Carer Talk: John Kingsbury, Home Instead Cleveland

At a recent Young At Heart session, we welcomed John Kingsbury from Home Instead Cleveland, a care at home company operating across Teesside. John spoke about what care at home involves, how to find it, and how it is funded — drawing not just on his professional knowledge but on his own experience as a former carer and as a family member who once had to navigate the system with no prior knowledge of it.

The session prompted an open and at times very honest conversation. This post is a summary of what was covered, intended as a resource carers can return to.

What is care at home?

Care at home — sometimes called domiciliary care — means a carer coming to someone’s home rather than the person moving into a residential setting. It is not one fixed thing. The level and type of support can range considerably, from a weekly companionship visit through to daily personal care, dementia support, post-operative or reablement care, palliative and end of life care, and live-in care.

The appeal of care at home is flexibility. Routines, mealtimes and daily structure can be shaped around the person rather than an institution’s schedule. Care is one to one. And the person stays in their own home, with their belongings and their memories around them.

Live-in care — where a carer stays in the client’s home — was also discussed as an alternative to a care home placement, and one that can work particularly well for couples.

What to look for in a provider

John was clear that Home Instead is not the only care at home provider, and that quality varies considerably across the sector. These are the things he highlighted as worth looking for.

Minimum visit length

Home Instead operates a minimum of 60 minutes per visit. Much of the council-commissioned care that exists operates on 15 or 20 minute visits because time is the financial lever in that model. A minimum visit length is one signal of whether quality is genuinely being prioritised.

Consistency

Home Instead matches clients to carers by relationship and profile. Carers are introduced to clients before they begin, and if a regular carer is absent, a replacement is introduced beforehand. For someone living with dementia, this matters enormously.

Fixed times

Visits are at fixed times rather than broad windows. John gave an example from his own family’s experience where carers arrived two hours late, meaning his mother-in-law had already attempted to turn her husband herself — something she was not physically able to do safely.

Carer quality and recruitment

Home Instead recruits one in every hundred applicants. Their average carer age is 51. Many have come to care following a personal or family experience, or as a deliberate career change. John was straightforward that finding and keeping the right people is one of the hardest parts of running a care organisation.

24/7 office support

An on-call operation runs around the clock, seven days a week. Carers do not wear uniforms, which John explained is a deliberate choice — not everyone wants it to be visible to neighbours that they are receiving care.

How to find care

John reflected that when his own family needed care, they had no prior knowledge of the sector and found the process bewildering. The main routes he identified were:

• Word of mouth and personal recommendation
• Google and online search
• The Care Quality Commission (CQC) — the regulatory body for care providers in England. You can look up any registered provider at cqc.org.uk and see their inspection rating
• Adult Social Services and First Contact teams at your local council
• Community groups and carer support networks such as Young At Heart

The funding picture

This part of the conversation drew the most from the room. Care funding in England is means-tested by the local council. The broad thresholds currently are:

• Above approximately £23,000 in capital — you pay for your care in full
• Between approximately £14,000 and £23,000 — the council contributes on a sliding scale
• Below approximately £14,000 — the council meets the cost

These figures exclude the value of your home in most circumstances, and the rules around property are complex depending on whether you are a couple and whether care is being received at home or in a residential setting.

At Home Instead, hourly rates start from £36.50 for companionship, rising to around £38 for personal care. That is at the premium end of the market. The National Care Association has benchmarked the true cost of legally compliant, quality home care at around £34.50 per hour — and even that figure is beyond what many councils pay their contracted providers.

For context, John suggested that full-time care home placement averages around £4,000 per month, though this varies considerably. One member of the group noted that at that rate, a capital sum of £23,000 would last less than six months.

John also noted that the sector faces further cost pressures from changes to National Insurance contributions and employment rights, which are likely to push prices higher. He did not shy away from how difficult the picture is for many families.

When needs become more complex

Several members of the group raised the reality that needs do not stay still. Someone may begin by needing companionship or medication prompts. Over time, they may need personal care, moving and handling support, supervision, or help managing agitation and distress. What worked six months ago may no longer be enough.

One carer spoke directly about whether bringing her husband home with carers coming in would be viable. John engaged with this honestly — acknowledging that depending on the level of need, care at home can sometimes cost more than residential care, particularly where two carers are needed at once or where someone requires support that one person alone cannot safely provide.

Care at home can be scaled up or down as needs change, which gives families more flexibility in managing both care and cost over time. But there are points where the right conversation has to include other options too.

Questions worth asking any provider

If you are starting to explore care at home, these are useful questions to put to any provider:

• What is your minimum visit length?
• Will the same carers visit regularly?
• How are carers introduced to the person before starting?
• Do you support people living with dementia at different stages?
• Can you provide medication support and personal care?
• What happens if a carer is off sick or on holiday?
• How quickly can care be increased if needs change?
• Do you provide support at weekends and evenings?
• What are your charges, and what makes costs increase?
• How do you work with families when care becomes more complex?

Useful resources

• Adult Social Care at your local council
• Care Quality Commission — cqc.org.uk
• Carers UK — carersuk.org
• NHS information on social care and care needs assessments
• Alzheimer’s Society — alzheimers.org.uk

Thank you to John Kingsbury and Home Instead Cleveland for giving up their time to speak with the group and for answering questions so openly. If you would like to find out more about their services, please speak to Alison at Young At Heart and she will point you in the right direction.

Note: This post is a summary of a community talk and does not constitute professional advice. Individual circumstances vary. If you are exploring care options, please seek guidance from the relevant professionals and services.