By the Big on Health editorial team, Ideas in Medicine Ltd.

This is not medical, legal or financial advice. Big on Health is a UK review site. For health worries, speak to the GP, pharmacist or NHS 111. If someone is seriously ill, injured or in immediate danger, call 999.

Companionship care is paid help that centres on company, conversation and the small everyday things that make a day feel normal: a chat over a cup of tea, a walk to the shops, someone to go with you to the library or the GP. It usually does not include hands-on personal care such as washing or help with the toilet. This guide explains what companionship care is, how it differs from personal care, what a carer can and cannot do, how families tend to book the hours, what it costs, and when it is time to step up to more support. We checked every source on 26 Oct 2026.

What companionship care is

“Companionship care” is a term used by care providers rather than an official category, so different providers mean slightly different things by it. In general it covers:

• Company and conversation at home: talking, reading together, playing cards, looking at photos, hobbies.
• Getting out: walks, a café, a lunch club, church, a social group, or visiting a friend.
• Going along to appointments, such as the GP, optician or hairdresser, and helping the person remember what was said.
• Light practical help: making a meal or a drink together, washing up, a bit of tidying, help with shopping or collecting a prescription.
• Prompts and reminders, such as reminding someone it is time to eat or to take their medicines, where that has been agreed.
• Keeping in touch: helping with phone or video calls to family.

The NHS lists many of these among the things a paid carer can help with, including preparing meals and drinks, doing the shopping, collecting prescriptions or a pension, remembering to take medicines, and getting out, for example to a lunch club.

Companionship versus personal care

The difference matters for safety, regulation and cost. Personal care is hands-on help with the body. The NHS includes washing and dressing, brushing hair, using the toilet, and getting in and out of bed. mygov.scot describes personal care as things like help to wash or dress, or getting in and out of bed.

A companion carer usually does not do these things. If a family assumes they will, and the carer assumes they won’t, someone can be left without help they need. So before anything starts, write down:

• the tasks the carer will do;
• the tasks they won’t do, such as personal care, giving medicines or handling money;
• what happens if, on the day, the person needs help that is outside the agreement.

The NHS says all homecare agencies in England must register with the Care Quality Commission (CQC). In Scotland, mygov.scot says the Care Inspectorate lists and checks home care services. In Northern Ireland, nidirect says home care agencies are regulated by the RQIA. In Wales, Care Inspectorate Wales regulates care services. If you use an agency, ask whether it is registered, and whether the same carer could provide personal care later if needs change.

Loneliness and older people

Many families first look at companionship care because a parent seems lonely. The NHS says loneliness can affect people of any age, but older people are particularly at risk if they live alone or do not have regular contact with others. It links loneliness with things like living alone, retirement, illness or disability, and bereavement. It also points out that you do not have to be on your own all the time to feel lonely.

The NHS suggests things older people can try, including keeping in touch with family and friends by phone or video, joining local groups or classes, inviting someone over even for a short visit, planning things to look forward to such as a walk or a trip to the cinema, and volunteering. It mentions befriending services from charities such as Age UK, The Silver Line and Re-engage. It also suggests asking the GP about social prescribing, where a link worker can help find local support and activities.

A companion carer can help with several of these at once: getting someone to a group they would not manage alone, setting up a video call, or simply being a regular, friendly face. Free befriending and community groups are worth trying too, and many families use a mix of both.

When low mood needs more than company

Company helps, but it is not treatment. The NHS says to see a GP if someone is struggling to cope with stress, anxiety or low mood, has had a low mood for more than two weeks, or things they are trying are not helping. It says free NHS talking therapies are available and people can refer themselves. If someone needs help urgently but it is not an emergency, call NHS 111. If someone has seriously harmed themselves or needs immediate help, call 999.

What a companion carer can and cannot do

Usually within companionship

• Conversation, activities and outings agreed with the person.
• Making simple meals and drinks, and eating together.
• Light housework linked to the visit, such as washing up.
• Shopping, errands and collecting prescriptions.
• Escorting to appointments and social activities.
• Reminders and prompts, as agreed.

Usually outside companionship

• Washing, bathing, dressing or help with the toilet.
• Helping someone move who needs lifting or equipment.
• Giving medicines, rather than reminding.
• Nursing tasks, such as dressings or injections.
• Managing someone’s money or signing documents for them.

If the person needs any of the second list, look at personal care from a carer trained to do it, or ask the council for a needs assessment.

How families book the hours

The NHS says homecare is very flexible: you might need a paid carer for only an hour a week or for several hours a day. Common companionship patterns include:

• A weekly outing, such as a two- or three-hour slot for shopping and a café.
• Several short visits a week, often around lunch, so the person eats well and has someone to talk to.
• Cover while family work, for example a set afternoon every week.
• A sitting service so the family carer can have a break. The NHS respite guidance says some charities offer a trained volunteer to keep the person company, usually for a few hours at a time. See Respite care in the UK.
• A regular evening visit to help someone settle, if evenings are when they feel most alone.

Continuity matters a lot in companionship. A friendly face the person knows is worth more than a rota of strangers. Ask whether you can have the same carer each time, and who covers if they are ill or on holiday.

What companionship care costs

The NHS gives £15 to £30 an hour for a paid carer at home, varying by area, and a typical hourly rate of around £20. It does not give a separate figure for companionship. Rates depend on where you live, whether you use an agency or a self-employed carer, the time of day, and minimum visit lengths. Ask:

• What is the hourly rate, and is there a minimum visit length?
• Are evenings, weekends or bank holidays charged differently?
• Is travel charged, including mileage for outings in the carer’s car?
• Who pays for coffee, lunch or tickets on an outing?
• What notice is needed to cancel?

See Home care costs in the UK in 2026 for more on rates.

Help with paying

The NHS says Attendance Allowance and Personal Independence Payment are not means-tested and can be used towards the cost of care. See Attendance Allowance. Whether the council will pay towards companionship depends on its assessment of the person’s needs. Even if you plan to pay yourself, the NHS says a needs assessment is free and helps you explain to a carer what help is needed, and that if you are not eligible for council help, the council must still give free advice about help in the community. For the bigger picture, see Paying for private care in the UK.

Companionship-type help is often not personal care, so in Scotland it may be charged even though personal care is free. Rules and figures change, so check with the council or Trust before making plans.

Choosing a companion carer

Personality and reliability matter as much as experience. Before you agree anything:

• Meet first, with the person who will receive the visits, and let them have a say.
• Check a DBS or equivalent. See DBS checks when hiring a private carer.
• Take up references, ideally from recent care or companionship work.
• Agree the tasks, hours and rate in writing, including what happens on outings.
• Check driving arrangements if the carer will drive the person: licence, and insurance that covers it.
• Talk about money: how shopping is paid for and how receipts are kept.
• Agree a review after a few weeks.

If you employ a carer directly rather than through an agency or platform, the NHS says you take on the legal responsibilities of an employer. Our guides Finding a private carer in the UK, Questions to ask before hiring a carer and Care agency vs private carer in the UK walk through the options.

When to step up to personal care

Needs often change slowly, and companionship can be a gentle first step that makes it easier to accept more help later. Signs it may be time to look again include:

• the person is struggling to wash, dress or use the toilet;
• they have had a fall, or are unsteady on their feet;
• they are forgetting meals or medicines even with reminders;
• the companion carer is being asked to do things outside the agreement;
• nights have become a problem;
• a family carer is exhausted.

At that point, ask the council for a needs assessment and, if a relative is doing a lot of caring, a carer’s assessment. Our guide Signs a parent needs help at home may help you spot changes. If nights are the gap, see Overnight care at home. If someone needs a person on hand most of the day, see Live-in care in the UK.

When to get urgent help

• Call 999 if someone is seriously ill or injured, or their life is at risk.
• NHS 111 if you are worried about someone’s health and it is not an emergency.
• The local council or Trust if care at home breaks down and you need social care help quickly.

Related guides

• Finding a private carer in the UK
• Questions to ask before hiring a carer
• DBS checks when hiring a private carer
• Signs a parent needs help at home
• Respite care in the UK
• Overnight care at home
• Live-in care in the UK
• Paying for private care in the UK
• Comparing care options in the UK

Sources

All checked on 26 Oct 2026.

• NHS: Feeling lonely (including loneliness in older people)
• NHS: Help at home from a paid carer
• NHS: Paying for your own care (self-funding)
• NHS: Carers’ breaks and respite care
• NHS: Getting a care needs assessment
• NHS: Financial assessment (means test) for social care
• mygov.scot: Care at home
• mygov.scot: Costs of personal and nursing care
• mygov.scot: Self-directed Support
• GOV.WALES: Charging for social care
• Care Inspectorate Wales
• nidirect: Employing a paid carer or personal assistant
• nidirect: Support to stay in your own home
• nidirect: Direct payments for care
• GOV.UK: Apply for direct payments

This page is general information, not medical, legal or financial advice. Check care and funding rules with the local council, Health and Social Care Trust or GOV.UK before making plans.

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