As I am sure many involved in 24 hr home care know there are two types of 24 hour agencies. Those who can introduce you to a carer (around 1,200 a week) and those who manage it all from an office (but for much more - at least 1,600 a week which is generally for more complex needs).
Only latter are CQC rated. Some of the ones that introduce you are also very good as they have many carers to choose from with qualifications if needed, very good systems, a range of staff like clinical and relationship managers etc, and can find and replace carers very quicky (if illness or anything goes wrong) and and really help you out (some have excellent reputations with this). Some also have offices staffed 365 days a year unlike the fully managed ones (M-F). So its is not always necessary to pay so much for a service that can be done through family and an intro agency. The intro agencies also have Apps where you can see what the carer has done.
However, I have heard that LA’s or COP will only use CQC rated agencies. Some say very fixed so that the LA is covered. Others say it can be flexible. I have also heard its linked to some case law on this. Yet to find this. However, with family, friends and support from an intro agency one can achieve virtually the same, especially if you have family/friends going in every day monitoring that everything is OK. Family would be involved in the care planning anyway, so you don’t need another, and would know how things are going more than a far away office checking an App. I can appreciate that an office to manage all may be useful if the family doesn’t have time.
Has anyone come across any examples of when someone has been allowed to have a non CQC rated company for 24 hr care? There must be precedents out there, maybe? Obviously the person needs to be safe and protected (without doubt), but if this can be done by a team of family and friends who are fully committed, has anyone heard of a LA still insisting on CQC only (extremely expensive to the elderly person and could reduce funds so they cant live at home as long). I have heard of situations where a LA has opted for companies that may even be less suitable (small but CQC rated) for the CQC rating, rather than having a big intro agency who can ensure the person is more safe due to speed of replacing and open 24/7 365 (but not CQC rated). The big intro agencies, can replace and find good carers in flash in emergencies that smaller CQC agencies won’t be able to do. Also some of the expensive managed companies only work 5 days, then have to do huge catch ups on whats happened on the weekend, on Monday mornings. Of course they have emergency line, but its not the same as a fully staffed office that can action very fast.
I am aware of all the criteria for a CQC rating etc. Its all something a family would also be very intrinsically motivated to achieve too. The CQC can’t actually monitor you own individual situation and some are very out of date by many years. Its a standard the agency has to meet (which is obviously a good thing), but there are no guarantees the person has those standards met daily, e.g. enough to drink and other things. Those closely involved would be able to see this though. This can be the break cover carers too. So there are already many on front line seeing the day to day reality that a CQC rated office can’t see.
Any info on the perspectives of LA and COP and other professionals insisting on CQC ONLY would be handy to know. Thanks.
@4leafclover i would speak to your council and ask them. You could try Age.uk and ask them.
I cannot help much with your question, but where did you get your stats from "As I am sure many involved in 24 hr home care know there are two types of 24 hour agencies. Those who can introduce you to a carer (around 1,200 a week) and those who manage it all from an office (but for much more - at least 1,600 a week which is generally for more complex needs).
Only latter are CQC rated.
Thank you! I can see a reply button now. They seem to think it has to be fully managed, but in other parts of UK, I have heard different stories. So it may depend on where and flexibilty to some extent. I think it is obviously safer for a LA to have the CQC rating.
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Thanks. If you go on the internet, a lot of the Fully Managed agencies market themselves using the CQC rating (the 5 criteria) and more. They will say that Intro Agencies don’t have a CQC rating as they only provide an intro to the carer. But these Intro agencies can provide a huge advantage to a family with being able to replace carers 365 days and provide similar benefits, and also provide Apps. It just really comes down to who is ultimately legally in charge - the family or the company. There are some good and well known ones in London that can replace carers very fast due to their size.. Generally, the Intro agencies are charging close to Care Home weekly rates of around 1,200 p/w (yet you can find very highly qualified carers on their books!). The Fully Managed agencies seem to be quoting above 1,500. Some go even higher to 1,800 ++ (on their websites) but say that those rates are generally for complex needs or those without family to help. Its just what you get told.
@4leafclover who are saying it has to be fully managed the council. Would the person be self funding and paying for there own care and not council funded. Are you on about family and friends providing all there care and not using agency care. If people need more than 4 calls a day then councils look at other options residential care and care homes . I’ve not known councils provide 24 hour care. Even my friend who’s dad was on end of life could not get more than 4 calls a day provide from the council .the family had to do the rest and a hospice provided two nights care as that was all they could spare which my friend was grateful for.so I don’t know where you get your statistics from above because councils do not provide fully funded care for 24 hour care for home care they look at other options. If you are meaning that the person is going to be self funding and paying for there own care without any financial help from the council.then I would think the person and family can get the care from whatever agency or place they wish as the council are not funding any of it.
And another thing to think about is if somewhere is not CQC covered.Say someone seriously injuries your relative , places are CQC registered for a reason .to protect people.
Also councils are not the same. Depends in the area you live. But I cannot see any councils not using agencies that are not CQC registered to cover themselves if anything went wrong. And if an agencies was not CQC registered wouldn’t you want to know why and what they have to hide by not being CQC registered.
And if the person is self funding there own care without any financial help from the council .then I think the person can have care from whatever agency or place they want as it is them paying for it and not the council.
These are good questions and sorry to not be clear 
Council say fully managed and therefore, effectively it has to be CQC. Its the only way for her to get home so far (otherwise stays in Care Home). The CQC rating seems to be extremely important (even if very old - some are many years out of date). The CQC rating carries a huge amount of weight in decisions. Its not surprising as the company has to uphold those standards which is important. Although if rarely checked there is no way of knowing its being met, unless family of friends visit every day which they would so its all covered anyway.
Self funding. The extra cost he is being forced to pay to get home (due to insistence on CQC), would reduce the time at home.
The 24 hour care agency provides list of carers that exactly match your criteria, e.g. qualifications and experience (you can get references), You choose one. Then you meet them. If it doesn’t work out they replace them (fast). They live in your house and have 2 hour breaks each day, which you cover with own carer.
Carer, family and friends would see the person every day on visits, so can see that they are ok or if anything isn’t going well.
LA have to approve the choice of agency and they say it has to be CQC rated (as do powers above) which is only the fully managed ones that are around 1,600++ (compared with 1,200 standard rates) with. The companies themselves say you don’t need to pay so much if the person doesn’t have complex needs and has family doing it all anyway. Its duplicating. Its just that the council want an independently managed company managing the care. Effectively, they getting all the info from the family and manage it from an office.
There must be precedents out there and when I find them, it may be useful for many in the same situation.
Sorry I didn’t see all your message before I just replied.
Its not that its about having a type of company where some of CQC and some aren’t. I agree with you there in what are they hiding in being not rated. Its just the distinction between Intro agencies (not CQC as they just provide a carer and family managed it) and ‘fully managed’ who manage it from an office and are CQC registered.
I agree you wouldn’t want to choose NON CQC when there are CQC rated ones. That would certainly raise questions.
Its just that there are either:
- Intro agencies (where family are in charge, but the agency does a lot to help like replacing carers fast and provide an App)
- Fully Managed agencies, where family are less involved
@4leafclover so you are saying they are having a live in carer who will live with them and they are self funding the live in carer themselves. My auntie had a live in carer for 4 years which they had to fund privately so she could stay at home. She has now gone into a carehome. The agencies they used was one that was contracted to there council.
I see what you mean now. The terms of her being released from hospital is that she has a live in carer that comes from a CQC registered agencies or they will not discharge her home but to a care home. Is that what you are saying. I don’t know if you can go with that at the start to get her home and then further down the line you can change the agency.
But you have said to be discharged from hospital they have said she has to have a fully managed agency and cannot have an intro because they are not registered by CQC.and if that is the case then how have you a choice you have said if you don’t have a CQC registered one then they will put her in a care home.
this is different situation I ended up in hospital a couple of years ago I broke 6 bones. After 4 months I cam home. I was given a list of 4 care agencies I don’t know if they were all contracted to my council must have been I picked one. I had to have 4 carer calls a day and a couple of other items or they would not release me home from the hospital. And the carers from the agency came and looked after me till I could manage .i know it was CQC registered.
@4leafclover you could give age.uk a ring they provide care to so could also give you some information.you could also look on there website to see what it has to say on there to.
Oh thats good to hear from someone who has had live in carers. It wouldn’t be polite to ask if it was an Intro agency or Fully Managed agency, but I imagine if the council was involved it would have been the latter then. Of course no need to say. I am very impressed with the Intro agency as they have such a good reputation and even provide carers to the fully managed ones! Its just that Intro companies dont need to be CQC rated according to CQC, I believe.
I am sure you know all about this, having had an Aunt with live in care.
This person ONLY wants to live at home. Doesnt have many years left in the big scheme of things and its their wish so long as practical. In LPA too. One of the big issue is these costs of a CQC one (1,600+) will mean less years at home and less of other things they want and need. Their safety would be well and truly protected as people will be there every day including back up breaks carer who has known this person years already. They would be very safe, more than most due to the set up.
It wouldnt be a case of one person in day and another at night. There would be loyalty built which hopefully makes it even safer. We know of CQC rated places that certainly were not doing things or stayinmg the time they should, but the rating can make them look safe. This person has people who are incredibly supportive and prioritise safety and health. Its a duplication of resources.
I have heard there was a similar case, and a non CQC one was allowed, and I am awaiting news on this case. Ultimately, things can look safe on paper, but in practical terms, they can be very safe if not even safer (for the extra cost saved you could even have someone monitoring a few times a day). I suppose its about who is ultimately responsible. I’m not sure if its the LA or the family, if you go non CQC. I will double check this.
I just saw this. I am sorry to hear about 6 bones broken. Thats awful! I hope you are no longer suffering form that event and you are well!!
Good idea. They may have heard of similar example cases. Thank you so much for your time and understanding. I hope you have a lovely day.
@4leafclover it was a care agency that bids on contracts with our council .funny enough it was the same agency that provided my care that I picked off the list of four from the hospital. I found out when I came home that they were the best one in my area which at the time I did not know. I know my cousin said it cost a fortune but there was nothing they could do about that.
You have said that the person is still in hospital or are they home .and that they won’t let them out of the hospital and will put them in a care home didn’t you if it’s not CQC registered the agency .If that is the case then you will have to have a CQC registered one if that is what your council have said. Even if someone has had a non CQC one they may not be from your area. And then once the person is home them you could change the agency to another one if she is funding her own care.
If you employ a carer yourself then you are the employer and you are fully responsible. also if they are in hospital be wary of the time and discharge date and sorting things out for coming home because if they want them out and things are not sorted out at home they could put them in a home saying things are not sorted.im not saying they would do.
@4leafclover im better than I was thankyou ,walking abit wobbly. Was 2 years of hell. Unfortunatly there are good ones and bad. Another thing you could do is ask around in your area if you know people who have care ,or you know people who know people who have care and see what they say about the agencies that provide care where you live for there relatives if there good or not. Not just by reading on the internet because anyone could write anything. So ask around .you have a lovely day too and take care.