When care providers look at what policies they need, it is tempting to assume that a domiciliary care service just needs a scaled-down version of a care home's policies. That is not the case.
Both types of provider must register with the Care Quality Commission and meet the same fundamental regulatory standards. But the policies they need, and the way those policies must be written, differ based on how care is delivered. Understanding those differences matters whether you are setting up for the first time or expanding from one type of service to another.
Why the Two Settings Need Different Policies
The key difference between domiciliary care and residential care is the environment where care takes place.
In a residential care home, the provider controls the premises, the staffing, and the daily routine of the people living there.
In a domiciliary care service, care workers visit people in their own homes, where the provider has much less control over the environment, other people present, and the risks that may exist.
This difference has a direct effect on the policies a service needs. A care home policy with only the provider name changed will not stand up to CQC scrutiny when applied to a domiciliary service. The same is true in reverse.
Policies Required by Both Types of Provider
Despite their differences, both care homes and domiciliary care services need the following core policies:
Safeguarding adults
Health and safety
Infection prevention and control
Medicines management
Complaints procedure
Whistleblowing
Confidentiality and data protection
Recruitment and safer staffing
Training and supervision
Equality and diversity
For each of these, the legal requirements are the same. But the content must be tailored to reflect how the policy works in practice for each setting.
For example, an infection control policy for a domiciliary care service must address:
Working across multiple households
Managing PPE when storage space in a client's home is limited
Responding to outbreaks when service users are spread across a wide area rather than sharing a building
Policies Specific to Domiciliary Care Services
Some policies are unique to domiciliary care, reflecting the realities of working in people's homes.
Lone Working
This is the most significant difference. Care workers in domiciliary services work alone, sometimes in situations where risks are not visible to anyone else. A lone working policy must cover:
How workers are monitored during visits
How they raise concerns in the moment
What happens if a worker does not check in as expected
How the service responds if a worker is placed in an unsafe situation
Key Holding and Home Access
Many domiciliary providers hold keys or access codes for service users' homes. The policy must set out:
How keys and codes are stored and tracked
Who is authorised to use them
What steps to take if a key is lost or a code is compromised
Environmental Risk Assessment
Care workers need a clear process for assessing and reporting hazards within a service user's own home.
Travel Between Visits
This includes lone worker safety during travel and what to do if something goes wrong between visits.
Managing Refusals or Non-Attendance
The policy must cover what to do when a service user refuses care or is not home when a worker arrives.
Policies Specific to Residential Care Homes
Residential care homes have their own set of requirements that do not apply to most domiciliary services.
Deprivation of Liberty Safeguards (DoLS)
DoLS apply to residential settings where people with reduced mental capacity may be living in circumstances that restrict their freedom. Care homes need policies covering:
How they identify when a DoLS authorisation is required
How they apply for one
How they review and manage authorisations once granted
This does not apply in a domiciliary context. Individuals are living in their own homes and have not been deprived of their liberty by the provider.
Nutrition and Hydration
In residential settings, the care home is responsible for planning and providing meals throughout the day, so these policies tend to be more detailed. A domiciliary provider may address nutrition in care planning, but the focus is on monitoring and reporting rather than meal planning.
Missing Person Procedures
Care homes need a procedure for when a resident leaves the premises without notice. Domiciliary providers address a related but different situation: what to do if they cannot gain entry to a service user's home or cannot make contact and their wellbeing is in doubt.
How CQC Assesses Policy Compliance in Each Setting
CQC uses the same five key questions for all providers: Safe, Effective, Caring, Responsive, and Well-led. But the evidence inspectors look for differs by setting.
What Inspectors Focus On | Domiciliary Care | Residential Care Home |
|---|---|---|
Lone working arrangements | Key area of scrutiny | Less relevant |
Medicines management | General processes | Detailed, complex processes |
DoLS authorisations | Not usually applicable | Key area of scrutiny |
Infection control | Across multiple households | Within a shared building |
Monitoring service users | Remote monitoring challenges | Day-to-day contact and observation |
In both cases, the core test is the same: do your policies match how your service actually works, and can your staff demonstrate that they understand and follow them?
Running Both a Care Home and a Domiciliary Service
Some organisations run both a residential care home and a domiciliary care service, sometimes under the same registered provider. It can be tempting to develop one policy suite that covers both. In practice, it rarely works well.
CQC registers each service location separately. Inspectors for a domiciliary service will expect to see policies relevant to that service. A combined policy covering both residential and home care scenarios can be difficult for staff to navigate and may not adequately address the specific risks of either setting.
Good practice is to maintain separate policy suites for each service type, with shared foundations where appropriate and clear cross-references where processes overlap.
If you are building policy documentation for a domiciliary care or residential care service, HeroDocs provides separately tailored policy suites for each setting, written to reflect CQC requirements and the practical realities of each type of care delivery.