The checklist families wish they'd had before they signed

Choosing a home care provider after a hospital discharge is one of the most important decisions a family can make — and one of the ones with the least time to make it. You're comparing agencies quickly, often under pressure, without much to go on beyond a website and a phone call.

These 20 questions are designed to be asked before you commit to any provider. They reveal what the agency's operations actually look like, what the experience of care will be in practice, and where the cracks might appear when things don't go to plan.

About their regulation and compliance

1. What is your current CQC rating?

All regulated home care providers in England must be registered with the Care Quality Commission. Their current rating — Outstanding, Good, Requires Improvement, or Inadequate — is publicly available on the CQC website. Ask for it directly, then verify it yourself. A provider who hesitates or can't tell you their rating is a concern.

A Good or Outstanding rating is the baseline. Requires Improvement ratings warrant specific questions about what has improved since the inspection.

2. When was your last CQC inspection?

CQC ratings can be years old. A Good rating from 2019 tells you very little about the service in 2025. Ask when the last inspection took place and what the key findings were. If it's been more than two years, ask why no re-inspection has occurred and what quality assurance processes the provider uses in the interim.

3. Are all your carers DBS-checked?

DBS (Disclosure and Barring Service) checks are a legal requirement for anyone providing personal care. All carers should hold an enhanced DBS check. Ask for confirmation that checks are in place before a carer enters your relative's home — and ask how often checks are renewed (enhanced checks have no formal expiry date, but reputable providers will refresh them regularly).

4. Do you carry Employers' Liability and Public Liability insurance?

Any reputable agency will carry both. Employers' Liability insurance covers carers if they are injured at work. Public Liability covers the agency if a carer damages property or injures a client. If a provider cannot confirm their insurance status immediately, do not proceed.

About their carers and staffing

5. Will my relative have a consistent, named carer?

Consistency matters enormously in home care — particularly for people with dementia or anxiety. Ask whether your relative will be assigned a named carer for regular visits, and what the policy is for cover when that carer is on leave. "We do our best" is not an acceptable answer. Ask for specifics.

6. How are your carers recruited and trained?

Ask whether carers are employed directly by the agency or engaged as self-employed contractors. Directly employed carers give the agency more oversight and accountability. Ask what induction training is required and whether carers receive specialist training for conditions like dementia, Parkinson's, or post-stroke care.

7. What is your carer-to-supervisor ratio?

Carers should be regularly supervised and supported. Ask how often carers are observed carrying out care visits, how often they have formal supervision meetings, and how concerns are escalated.

8. What is your staff turnover rate?

High carer turnover is one of the strongest indicators of a poorly managed agency. It disrupts consistency, increases risk, and often signals that carers are under-supported. You won't always get an honest answer, but the question itself tells providers you know what matters.

About how they deliver care

9. How is the care plan developed — and who is involved?

A good care plan is built around the individual's needs, preferences, and goals — not just a list of tasks. The process of creating it should involve your relative (where possible), family members, and any relevant health professionals. Ask who develops the plan, whether the care recipient is involved, and how detailed it will be.

10. How often is the care plan reviewed?

Needs change, particularly after a hospital discharge. Ask how frequently the care plan is reviewed as a matter of course, and what happens if needs change between reviews. A rigid plan that doesn't flex is a risk.

11. How do carers document what they've done during a visit?

Most reputable providers now use digital care records — often via an app on a carer's phone. This means care visits are logged in real time, giving families and supervisors visibility. Ask whether you will have access to digital visit records. This is an important transparency indicator.

12. How do you manage medication?

If your relative requires help with medication — prompting, administering, or recording — ask specifically how this is handled. Which carers are trained and authorised to administer medication? What is the process if a dose is missed or a concern arises?

About reliability and escalation

13. What happens if a carer doesn't arrive?

This is arguably the most important question you will ask. Missed visits are the single most common care complaint. Ask what the specific procedure is if a carer is late or absent — how quickly will someone contact you, who covers the visit, and what is the escalation path?

14. What is your out-of-hours contact process?

Care concerns don't happen only during office hours. Ask who the family should contact if there is a problem in the evening or at the weekend, and how quickly they can expect a response. A dedicated out-of-hours number is a mark of a well-run service.

15. How do you handle safeguarding concerns?

Ask whether the agency has a named safeguarding lead, and what the process is if a carer observes signs of neglect, abuse, or deterioration. Any hesitation or vagueness in the answer to this question should be taken seriously.

About costs and contracts

16. What is the hourly rate, and what does it include?

Ask for a full written breakdown. Some agencies charge separately for travel time, night rates, weekend rates, bank holiday rates, or equipment. Understand the full cost before agreeing.

17. What is your minimum visit length?

Some agencies have a minimum visit time of 30 or 60 minutes. This matters if your relative needs shorter check-in visits and you don't want to pay for time that isn't used.

18. What notice period do I need to give if I want to change or cancel the arrangement?

Circumstances change. A contract with an onerous notice period or cancellation fees can create problems if care needs shift or you want to change provider. Ask for this in writing.

About their values

19. Can you provide references from current or recent families you support?

Reputable agencies should be willing to put you in touch with families who have consented to share their experience. Reviews on homecare.co.uk and Google are useful, but direct references add another layer.

20. What makes your service different from other providers in this area?

This open question tells you a great deal about how the agency thinks about care quality — and whether their answer resonates with what matters to your family. A great provider will have a clear, genuine answer. A poor one will give you marketing language.

Download this checklist

Use this list on your first call or visit with any provider. Care-AI-UK provides verified CQC ratings and review summaries for all listed providers so you can enter that first conversation already informed.

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In this series:

20 Questions to Ask a Home Care Provider Before You Agree to Anything