choosing

20 questions to ask before picking a home-care agency

The interview script we wish every family had — adapted from CQC's own assessment framework

By Sam Nash · Founder & Editor

Updated 6 May 202614 min read

Most families choose a home care agency under pressure — after a hospital discharge, after a fall, after a crisis moment when things at home have clearly shifted beyond what the family can manage alone. The conversation with a provider often happens in a hurry, and the questions that get asked are the obvious ones: How much does it cost? When can you start?

These are not the wrong questions. But they are not the most useful ones.

The questions below are drawn from the CQC's own single assessment framework — the same framework inspectors use when they assess whether a home care provider is Safe, Effective, Caring, Responsive, and Well-led — and from what families most often say they wish they had asked before things went wrong. For each question, we describe what a strong answer sounds like and what a red flag sounds like.

You do not need to ask all 20 in a single call. But you should ask most of them before signing anything.

Care quality

1. Will my relative see the same carers each visit?

Why it matters: Continuity is one of the strongest predictors of care quality. People receiving care — particularly those with dementia, anxiety, or any condition affecting cognition — are more settled, more cooperative, and generally better cared for by familiar faces. The NICE guideline on home care quality (NG21) specifically recommends that older people should expect continuity of care workers.

Strong answer: "We aim to have a core team of one or two carers for each client, matched to your relative's needs and personality. Cover arrangements during holidays and sickness involve carers from that team where possible."

Red flag: Vague reassurance ("We try our best") or a system where carers are allocated daily from a pool, with no named team for your relative.

2. What happens if a carer rings in sick?

Why it matters: This happens. Every agency. What matters is the system for handling it — and whether that system prioritises the client or the agency's convenience.

Strong answer: "We have a duty manager on call at all times. If a carer calls in sick, we contact you immediately — by 7am if it's a morning visit — and confirm who will cover and when. We don't cancel visits without a replacement unless there is truly no one available, and we'd tell you that directly."

Red flag: "It doesn't usually happen" or vague language about "making every effort." An agency that has never been asked this question, or that struggles to describe a specific process, has probably not thought it through.

3. How do you handle a situation where a carer and client don't get on?

Why it matters: Not every match works. The question is whether the agency can respond to this honestly and practically.

Strong answer: "We ask carers and clients (or families) to tell us if something isn't working, and we take those requests seriously. We would try an alternative carer as quickly as possible. We would not ask you to manage a relationship that is causing distress."

Red flag: Defensiveness about carers, or an implication that clients are expected to adapt rather than the agency to respond.

4. Can I see your most recent CQC inspection report?

Why it matters: Any reputable agency will offer this without hesitation. The report tells you what inspectors found during their last visit — including anything they required the agency to improve.

Strong answer: Immediate yes, with the report either emailed or signposted on the CQC website. A willingness to talk through any areas for improvement.

Red flag: Hesitation, a claim that the report is "out of date" or "not representative" without further explanation, or failure to mention the CQC at all.

You can find any CQC-registered provider's inspection report directly at cqc.org.uk. Always check the date of the report — a rating from 2021 tells you less than you might think. Our guide to CQC inspections explains what to look for beyond the headline rating.

Carer training

5. What dementia training have your carers completed?

Why it matters: "Dementia training" can mean a 30-minute online awareness module or a substantive qualification. The difference is significant. Skills for Care's dementia training framework distinguishes between Tier 1 (awareness), Tier 2 (enhanced — appropriate for carers providing regular direct care), and Tier 3 (specialist). Ask which tier carers working with your relative have completed and whether they can evidence it.

Strong answer: "Carers assigned to clients with dementia have completed Tier 2 training under the Skills for Care framework. We also have [number] staff with Tier 3 qualifications who support complex cases and provide supervision."

Red flag: "All our carers are fully trained in dementia" without specification of what that means, or any reluctance to say what framework the training is based on.

6. What moving and handling training have your carers received?

Why it matters: Poor moving and handling technique is one of the most common causes of injury to both clients and carers. Any carer supporting someone with mobility difficulties should have received hands-on, assessed moving and handling training — not just an online module.

Strong answer: "All our carers complete face-to-face moving and handling training as part of induction, and refresh it annually. For clients who need hoisting, we carry out a specific risk assessment and ensure carers are trained on the equipment in use."

Red flag: Online-only training for moving and handling, or any suggestion that equipment-specific training is arranged after care begins rather than before.

7. How do you train carers in medication management?

Why it matters: Medication errors are a serious risk in home care. NICE NG21 specifically identifies medication management as a high-risk area. Carers may be responsible for prompting, administering, or recording medication. All three require training and a clear protocol.

Strong answer: "We train all carers in medication administration and have a clear protocol for prompting, administration, and recording. We use a medication administration record (MAR) chart, reviewed regularly. We do not administer complex medications such as injections without additional training and a specific risk assessment."

Red flag: Carers who "help with medication" without any clear description of training or recording processes.

8. How do you induct new carers before they work with clients?

Why it matters: An agency with a 12-week structured induction before carers work unsupervised with clients is a different proposition from one that places carers with clients after a day's shadowing.

Strong answer: "We follow the Care Certificate as a minimum — 15 standards of knowledge and competence — completed within 12 weeks of starting. Carers are supervised by an experienced senior carer during their induction and are not left alone with clients until competence has been signed off."

Red flag: Short induction periods, online-only training, or uncertainty about what the Care Certificate is.

Visit logistics

9. What is your minimum visit length?

Why it matters: Fifteen-minute visits are legal and used by many local-authority commissioned care packages, but they are often inadequate — and some providers charge for 30 minutes regardless. Understanding minimum visit lengths helps you assess whether the care plan is realistic and what the billing implications are.

Strong answer: Clear statement of minimum visit length (often 30 or 45 minutes), with an honest explanation of what can be achieved in that time. No pressure to accept shorter visits than are appropriate to the need.

Red flag: Minimum visits of 15 minutes for personal care tasks such as washing and dressing — an unrealistic timeframe for dignified care.

10. Can you cover early mornings, late evenings, and weekends?

Why it matters: Care needs don't follow a Monday-to-Friday, 9-to-5 schedule. A provider who can cover daily visits but only until 6pm, or who reduces to skeleton cover at weekends, is not a full solution for someone who needs regular support.

Strong answer: Clear confirmation of hours of operation, typical visit windows at each time of day, and explicit confirmation of weekend and bank holiday coverage — including whether weekend rates are higher and by how much.

Red flag: Weekday bias, or vague reassurance about "usually" being able to cover weekends without specifics.

11. What area do you cover, and do you have carers local to us?

Why it matters: An agency based 20 miles away, sending carers on long journeys between clients, is more likely to have punctuality problems and to price in travel time. Local carers typically mean more reliable visits and, often, better continuity.

Strong answer: Confirmation that they operate in your area, with carers who regularly cover the specific postcode. Willingness to give you a rough sense of how many clients they currently have nearby.

Red flag: An agency covering a very wide area without local teams, or one that cannot say how many carers operate close to you.

Care plan and oversight

12. Who writes the initial care plan, and how often is it reviewed?

Why it matters: A good care plan is personalised, detailed, and kept current. NICE NG21 recommends that care plans reflect the person's preferences, needs, and goals — not just a list of tasks. The plan should be reviewed at least every 12 months, and whenever needs change significantly.

Strong answer: "A care manager visits the client at home before care starts to carry out a full assessment. The care plan is written based on that assessment and reviewed with the family before care begins. We review it formally every six months, and immediately if something changes — a hospital admission, a fall, a change in health."

Red flag: A care plan written based on a phone call, or no clear review process.

13. Who is my main point of contact, and how accessible are they?

Why it matters: Day-to-day, you need to be able to reach someone who knows your relative's case — not just whoever answers the phone.

Strong answer: A named care coordinator or manager who is responsible for your relative's package, with a direct contact number. Clear guidance on who to contact outside office hours and how quickly to expect a response.

Red flag: A single generic office number with no named coordinator, or a suggestion that out-of-hours contact is only for genuine emergencies (leaving you unclear who decides what counts).

14. Can I (or my relative) see the carer's visit log?

Why it matters: Most good agencies operate a digital or paper visit log in the home — a record of what was done each visit, any concerns noted, and the carer's observations. This is invaluable: it tells you how a visit actually went, not just that it happened, and it creates an auditable record.

Strong answer: Yes — either a paper logbook kept in the home, or access to a digital system where notes are visible to the family and care manager. The log is shared with the client by default.

Red flag: No logbook or visit record, or one that is kept by the agency but not accessible to the family.

Cost

15. Can I have a full written fee schedule, including weekend and bank holiday rates?

Why it matters: The headline hourly rate is rarely the full picture. Weekend rates are typically 20–50% above weekday rates. Bank holidays can be double time. Minimum call charges, travel fees, and start-up charges add further. You need the full schedule in writing before you can accurately calculate a weekly care bill.

Strong answer: Immediate provision (or offer) of a written fee schedule covering all rates, surcharges, and any other charges (assessment fees, PPE, cancellation terms). No hesitation.

Red flag: Reluctance to put fees in writing, a suggestion that rates are "flexible" without specifics, or a fee schedule that omits weekends and bank holidays.

16. What is your cancellation policy, and what happens to billing if my relative goes into hospital?

Why it matters: Hospital admissions happen. If your relative is admitted and you are still paying for care visits that are not happening, that is a problem.

Strong answer: Clear, fair cancellation terms — ideally, billing stops within 24–48 hours of a hospital admission, with a similarly short notice period to restart. No long minimum-payment periods during planned absences (holidays, planned hospital stays).

Red flag: Long notice periods (one or two weeks) before billing stops, or a clause requiring payment for visits during hospital admissions.

Communication

17. How do I get hold of someone out of hours if there is a problem?

Why it matters: Problems with care do not happen only between 9am and 5pm.

Strong answer: A dedicated out-of-hours number answered by a duty manager — not just a voicemail — with a clear target response time. The duty manager should have access to care records and be able to take action.

Red flag: An out-of-hours number that goes to voicemail, or a suggestion that out-of-hours contact is only appropriate for genuine emergencies (again, leaving you to judge what that means).

18. How do you communicate changes to the care plan or concerns about my relative's wellbeing?

Why it matters: Carers are often the first to notice changes in a person's condition — weight loss, confusion, a change in mood, an unhealed bruise. The question is whether those observations reach someone who can act on them.

Strong answer: "Carers are expected to record any concerns in the visit log and flag them to the care coordinator immediately. The care coordinator contacts the family directly for anything significant, and will escalate to a GP or district nurse if clinically indicated."

Red flag: An impression that carers are task-focused rather than observational, or uncertainty about how concerns reach management.

Safeguarding

19. How do you handle a safeguarding concern?

Why it matters: Safeguarding — protecting vulnerable people from harm, abuse, or neglect — is a legal duty. An agency that cannot clearly describe its safeguarding procedures has not taken this seriously enough.

Strong answer: "We have a designated safeguarding lead who is trained in adult safeguarding procedures. Any concern — from a carer or a family member — is taken seriously and assessed immediately. We report to the local authority safeguarding team and the CQC as required. We have a clear whistleblowing policy for staff."

Red flag: Vague reassurance ("We take this very seriously") without a specific process, or uncertainty about who the designated safeguarding lead is.

20. Are your carers DBS-checked, and how is this maintained?

Why it matters: All carers working with vulnerable adults must have a Disclosure and Barring Service (DBS) check — an enhanced check, not just a basic one. The DBS Update Service allows ongoing monitoring rather than point-in-time checks.

Strong answer: "All our carers have an enhanced DBS check, completed before they work with any client. We subscribe to the DBS Update Service, which means we can check for any new information on an ongoing basis. No carer works unsupervised with a client until the check is cleared."

Red flag: Basic rather than enhanced DBS checks, or carers beginning work with clients before their DBS has been returned.

Printable checklist

Use this before each call. Tick off what you have covered.

Care quality

Will my relative see the same carers?
What happens if a carer is sick?
How do you handle carer-client mismatch?
Can I see your CQC report?

Training

Dementia training level and framework?
Moving and handling — hands-on assessed?
Medication management protocol?
Induction process — Care Certificate?

Logistics

Minimum visit length?
Early morning / evening / weekend coverage?
Local carers in our area?

Care plan and oversight

Who writes the care plan and when?
Named coordinator and contact number?
Visit log accessible to family?

Cost

Full written fee schedule, including surcharges?
Hospital admission / cancellation policy?

Communication

Out-of-hours contact procedure?
How are concerns communicated to family?

Safeguarding

Safeguarding procedure and designated lead?
Enhanced DBS and Update Service?

For context on what you will find in a CQC report once you ask an agency to share it, see our guide to CQC inspections. If you are working through discharge arrangements at the same time as choosing an agency, the hospital discharge guide covers how the two processes can run in parallel without either being rushed.

Frequently asked

Quick answers

How many agencies should I contact before making a decision?

Contact at least three. One agency is too few to make a comparison; two gives you a binary choice rather than a real picture of the market. Three gives you enough to see where one provider is stronger or weaker than the others, and to have a realistic sense of typical pricing in your area. If you are being referred by a hospital discharge team, they may suggest a specific agency — you are not obliged to accept that referral and should still speak with alternatives.

Should I meet the agency in person before deciding?

If possible, yes — particularly for live-in care or complex needs. A face-to-face meeting at your relative's home allows the care manager to assess the environment properly, and gives you a direct sense of how they communicate and whether they listen. For visiting care at lower need levels, a detailed phone call or video call is often sufficient for the initial assessment, with a home assessment following before care starts. Be cautious about agencies that are willing to commit to a start date without ever visiting or speaking with your relative.

Can I ask to see the care plan before signing anything?

Yes. A good agency will want to produce a care plan before care begins — not as an afterthought. Ask when the care plan assessment takes place, who conducts it, and when you will receive a draft. You should have the opportunity to review and contribute to it before care starts. The care plan belongs to the person receiving care and their family; you should not be required to sign a contract that commits to a start date before the plan has been discussed and agreed.

Are there questions I should not ask?

There are questions that are unlikely to produce useful answers: very general ones ('Are your carers good?') or questions that invite a scripted reassurance ('Do you treat your service users with dignity?'). The questions that reveal most are specific and scenario-based — 'What happens if a carer rings in sick on a Tuesday morning?' or 'Tell me about a time a care plan changed quickly because a client's needs changed.' These require a real answer, not a marketing one.

What does a CQC-registered agency mean, and is it enough?

CQC registration is a legal requirement for any organisation providing personal care in someone's home in England. It is a floor, not a ceiling. A registered agency has met the baseline requirements to operate; a Good or Outstanding CQC rating tells you they meet or exceed standards. But registration alone, or even a headline rating, is not a complete picture: always read the actual inspection report, check the date it was published, and ask the agency about any areas for improvement identified. Our guide to CQC inspections explains what to look for in a report.

What if I want to change agency once care has started?

You can change agency at any point. Your relative is not bound to a particular provider by anything other than the contract notice period — typically 2–4 weeks. If care is funded by the local authority, you may need to discuss the change with the care manager, but you retain the right to choose your provider. If you have serious concerns about the quality of care — a safeguarding concern, persistent missed visits, a lack of confidence in management — you do not have to give notice; you can contact the council or find an alternative immediately. Do not stay with a failing provider because changing feels difficult.

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