How to hire
Start by naming the help you actually need. Live-in care means a carer moves into the spare room and provides daytime support with sleep-in cover overnight; visiting care means carers call at set times through the day; waking-night cover means someone alert through the night. Live-in suits people who want to stay in their own home with company on hand, including couples who want to stay together, while visiting care suits lighter needs and waking nights suit anyone who regularly needs help after dark.
Ask Telford and Wrekin Council for a Care Act assessment before you sign anything [5]. A social worker or practitioner looks at daily life, from washing and dressing to getting out and about, and decides whether you qualify for council-arranged support; a separate financial check then works out what you pay. Even if you plan to pay yourself, the needs assessment is free and anyone can ask for one, and it spells out exactly what help is needed [2].
Start the council route through Family Connect, the council's first point of contact for adult social care [5]. The assessment itself can run by phone, face to face or video call with a social worker or practitioner, and the assessment and any advice are free, though services after it are means-tested through a separate financial check [5]. If you look after someone unpaid, you can ask for a carer's assessment in your own right, and an occupational therapy assessment can put equipment on loan in the home or recommend adaptations where needs are complex [7]. Support the council arranges is reviewed each year, or sooner if circumstances change [5].
Check the regulator before you shortlist. Every home-care agency in England must register with the Care Quality Commission, which inspects services against five questions — safe, effective, caring, responsive and well-led — and publishes ratings from Outstanding down to Inadequate [1]. Search the agency's name on the commission's pages, open the latest report, note its date, and read what inspectors actually saw rather than the headline alone [1]. A missing entry tells you something too.
Meet the agency and, if possible, the carer who would actually come. Ask whether you keep the same faces week to week, how sickness and holiday cover works, who supervises the carers and how often the care plan is reviewed. Ask how night cover works in practice — what counts as a sleep-in night, what happens if you call twice, and when waking cover starts instead. Several Telford agencies offer a free first assessment, so use it to test responsiveness as well as expertise.
Walk the home with the carer's needs in mind. A live-in carer needs a private bedroom and meals from the household, with a daily break built into the arrangement [8]. If the occupational therapist recommends adaptations and the home sits in the Ironbridge Gorge conservation area or is listed, check with council planning before work starts: an Article 4 Direction brings minor works under planning control there, and the council runs free planning surgeries with a residents guide to help [10]. Parking matters too, since the carer comes daily: Ironbridge runs a permit scheme through MiPermit covering the Gorge car parks, with visitor permits for extra vehicles [9]. Raise parking and access on the first assessment visit.
Get every quote in the same shape so you can compare. It must show the weekly rate for live-in care or the hourly rate for visits, exactly what sits inside that figure, which extras cost more, how holiday and sickness cover is arranged and charged, what night calls cost, and how and when fees are reviewed. Ask who employs the carer — a managed agency handles payroll, training and cover, while an introductory match or direct hire leaves those duties with you.
Before the start date, hold the signed contract with its standard terms, the written care plan naming what will be done and when, the confirmed rate with extras and notice terms listed, and the latest inspection report you read. People with primarily health needs can get NHS continuing healthcare, which covers the full cost with no means test after an assessment, at home or in a care home — ask your GP or district nurse for one [4]. File every fee-review letter and care-plan update as they arrive.
A typical arrangement runs first contact, free assessment, written care plan, like-for-like quotes, signed contract, then the start date. Treat the assessment as a two-way test: note response times, whether you meet the actual carer, and whether night cover and holiday cover are spelled out before anything is signed. After the start, use each review to check the plan still fits.
Pricing
As of autumn 2026, national guides put a typical hourly rate for a carer visiting at home at around twenty pounds, though this moves with where you live [2]. The Homecare Association recommends councils pay at least £34.42 an hour for sustainable care in 2026-27, and self-funders dealing direct with an agency can expect to pay at least that rate [3]. Treat the lower figure as the going rate and the higher one as what good care actually costs to deliver.
Live-in care is priced by the week. The NHS guide puts a live-in carer at around eight hundred pounds a week, rising to around sixteen hundred where needs are heavy [2]. What moves the figure is the level of need first — dementia specialism, clinical tasks and restless nights add the most — then whether one carer suffices or two are needed, then whether the booking covers one person or a couple, and finally the area [2] [3].
A national cost guide updated in spring 2026 puts dementia-specialist live-in care at fourteen hundred to seventeen hundred pounds a week, with complex or high-dependency care at sixteen hundred to two thousand pounds a week where clinical tasks, two-person transfers or restless nights enter the picture [8]. The premium reflects specialist training and heavier staffing, so the assessment needs to name night needs and clinical tasks plainly for the quote to hold.
For couples, the same guide puts one carer supporting two people at fourteen hundred to sixteen hundred pounds a week, a small step up from a single placement [8]. Whatever the headline rate, budget beyond it: the household feeds the carer, bills run higher with an extra person at home, and holiday cover needs its own arrangement and price [8].
On VAT, regulated personal care is generally exempt when the provider is registered with the Care Quality Commission, which is why quotes rarely mention VAT at all [6]. Ask which extras sit outside the care package, since separable goods and services can be treated differently, and query any quote that does add VAT line by line [6].
Get the whole figure in writing before signing: the weekly or hourly rate, each extra with its price, how holiday and sickness cover is charged, what night calls cost, how fees are reviewed, and the notice terms on both sides. If savings are near the council's limits, ask for a financial assessment early — above twenty-three thousand two hundred and fifty pounds you fund the care yourself, and the home itself does not count while care is delivered in it [2]. Attendance Allowance and similar benefits are not means-tested and can go toward the bill [2].
Red flags
No entry for the service on the Care Quality Commission register [1].
No written care plan or standard terms offered before a start date is set.
A weekly rate quoted without saying what sits inside it and which extras cost more.
No named regular carer and no clear answer on who covers sickness and holidays.
Night cover left vague, with sleep-in and waking cover never spelled out.
Pressure for a large upfront payment beyond a fair, returnable deposit.
Fee-review and notice terms missing from the paperwork.
Visit times drifting by hours with no call ahead and no revised rota offered.
No complaints process named in the paperwork or on the website.