Selecting the best home care is a crucial, often difficult decision that can become overwhelming when there is an abundance of care choices out there. Knowing what to look for and the right questions to ask will help you find the best quality home care for someone with a learning disability in London.
Choosing home care is a big decision—especially in London, where options are plentiful but quality varies. The goal isn’t just to find any provider; it’s to choose the right home care provider for someone with a learning disability in London—one that understands communication, sensory needs, routines, and the person’s life goals, not only their “tasks.”
We will discuss how to evaluate home care providers, what makes them stand out, and other important factors, such as their ratings, reputation, attributes, and values that you should consider. We also provide you with a list of specific questions to ask potential home care providers to be able to make an informed decision – one you will have confidence in.
1) Start with what “good” looks like (so you recognise it)
CQC ratings and reports. Every regulated provider in England is overseen by the Care Quality Commission (CQC). You’ll see one of four ratings—Outstanding, Good, Requires improvement, Inadequate—with inspection narratives that explain why. Since 2023–25, CQC has been scoring against “quality statements” under a single assessment framework; the overall rating still rolls up from those judgements. Read the latest report and check how the provider performs on Safe, Effective, Caring, Responsive, Well-led before you call.
For learning disability and autism specifically, CQC expects providers to meet Right support, right care, right culture. In plain English: the setting and model must maximise choice and independence (Right support), care must be person-centred and uphold human rights (Right care), and the culture must consistently respect dignity and inclusion. Look for explicit evidence of this in the report and on the provider’s website.
2) Get the legal basics right (non-negotiables)
Safeguarding duty.
Providers must prevent abuse and improper treatment and act fast if concerns arise—this sits in the Health and Social Care Act regulations that CQC enforces (see Regulation 13). Ask how staff escalate concerns and how families are informed.
DBS & regulated activity.
Home care for adults is usually a regulated activity, meaning workers should have an Enhanced DBS with Adults’ Barred List where appropriate. If you’re employing PAs via a direct payment, you’re classed as a “regulated activity provider” for checks.
Training: Care Certificate.
For new care workers, the Care Certificate (15 standards) is the sector baseline for safe, compassionate care. Providers should prove that staff have completed or are working towards it.
Mental Capacity Act (MCA).
Providers should show how they assess capacity, record best-interests decisions, and support the person’s voice and choices.
3) Build a London-ready shortlist (3–5 providers)
London is big, traffic is real, and punctuality matters. Aim for providers with teams already operating in your borough—travel time drives missed or rushed calls. Create a shortlist using:
- CQC directory & reports (filter for LD/autism expertise and “Good/Outstanding”).
- Word-of-mouth from local carers’ groups or SEND/LD forums.
- Providers that publish on-call arrangements and back-up cover for sickness, and who can evidence consistent arrival windows (not just time-and-task slots).
4) What specialist practice should you expect?
Positive Behaviour Support (PBS). PBS is a person-centred framework that seeks to understand the reasons for distressed or challenging behaviour and improve quality of life through proactive support—not just reactive measures. For many people with learning disabilities (and autistic people), PBS is the gold-standard approach. Ask about the PBS competency framework, who leads behaviour assessment, and how data informs changes to support plans.
NICE-informed service design. NICE guidance for learning disabilities and behaviour that challenges sets expectations around person-centred planning, skills building, family involvement and avoiding unnecessary inpatient care. A good provider should know this territory and be able to show how they translate it at home.
Right support, right care, right culture in practice:
- Right support → flexible rota built around the person’s routines, community access, choice of staff.
- Right care → communication passports, sensory profiles, clear de-escalation plans.
- Right culture → leaders visible to families, reflective practice, “nothing about me without me.”
5) Funding routes (and how they shape choice)
Personal budgets & direct payments (Care Act).
After a local authority assessment, you should receive a personal budget with the option of a direct payment to arrange your own support. Direct payments give more control over who provides care—useful when you need highly specific skills or language/cultural matching.
Managed services.
If the council arranges support, you can still express preferences (e.g., staff gender, language, time windows) and ask for providers with strong LD practice.
Private pay.
If you self-fund, insist on everything above—DBS, training, PBS, and transparent pricing for travel and unsocial hours.
6) Questions to ask on a discovery call (steal this list)
- How do you ensure continuity of staff? (Probe for core team vs constant rotation.)
- What LD-specific training do carers receive beyond the Care Certificate? (PBS, communication, sensory needs.)
- How do you apply the Mental Capacity Act in day-to-day decisions? (Look for best-interests processes and supported decision-making.)
- Can you share your CQC report highlights and any improvements since? (They should know their actions cold.)
- What’s your punctuality KPI in my postcode? (Ask for last-quarter data.)
- How do you co-produce support plans with the person and family? (NICE signals involvement is key.)
- When behaviour becomes distressed, what’s your step-by-step plan? (Expect PBS language, proactive strategies, and data review.)
- Safeguarding: Who is the safeguarding lead and how are concerns escalated out of hours?
7) Visit and “see the work”
Even for home care, you can meet the team and, where appropriate, shadow a similar call (with consent) or review anonymised rota patterns and daily notes. Ask to see:
- A sample support plan (communication, sensory, health needs, PBS plan).
- Goal tracking (e.g., independent travel steps, community participation).
- Training matrix for the team that will support you. (Look for induction + LD training + refreshers.)
- Incident and learning logs (evidence of reflective practice and change).
- Contingency plan for travel disruption (hello, London), sickness cover, and extreme heat/cold.
8) Build the contract around the person (not just minutes)
Insist your agreement captures:
- Minimum visit length that fits real tasks and communication needs.
- Preferred days/times and any non-negotiables (e.g., religious observance, community clubs).
- Continuity rules (e.g., only trained staff on core tasks; advanced introduction for any new staff).
- Data & reviews: monthly goals, PBS data summaries, and a named supervisor you can reach.
9) Onboarding done right (first 30–60 days)
A great provider will suggest a staggered start: shadowing > co-working > gradual handover, so trust builds at a humane pace. Expect:
- A communication passport and sensory profile were completed in week one.
- MCA check for any decisions where capacity is uncertain; record best interests where required.
- PBS baseline: what triggers distress, what soothes, what skills to teach first.
- Safeguarding map: clear contacts and escalation period.
10) Red flags (walk away if you hear these)
- “We rotate staff all the time—you’ll see who’s free.”
- “We don’t really use PBS; we just keep people safe.” (Safety is the floor, not the ceiling.)
- “DBS takes too long; we’ll start them while it’s pending.” (For regulated activity, this is a hard no.)
- Vague answers on the Mental Capacity Act or safeguarding.
London-specific tips that actually help
- Think travel radius. In practice, many punctuality issues are traffic issues. Aim for a provider with staff who live or work near your borough and can swap intelligently when the Tube pauses.
- Cultural match matters. London is diverse; ask for language skills, faith literacy, and community connections.
- Evenings/weekends. Many life-enhancing activities are on evenings or Saturdays. Check the provider’s 7-day offer and on-call arrangements.
- Hospital liaison. If hospital attendances are likely, ask how they support reasonable adjustments and discharge planning.
Funding & control: make the system work for you
Under the Care Act, eligible adults should receive a personal budget; many families choose direct payments so they can pick and manage providers (or employ PAs) directly. Direct payments can flex to fund specialist training, PBS input, or community programmes—agree outcomes with the council and keep records. If self-funding, you still deserve the same transparency: DBS, training proof, clear costs, and data-led reviews.
The bottom line
Choosing the right home care provider for someone with a learning disability in London is an important decision that requires careful consideration. By assessing the qualifications, services, reputation, and cost of a provider, you can ensure that your loved one receives the best possible care. A good home care provider will focus on delivering compassionate, personalised care that enhances the quality of life for your loved one.
Contact us if you’re in the process of selecting a home care provider. We’re here to help you find the right support for you or your loved ones. Learn more about our range of services and how we can support someone with a learning disability.