The Important Factors When Choosing Domiciliary Care


A survey conducted during the period 7 July to 19 August 2014 prepared by Mumsnet for the Care Quality Commission (CQC) offers some useful information about what is important to people who are looking for care for a relative. The survey had 259 respondents; all of whom were users of Mumsnet or Gransnet.

There are a number of factors that the survey shows are of critical importance to most people looking for home care. I don’t think that this was intended to be an exhaustive list. There may well be other factors that you might add to the list. The factors discussed below just happened to be the ones that the survey chose to ask respondents about the importance that they would place on each of them. Let’s examine these factors.

Finding a homecare services that offers a choice of times for visits

It offers no surprise to me that 92% of respondents thought that this was a very or quite important factor when considering choosing a home care provider. Domiciliary care provides some very distinct advantages for its recipients. Not least of these advantages is that home care allows you to remain living independently in your home and to continue with your own routine. If, however, you are told that you cannot have the times you want for your calls the effect can be to disrupt severely the routine you are used to.

It is necessary to be realistic and reasonable when considering the times that visits can be arranged. A good home care provider will always go the extra mile to give its customers calls at the times that its customers want. Why wouldn’t it? That is good business practice and good customer service. Sometimes, though, there will be operational and logistical challenges that make it next door to impossible to satisfy every customer with calls down to the minute.

What is quite unreasonable, though, is for providers to dictate the times that customers can have calls. Worse than this, I should suggest, is for providers to dictate that calls will fall into a designated time slot that might span 2 or 3 hours.

Every home care provider has times in the day that might be considered pinch points: mornings between about 7.30 and 10.30 would qualify as pinch points for most providers. If every customer wanted a call at, say 8.00, something would have to give. Of course, in reality, customers, thankfully, do not all want the same time. Therefore, it would not be unreasonable for providers and customers to work out a schedule that allows most (if not all) customers to have a call within 10-15 minutes either way of their chosen times.

Finding a homecare service that provides a choice around male and female carers

It is not unusual for customers to specify their preference for a carer of a particular gender. In my experience, it is more likely to be that case that a female carer is preferred – often, but not exclusively, by female customers. This is especially the case where personal care is involved. In the survey, 69% of respondents thought this was a very or quite important factor when choosing home care.

I think it is understandable that customers will have a preference for the gender of their carer. It may be a request that some providers are uncomfortable about acceding to – and I can understand that. However, where possible I don’t think it is unreasonable to offer this choice to customers. It’s also important that carers are not placed in situations that may be acutely uncomfortable for them.

Finding a home care provider that works well with other agencies and individuals

The precise wording of the question that the survey respondents were asked was: “How important or unimportant would you find the [following factor]: Finding a homecare service that works well with other services that are involved in the care of my parents, spouse or older relatives e.g. dentist, GP practice or social worker”, and 88% of those respondents thought that this was a factor that was very or quite important to them.

When you think about it, carers have a role that is of central importance in the lives of their customers. Amongst a very large number of other people involved in the care of any particular individual, it is likely to be that person’s carers who have the most contact with him or her. In some cases, this contact can be several times a day 7 days a week. Little wonder, then, that the ability to work well with other agencies is regarded as so important.

And working well with these other agencies and individuals often comes down to communicating with people. The ability of human beings to use language is one of the things that separate us from the animals. I know that we are told that other animals can communicate, but none have produced the equivalent of the works of Shakespeare.

We human beings have this wonderful tool that we call language. With language: we talk to each other, we listen to others, we text each other, we use email and snail mail, we have social media presences and we read books, watch television and listen to the radio. None of those things would be possible without language. And yet so often we communicate so poorly with each other.

Finding a home care provider that communicates with key people in the customers life

As in the factor above the exact question was slightly longer. It read: “How important or unimportant would you find the [following factor]: Finding a homecare service that communicates with me effectively by keeping me updated on my parent/spouse/older relative’s care and involving me in decisions.” This time 93% of respondents thought that this factor was very or quite important for them.

The person who is being cared for has to be at the centre of everything that a home care provider does with regard to that persons care. However, it is very often the case that there are other people in the customer’s life who need to be consulted and involved in the care of that person.

It goes without saying that providers must comply with the obligations of confidentiality that are placed on them. However, these obligations are manifestly not there to prevent significant people in the lives of customers being reasonably involved in the care being provided to those customers.

Finding a home care provider that treats customers as individuals

This question asked: “How important or unimportant would you find the [following factor]: Finding a homecare service friendly, compassionate and well trained staff that treat my parent/spouse/ older relative as an individual, spend time with them and take into account their likes and dislikes when providing care.” I doubt that anyone will be surprised that 97% of respondents considered this factor to be very or quite important.

There’s a lot in that question, but essentially it reduces down to that fact that everyone is different. There is no one size fits all with care. The very highest standard of care can be achieved only when it is recognised that each customer has his or her own requirements. And it’s not always possible to find these out immediately.

Home care providers will assess an individual’s needs and find out as much as possible about him or her prior to care starting. But it’s virtually impossible to discover everything immediately. And the truth is that providing care is as much about building relationships with customers as it is about the delivery of the technical side of care. Relationships evolve and as they do carers find out more and more about an individual’s preferences. Much of this is about carers building trust and confidence with their customers.

The very best carers have outstanding interpersonal skills. In my experience, those with the very best interpersonal skills have something that just comes naturally to them. These are the people who, when their natural ability is combined with first class technical ability, make outstanding carers.

Finding a homecare service which provides specialist care for people with dementia (or similar conditions)

At first sight, it seems odd that just 71% of respondents thought that this was a very or quite important factor to be taken into account when considering home care. On reflection, however, it is understandable. In many cases, people may be looking for care that is fairly general. The relative for whom care will be provided may have no specific condition and the care sought may be quite generalised personal care, companionship or other type of care.

However, where your loved one has a specific condition it follows that specialist care will assume far greater importance. In such circumstances, it is highly probable that you will want to find out a little more about the training and experience that potential carers have.

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