The care sector has a language problem. Terms like "carer", "companion", "support worker", and "home help" are used loosely and interchangeably, which makes it genuinely difficult for families to understand what they're looking at, let alone what they should be paying for.
Here's a clear-eyed breakdown.
What a carer does
A carer, specifically a domiciliary carer, also called a home carer, provides personal care. That means help with washing, dressing, medication management, mobility, continence, and other activities of daily living that a person can no longer manage safely on their own.
Domiciliary care is regulated by the Care Quality Commission (CQC). Providers must be registered, inspected, and meet specific standards. Carers receive formal training in moving and handling, medication administration, safeguarding, and other clinical areas.
This regulation exists for good reason. Personal care involves real risk. A medication error, a fall, a safeguarding concern. The regulatory framework protects the people being cared for.
What a companion does
A companion provides social support. That means company, conversation, shared activities, light help around the house, accompanying someone to appointments or on errands, and being a warm, consistent presence in someone's week.
Companion care is not regulated. It doesn't involve personal care, medication, or anything that would require clinical training. This is an important distinction, as it's what keeps the cost lower and the relationship more flexible.
What companion care does require is vetting, judgment, and genuine warmth. A good companion isn't just someone who shows up, they're someone who knows your parent's interests, remembers what they talked about last week, and leaves them feeling better than when they arrived.
Domiciliary carer
•
Personal care and hygiene
•
Formal clinical training
•
Typically 30–60 min visits
Companion
•
Conversation and company
•
Shared activities and outings
•
Not regulated (no personal care)
•
Vetted and personally matched
•
Typically 2–4 hour visits
•
£25–40/hr depending on provider
What does each one cost?
DOMICILIARY CARE
£25-38
Per hour, London
COMPANION VISIT
£20-40
Per hour, London
LIVE-IN CARE
£800-1,200
Per week, UK
The cost difference between domiciliary care and companion care is less dramatic than many people expect at an hourly rate. The bigger difference is in what you get for the money, and what your parent actually needs.
Can they overlap?
Yes, and often the right answer is both. If your parent needs personal care in the morning, a domiciliary carer is the right person for that. If they need company on Tuesday and Thursday afternoons, a companion is the right person for that, and likely a much better use of money than asking a regulated care provider to send someone for a social visit.
The mistake families often make is assuming that because they've engaged a carer, the loneliness problem is solved. It usually isn't. A carer doing a 45-minute morning call is focused on a task. A companion spending two hours watching television, playing cards, and hearing about your parent's life in the 1970s is doing something completely different.
Which one does your parent actually need?
If the answer to any of these is yes, a carer is likely necessary: Does your parent need help washing or dressing? Do they have medication they can't reliably manage alone? Have they had a fall or are they at risk of one? Has their GP or a social worker recommended a care assessment?
If the answer to these is more relevant, a companion may be what's actually needed: Is your parent physically able but increasingly isolated? Are they lonely but reluctant to join groups or activities? Do they seem to come alive when someone visits but struggle when left alone? Are you worried about them but not sure there's a clinical reason?
The two aren't mutually exclusive. But understanding which gap you're trying to fill is the most useful question to start with.
