Children’s domiciliary care is care and support delivered to a child in their own family home, by trained carers from a registered agency. It is different from a children’s home, where a child lives away from their family. For many families, it means a disabled child, or a child with complex health or behavioural needs, can stay at home with their parents and siblings while a carer takes on some of the daily support.
This guide explains what the care covers, who it is for, how assessments and funding work in England, and what to look for in an agency. We are Kells Care, a London home care agency with over 30 years of experience, and we support children and families every day. Families may also describe this support as homecare or care at home.
The word “domiciliary” simply means in the home. GOV.UK describes domiciliary care as services that support a person in their own home, and in England an agency providing personal care in someone’s home must register with the CQC. For a child, that means carers come to the family home, and sometimes go out with the child to school, clubs or appointments, depending on what has been agreed.
A children’s home is a different thing. GOV.UK explains that a children’s home is a place where children live or stay without their families. Under the Care Standards Act 2000 it is an establishment providing care and accommodation wholly or mainly for children, and a child here means anyone under 18. Many of the search results for this topic are about residential homes, so it helps to be clear which one you are looking for.
The difference matters for family life. With home care, your child keeps their bedroom, their routines, their school and their relationships. The National Framework for Children and Young People’s Continuing Care says care planning should treat the child’s home as the focus of care. It also says residential care should be used only when other interventions have failed or where there are safeguarding issues.
There is no single label for a child who may benefit from care at home. The NHS describes a child as having complex needs if they have an illness, disability or sensory impairment and need a lot of additional daily support. This may be present from birth or arise after an illness or injury.
In practice, families come to us because of:
The Hillingdon Safeguarding Partnership’s 2024 practice guidance describes complex needs as two or more needs affecting a child’s wellbeing that typically interact and make each other worse. It also stresses that these children should have the same opportunities, rights and protections as all other children. We agree, and it shapes how we plan care around each child.
Good children’s care is built around the child’s day, not a fixed list of tasks. Typical support includes:
Our home care services cover child disability care, learning disability, mental health conditions, physical disability and respite cover. For families of children with learning disabilities, autism or challenging behaviours, support is designed around the child and their family. You can read more in our guides to learning disabilities at home and what autism support involves.
Home care is not the same as medical care. The NHS explains that a child’s medical and healthcare needs are the responsibility of local NHS health services. This includes equipment such as special beds, hoists and aids for incontinence, mobility or hearing, usually provided free. Specialist clinical services, such as paediatric foot care, sit with health professionals. A home carer works alongside them and follows the care plan they set.
An occupational therapist can also advise on equipment and adaptations. Our guide to occupational therapy home assessments explains what to expect.
The route differs between England, Scotland, Wales and Northern Ireland. The steps below apply to England.
The NHS advises that to access services from the local authority, you need to ask for your child to have a needs assessment. Carers UK explains that assessments for disabled children in England are carried out under the Children Act 1989, and councils have a duty to assess a child in need under 18 for any services they or their family may need. You can request this in writing, which gives you a record of the date.
The NHS says local authorities are responsible for non-medical care a child is assessed as needing. That includes daily-living equipment, home care, special educational needs support, play schemes and respite care. Health services cover medical needs. When a child’s needs cannot be met by existing universal or specialist services alone, the National Framework says a continuing care package is required. Children with a continuing care package have the right to a personal health budget.
The NHS notes that a child may also need an education, health and care (EHC) plan if they need more support than their school provides. Our guide explains how an EHCP can help secure home care for your child.
Respite is often the first support families need and the last they ask for. Our guide to respite funding in the UK sets out the assessments worth requesting. Our page on eligibility for domiciliary care gives the wider picture.
NICE guideline NG213 covers support for disabled children and young people with severe complex needs from birth to 25. It aims to get education, health and social care services working together so families get more coordinated support. If you are being passed between departments, it is reasonable to ask who is coordinating your child’s support.
Some families arrange care privately, either alongside council support or while they wait for an assessment. If you are budgeting, our guide to disabled children’s home care costs in London is a good place to start. We will give you a clear quote after talking through your child’s needs.
You are letting someone into your home to care for your child. It is right to ask detailed questions. A short checklist:
| Question | Why it matters |
|---|---|
| Is the agency registered with the CQC? | In England, a domiciliary care agency must register with the CQC to provide care in a person’s home. |
| Are carers DBS checked? | An enhanced check is a basic safeguarding step when working with children. |
| What training do carers have for my child’s needs? | Autism, epilepsy, moving and handling, and behaviour support need different skills. |
| Who will the carers be? | Consistency helps children settle and builds trust. |
| How are concerns raised and handled? | The agency should have a clear safeguarding policy that every carer knows. |
| How is the care plan reviewed? | A child’s needs change as they grow. |
| What happens if a carer is ill or late? | You need a plan for cover. |
Our guides explain the regulator’s role: what CQC regulation is, the CQC’s role in home care and how to read CQC ratings.
The same care for safeguarding runs through residential children’s care. The Children’s Homes Regulations 2015 require a registered person to implement a policy to safeguard children from abuse or neglect. That covers prompt referral of allegations. At home, you are the first line of oversight, so choose an agency that welcomes your questions.
We have supported London families for over 30 years, and the pattern is consistent. Children settle best when the people helping them come to them, in the place where they feel safest.
A child with autism or a learning disability often depends on routine. When a carer fits into the existing day, rather than the child fitting into a new setting, there is less distress and more progress with everyday skills. Parents tell us the same about themselves: they cope better when they know a familiar, trusted person is coming.
That is why we match carers carefully and plan each package around the individual child. Our carers are fully qualified and DBS checked, and we are regulated by the CQC. Our aim is the same for children as for any client: quality of life, independence, dignity and freedom of choice.
If you are unsure what kind of support to ask for, call us. We will talk through your child’s day and what would help most.
Dan
The NHS advises families to prepare a contingency plan covering the child’s details, medical requirements and emergency contacts, in case a parent falls ill or dies. It is not an easy document to write. It is much easier to write it calmly, with a carer or key worker who knows your child, than in a crisis. Share it with the people named in it.
Review the care plan regularly and after any big change, such as a new school, a new diagnosis, a hospital stay or puberty. Ask whether the hours, the activities and the carer’s skills still fit. A good agency will raise changes itself, and will listen when you do.
NICE guidance NG43 defines transition as a purposeful and planned process of supporting young people to move from children’s to adults’ services. It warns that young people with complex and multiple needs are at particular risk of falling into service gaps. Practical steps:
Because we also support adults, a young person can often stay with carers they already know as they move on. Our wider care options for families guide may help you plan.
We provide domiciliary care across London, from call-in visits to live-in care. For children, that includes support for those with learning disabilities, mental health issues, autism and challenging behaviours, child disability care and respite cover. Every carer is fully qualified and DBS checked, and we are regulated by the CQC.
To talk about your child’s needs and what a care plan could look like, visit our children’s and home care services page or contact us through kells-care.com.
No. Domiciliary care takes place in the child’s own home, with carers visiting. A children’s home is a place where children live without their families. Most families who need support with daily life want the first option, so the child stays at home.
In England, councils are responsible for non-medical care that a child is assessed as needing, and the NHS covers medical needs. Some families also pay privately, alone or alongside council support. Start by asking your council for a needs assessment.
Not always. An EHC plan is for children who need more support than their school can provide, and it can bring health and social care together with education. The needs assessment is the first step for most families.
Often, yes, where it has been agreed in the care plan and the carer is trained. We offer medication assistance as part of our services. Talk to us about your child’s specific needs.
Support moves from children’s to adult services, and planning should start early. Keeping the same carers and bringing the care plan with you helps the change go smoothly.
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