What to Ask Before Hiring a Home Care Provider

Home care is not a single service. It is a broad category that includes personal support, nursing, companionship, respite, and specialized dementia or palliative care. Before you can ask the right questions of a provider, it helps to understand what the industry actually looks like and who the players are.

Agencies versus independent caregivers

Most home care is delivered through one of two models:

• Agency model: You hire a company, and the company assigns and manages caregivers. The agency handles scheduling, backup coverage, payroll, insurance, and worker supervision. If your regular caregiver is sick, the agency finds a replacement.
• Independent caregiver: You hire an individual directly. This often costs less per hour, but you take on more responsibility. You may need to manage their schedule, handle tax withholding, arrange your own backup if they are unavailable, and verify their credentials yourself.

Neither model is wrong. Many families use both at different stages. The important thing is knowing which you are evaluating so you ask the right questions.

A note on terminology across countries

This guide uses the most widely recognized terms. Roles are described by what the worker does, not just their title, because the same job goes by different names depending on where you live:

• Personal support worker (PSW) is the common Canadian term for a worker who helps with bathing, dressing, grooming, meals, mobility, and basic home tasks. In the United States, the same role is often called a home health aide (HHA) or certified nursing assistant (CNA). In the United Kingdom, the equivalent is a care worker or care assistant. In Australia, it is often called a personal care attendant or support worker.
• Registered nurse (RN) or registered practical nurse (RPN/LPN) handles clinical tasks: wound care, injections, catheter management, medication administration, health assessments. In the UK, this role is a district nurse or community nurse. In Australia, it is a community registered nurse.
• Companion provides social support, light tasks, accompaniment to appointments, and meaningful company. This role exists under similar names in most countries.

If you are outside Canada or the United States, ask any prospective provider what the equivalent regulated roles are in your region, and what credentials workers hold.

The most useful thing you can do before contacting any provider is write down exactly what you need. Vague requests get vague answers. Specific requests let you compare apples to apples.

Write down:

• The specific tasks that need support (bathing, dressing, meals, medication reminders, housekeeping, mobility, companionship, nursing)
• How many hours per day or week
• Whether the schedule needs to be fixed or flexible
• Any specific requirements: language spoken, gender preference, experience with dementia or a particular condition
• Whether this is for a private home, a retirement residence, or a long-term care facility

Note: Home care workers can be privately hired to provide support inside a retirement residence or long-term care facility in most jurisdictions. If this applies to your situation, tell the provider upfront so they can confirm whether they work in those settings.

Ask these of every agency or independent provider you evaluate. Write down the answers so you can compare later.

Licensing and standing

• How long have you been operating?
• Are you licensed, accredited, or registered in this region? What does that mean in practice?
• Are you a member of any home care industry associations? Which ones?
• Do you carry general liability insurance? Are workers covered under a workplace safety insurance policy?

Workers: screening, training, and employment status

• Are your caregivers employees or independent contractors? What does that mean for supervision, training, and liability?
• What background checks do you conduct? Criminal record checks? Vulnerable sector checks?
• What training is required before a worker is assigned? Is training ongoing?
• What credentials or certifications do the workers hold?
• How do you supervise workers in the field? Is there a supervisor who checks in on client visits?

Why this matters: Whether workers are employees or contractors changes who is legally and practically responsible for them. Contractors may not be covered by the agency’s insurance or subject to the same oversight. Many families do not ask this question and are surprised when a problem arises.

Scope of services

• What exactly is included in your service? What are you not able to do?
• Do you provide personal care, nursing, companionship, or some combination? Which of those are your workers trained and regulated to provide?
• Can you provide care in a retirement residence or long-term care facility if needed?
• Can the level of care be increased or decreased as needs change?

Pricing and contracts

• How is pricing structured? Hourly, by visit, or by care package?
• Is there a minimum number of hours per visit or per week?
• Are there additional charges for evenings, weekends, or public holidays?
• Are there fees for initial assessments, care plans, or administration?
• Is there a written service agreement? Can I read it before I sign?
• What is the cancellation policy? What happens if we need to stop services?

• What happens if my regular caregiver is sick or unavailable? How far in advance do you let us know?
• Will we have the same caregiver consistently, or does it rotate? What is your approach to continuity of care?
• How do we communicate concerns or feedback? Who do we call if something goes wrong?
• Is there someone available after hours or on weekends if there is an urgent concern?
• Can I speak with references from current or past clients or families?
• How do you handle complaints? Has your agency ever lost its license, registration, or accreditation?

What good answers look like: A reputable provider will answer these questions directly, provide written documentation without being asked, and welcome the request for references. Vagueness, pressure to sign quickly, or resistance to putting things in writing are all warning signs.

• How do you match caregivers to clients? Can we meet the caregiver before they start?
• What happens if the match is not working? Can we request a different caregiver?
• Do you have experience with the specific diagnosis, condition, or situation?
• How are workers trained to handle behavioral changes, emergencies, or falls?
• What is your policy if a worker witnesses signs of abuse, neglect, or a change in a client’s condition?

These are not automatic reasons to walk away, but they warrant careful attention:

• Pressure to sign a contract before you have had time to review it
• Inability or unwillingness to provide references
• Vague or inconsistent answers about worker credentials or background checks
• No clear backup plan when a caregiver is unavailable
• Billing that is unclear or difficult to get in writing
• A high turnover of caregivers with no explanation
• Workers who are not employees but are described loosely as “our people”

Most reputable agencies will conduct an in-home care assessment before services begin. This is a visit where a coordinator comes to the home, talks with the person receiving care and their family, and develops a written care plan. The care plan documents what support is needed, how it will be delivered, and how progress will be monitored.

Ask for a copy of the care plan before the first visit. Review it carefully. It should match what you discussed and reflect the actual needs of the person receiving care.

Plan to reassess within the first few weeks. How is the match working? Are the needs being met? Is the person receiving care comfortable with the caregiver? Early feedback is easy to act on. Problems that go unaddressed for months are harder to resolve.

1. Write down the specific tasks and hours needed before contacting anyone.
2. Contact at least three providers. Compare their answers side by side.
3. Request written quotes, service agreements, and references before deciding.
4. Ask to meet the caregiver before services begin.
5. Check whether publicly funded home care is available in your area before committing to private-pay costs.
6. Download the checklists below and bring them to every call or meeting.

Find vetted home care providers in the directory.