuring thing anyone can offer. I keep the order of things steady, I do not correct or argue, and I follow the person's pace on the day.
I am also honest about the end of what I can do. There is a stage of dementia where one carer is not enough, where nights become unsafe or where two people are needed for moving. When I can see that stage approaching, I will say so and help you look at what comes next. That is a harder conversation than pretending, and it is the right one.
Working with everyone else involved
Long term care usually means other people are involved too. A GP. District nurses. A social worker, if the council is involved. An occupational therapist who has been out to look at the stairs. With your permission I keep in touch with them, pass on what I notice, and keep the sort of records that make their job easier. I do not speak for you and I do not make decisions for you. I make sure that what happens at home is known to the people who need to know it.
The single point of failure, and what to do about it
One carer is a single point of failure, and any family arranging long term care with an independent carer should say that out loud. If I am ill, on holiday or, one day, no longer doing this, there is nobody behind me to step in. I do not hide from that. Before any long term arrangement starts, I help you put a backup in place, whether that is family, a neighbour, or a second provider kept warm. I encourage you to keep it alive even in the years when it is never needed. That is what makes the arrangement safe enough to rely on.
Why long term care works better with one carer
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A relationship, not a rota
Over months and years, the same person coming through the door is what turns care into something that feels like part of life rather than an intrusion into it.
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The agreement grows with you
What was two mornings a week can become every morning. The agreement is reviewed with you, not changed at you.
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Small changes get caught
Seeing someone regularly for a long time means I notice the slow drift. Less appetite, more confusion, a fall that was not mentioned.
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Family know where they stand
A regular update, in whatever form suits you. Long-term care works best when nobody is guessing.
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Honest about capacity
Because I work alone, there is a point where one carer is no longer enough. I will say so early and help plan what comes next.
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Terms you can read
My usual minimum term is three months, paid in advance, and that is open for discussion at the first visit. Either of us can end it with two weeks notice, and the rate does not change without telling you in writing first.
Starting an arrangement that is built to last
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Step 1: A phone call
Tell me what is going on. No script and no sales pitch. If it is not something I can safely take on, I will say so on that call.
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Step 2: A visit, free of charge
I come to you. We sit down, talk through what would actually help, and you decide whether I am the right fit. No charge and no obligation.
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Step 3: A written agreement
Days, times, what I will do and what it costs, in plain English. Yours to keep, and nothing in it changes without asking you first.
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Step 4: We start
Same carer, every visit. After a few weeks I know the routine, the neighbours, and which mug is the right one.
How this compares
Three ways families arrange care at home. None is right for everyone, and the honest answer is usually about what matters most to you.
| Question | Private Independent Care | An agency | Live-in care |
|---|---|---|---|
| Who turns up | Me, every time. You met me before anything was agreed. | Whoever is on the rota that day. Often a different person each week. | One carer living in the house, with a second covering their days off. |
| How long a visit lasts | As long as we agreed. I am not counting down to the next address. | Frequently 30 minutes, sometimes 15, and the travel between calls comes out of it. | Not visit based. Support is available through the day, with agreed breaks. |
| What you pay for | Between £20 and £40 an hour for the hours I am with you, one figure agreed in writing before we start. Usual minimum term three months, paid in advance, open for discussion at the first visit. | An hourly rate set by the agency, which also pays for an office, a manager and a rota. Ask each one for its rate and terms. | A weekly fee, usually well over a thousand pounds, plus board and lodging. |
| When I am ill or away | I cannot send anyone else. You keep a backup arrangement, and I help you set one up before we start. | The office sends a replacement, though you may not know them. | The provider arranges relief cover. |
| Who you deal with | Me. The person doing the care is the person you ring. | A coordinator or care manager, then the carer. | The provider, then the carer. |
| Regulation | Engaged directly by you, working under your direction, which sits outside CQC registration. DBS checked and insured, and I will show you both. | Registered with the CQC and inspected. | Usually a provider registered with the CQC. |
I do not offer live-in, overnight or nursing care. If that is what is needed I will say so at the first phone call.
What it costs
Hourly rate
£20 to £40 per hour
Where in that range depends on what is needed. I give you one fixed figure at the free first visit, in writing, before anything is agreed.
- The rate is all in. Mileage is included, there is no VAT to add, and there is no registration fee or charge for the first visit.
- Minimum visit one hour. Usual minimum term three months, paid in advance, open for discussion at the first visit.
- A visit I miss, or cannot complete because I am ill, is not charged. The time is carried over to another visit or refunded, whichever you prefer.
- A visit you cancel with 48 hours notice is carried over. With less notice it is charged.
- 14 days to change your mind after signing the agreement. Visits you asked me in writing to start in that time are paid for.
- Two weeks notice to end the arrangement, from either of us. If it ends early you pay for the visits made and the notice period, and the rest is returned.
Questions families ask
How long have your arrangements typically lasted?
I am a new business, so I will not pretend to a track record I do not have yet. What I can tell you is how it is set up. The agreement starts with my usual minimum term of three months, paid in advance, which is open for discussion at the first visit, and carries on after that with no end date. It is reviewed whenever things change, and either of us can end it with two weeks notice.
What happens when needs increase?
The agreement changes. More visits, longer visits, or a different mix of help. I will tell you what I can take on and what I cannot. If the point comes where one carer is no longer enough for safety, I will say so plainly and help you look at other options, rather than stretching until something goes wrong.
Do you support people with dementia over the long term?
Yes, at any stage where home is still the right place to be. Continuity is the single most useful thing in dementia care, and it is the thing this arrangement is built on. As the condition progresses I will be honest with you about what is working and what is not.
Can you work alongside the GP, district nurses or a social worker?
I can and I do, with your permission. I will pass on what I notice, keep records you can share, and make sure appointments and visits from other services are not missed. I do not speak for you, but I can make sure you are heard.
What if you stop working or move away?
I would give you as much notice as I possibly could, and help you find another carer to take over. It is a fair question to ask any independent carer and you should ask it. The honest answer is that one person is a single point of failure, which is why I will encourage anyone in a long-term arrangement to keep a backup alive even when it is not being used.
Does the rate go up over time?
The hourly rate is agreed at the first visit, between £20 and £40, and it will not change without telling you well in advance. Any change to the rate would be in writing, with notice, and you could end the arrangement with two weeks notice if it no longer worked for you.
Other things I can help with
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Home Care
Help at home with the things that have become hard, from one carer you know.
About home care -
Visiting Care
Regular visits, morning, midday, afternoon or evening, that last as long as they need to.
About visiting care -
After Hospital Care
Support for the first few weeks back at home after a stay in hospital.
About after hospital care -
Domiciliary Care
What the term means, how it works with a direct payment, and how I differ from an agency.
About domiciliary care -
Personal Care
Washing, dressing and continence support, done with patience and privacy.
About personal care
Thinking further ahead?
Tell me where things are now and where you think they are heading. That conversation is usually the most useful part of the first call.