Domiciliary care — sometimes called domiciliary home care or home help — lets people stay in their own home rather than move into residential care. Demand has grown sharply: the Care Quality Commission (CQC) now regulates over 15,000 domiciliary care agencies in England, and roughly 500,000 people currently receive paid care at home. Here's what domiciliary care involves, what it costs, how the sector is regulated, and the insurance that workers and agencies need.
What Is Domiciliary Care?
Domiciliary care means paid support delivered in someone's own home, rather than in a care home. It covers personal care — washing, dressing, eating, medication and mobility support — as well as practical domiciliary home help such as light housework, shopping and companionship. Visits typically range from a 30-minute welfare check to several hours a day, and some people receive live-in domiciliary care from a single carer based in their home.
Domiciliary care is arranged in three main ways: privately (self-funded), through a local council following a needs assessment under the Care Act 2014, or via a direct payment, where the council gives the person funds to arrange and pay for their own care — often by employing a personal assistant directly.
How Much Does a Domiciliary Home Care Service Cost in 2026?
Hourly rates for a domiciliary home care service typically run from £26 to £38 an hour, with a UK average of around £32 an hour. The Homecare Association's recommended minimum price for 2026/27 is £34.42 an hour, reflecting the true cost of paying carers at least the National Living Wage plus travel time, training and employer costs.
London and the South East tend to sit above £38 an hour, while the North of England and Wales are typically closer to £26. As a guide, five hours of care a week costs roughly £160 a week (around £8,300 a year); live-in care averages about £220 a day. Councils may fund some or all of the cost following a means-tested financial assessment — check current thresholds on GOV.UK.
Domiciliary Care Agencies and CQC Regulation
Any domiciliary care agency providing personal care in England must register with the CQC — it's a regulated activity under the Health and Social Care Act 2008, and it's a criminal offence to provide personal care without registration. Since 1 July 2025 the CQC has used a two-stage application process: an initial "gatekeeping" check that the application is complete, followed by a full assessment of the provider's ability to deliver safe, effective care.
The sector has grown quickly — the CQC regulated 15,232 domiciliary care agencies in March 2025, up from 13,733 the year before. Before choosing a domiciliary care agency, check its current CQC rating and latest inspection report at cqc.org.uk, and ask how carers are recruited, trained and supervised.
Working as a Domiciliary Care Worker or Care Assistant
Domiciliary care is one of the UK's largest workforces — home care roles now account for around 740,000 filled posts, roughly 46% of the entire adult social care workforce. A typical domiciliary care worker or care assistant role is split fairly evenly between full-time (56%) and part-time (44%) contracts, and around a third of the workforce works on a zero-hours basis to fit around visit schedules.
Recruitment remains tough: most domiciliary care agencies report it's challenging to fill vacancies, and there are tens of thousands of unfilled posts nationally. No formal qualifications are required to start as a domiciliary care assistant, but agencies must provide induction training (usually to the Care Certificate standard) and ongoing supervision as a condition of CQC registration. Many workers progress into senior carer, care coordinator or registered manager roles.
Care workers can be employed directly by an agency, or self-employed and contracted to provide domiciliary home help — the employment status affects tax, holiday pay and insurance responsibilities, so it's worth getting this right from day one.
Domiciliary Care Insurance: What You Need to Know
Domiciliary care insurance needs depend on how you work:
Self-employed domiciliary care workers and personal assistants need public liability insurance as a minimum — it protects you if you accidentally injure a client or damage their property while working in their home. It isn't legally required for the self-employed, but it's strongly recommended and inexpensive, from around £69 a year. Professional indemnity cover is also worth adding if you provide health-related tasks such as medication support.
Domiciliary care agencies must hold employer's liability insurance for their staff — this is a legal requirement, with fines of up to £2,500 a day for non-compliance — plus public liability and, typically, professional indemnity cover appropriate to a regulated care provider.
Clients arranging care via direct payments and employing a carer directly are legally responsible for holding employer's liability insurance themselves, even though the funding comes from the council.
Compare domiciliary care and PA insurance on Compear — we list specialist UK providers covering self-employed carers, employed PAs and those managing direct payments.
Choosing the Right Domiciliary Home Care Service
Check CQC registration and rating before signing up with any agency — this is a legal minimum, not a nice-to-have.
Ask about continuity of carer — regular home care rota changes are one of the most common complaints about domiciliary care.
Clarify what's included in the hourly rate — travel time, minimum visit length, and out-of-hours or emergency cover can all vary between providers.
Get a written care plan setting out tasks, timings and review dates, and confirm what insurance the agency holds for its staff.
Useful Resources
GOV.UK — Find and choose care services
CQC — Check a domiciliary care agency's rating
Working in domiciliary care, self-employed or running an agency? Compare carers and PA insurance on Compear — specialist public liability cover from £69/year.
Costs and workforce figures reflect 2025/26 data from the Homecare Association, Skills for Care and the CQC and are subject to change. This article is for information and signposting only and does not constitute care, legal or financial advice. Check current rates and regulation with GOV.UK, the CQC or a qualified adviser.