There is a page on Nova Scotia Health's website that every Canadian family should read before hiring help at home, whatever province they live in. It is titled "Things to consider when hiring private unregulated home care," and it says, in the health system's own words, that private care services are not funded, monitored or audited by the health authority, and that it does not endorse or recommend any private agency. That is not Nova Scotia being unusually hands-off. As we found verifying the rules in every province for our guide to how agencies are regulated, nine of ten provinces license no private home care agency at all. There is no inspector coming. The interview you conduct at the kitchen table is the inspection, so it is worth conducting well. Here are the twelve questions that do the work, grouped by what they actually test.
Who is really working in my home?
1. Are your caregivers your employees, and are you registered with workers' compensation? Employees mean the agency handles payroll, coverage and supervision; contractors can mean those duties quietly land on you or on nobody at all. Workers' compensation registration is mandatory for home care employers almost everywhere in Canada, and a registered agency can produce a clearance or letter of good standing from its provincial board. If a worker is injured in your home and the agency was never registered, that is precisely the kind of gap you discover at the worst moment.
2. What insurance do you carry, and are staff bonded? Covered in detail in the FAQ below; the short version is that the answer should arrive as a certificate, not a reassurance.
3. Do you run criminal record and vulnerable sector checks on everyone, and how often? Here is what surprises most families: for private-pay agencies, almost no province legally requires these checks; the duties that exist mostly bind publicly funded employers. So the law is not asking on your behalf, and you should. Good agencies check everyone anyway and repeat checks on a cycle; New Brunswick's standard for funded agencies, every five years, is a reasonable bar to borrow.
4. Who supervises the caregiver, and is a nurse involved in the care plan? Someone qualified should own the plan, and you should know their name. If any nursing tasks are involved, ask who may legally perform them, because the line between what a nurse must do and what a support worker may do is real, provincial, and stricter than most families assume. In Quebec, for example, an unlicensed aide may administer medications only within a public CLSC home support program, an exemption a purely private agency does not inherit; PEI's health professions law goes as far as prohibiting anyone from supervising or assigning a reserved activity they are not themselves authorized to perform. You do not need to know your province's rules by heart. You need an agency that visibly does, and the difference shows in how this question gets answered: a specific "our aides remind and assist, our nurse administers, here is why" versus a breezy "oh, our girls handle all of that."
5. What happens when my caregiver is sick or quits? The honest answers are a backup roster and a communication promise with a timeframe. The wrong answer is silence on a Tuesday morning.
The money questions
6. What is the minimum visit length, and what do mileage, holidays and cancellations cost? The rate cards agencies do publish, Ohana Care's and Daughter On Call's among them as of August 2026, show minimum visits of two to four hours, mileage at 65 to 72 cents a kilometre outside city limits, and statutory holidays at time and a half. None of that is scandalous; all of it belongs in the quote. A short daily check-in priced against a three-hour minimum is the single most common gap between the hourly rate you were quoted and the invoice you receive; our cost guide walks through the arithmetic.
7. Will you charge sales tax correctly for our situation? Purely private home care is subject to GST or HST, but if your parent concurrently receives any publicly funded home care, additional private hours are exempt under the federal rules. An agency that knows this rule, and asks whether public care is in place before invoicing, is showing you its administrative competence in miniature.
8. What exactly will the invoice show? The right answer is visits, dates, times and services, line by line, traceable to records; the subsidies and tax credits in our government help guide mostly require exactly that paper trail.
The proof questions
9. How will I know each visit happened? The full answer is in the FAQ below. Ask it early, because agencies that verify visits at the door say so proudly, and agencies that reconstruct timesheets at month-end change the subject.
10. Will the same people come? Continuity is not a luxury in this work; it is how a caregiver notices that today is different from yesterday. No agency can promise one face forever, but they can tell you their honest approach to consistency and how many different people you should expect in a normal month.
The leaving questions
11. What notice ends or changes the service, in both directions, and how do rates change? Get the numbers in writing; the FAQ above shows what specific looks like.
12. Can you give references, and what is your complaints process? Then actually call the references, and ask each one the best question available: what went wrong, and what did the agency do next? Nothing never goes wrong in home care. The professionals are the ones with a good answer about what happened when it did.
One last piece of sequencing: before interviewing anyone, book the free assessment from your province's public home care program. It costs nothing, it may fund some hours, it changes the tax on the rest, and it gives you a professional's read of the need you are about to buy against. Then ask your twelve questions, in writing where it matters, and hire the agency that seemed pleased you asked.
Frequently asked questions
In nine of ten provinces, no. There is no licence for a private-pay home care agency, no inspection regime, and no government rating system; Nova Scotia Health's own guidance for families says private care services are not funded, monitored or audited by the health system, and that it does not endorse or recommend any private agency. Newfoundland and Labrador is the exception, requiring home support agencies to hold an annually renewed approval from the health authority. Standards do exist for agencies working under public funding contracts, which is one reason an agency that also holds government contracts has already passed a bar a purely private one has not. The practical consequence for families is simple: the questions you ask are the inspection, which is exactly why this list exists. Our guide on how agencies are actually regulated covers the details province by province.
It is cheaper per hour and heavier in every other way. Hire someone directly and you may become an employer in the eyes of CRA and your provincial workers' compensation board, with payroll deductions, premiums and filings that provincial self-managed care programs expect participants to handle, including workers' compensation coverage as a condition of funding in some provinces. There is no backup when your one caregiver is sick, no supervisor, and no agency insurance behind an injury in your home. One detail many families learn at tax time: CRA requires an individual, non-agency care provider to put their Social Insurance Number on receipts before attendant care can be claimed as a medical expense. Direct hiring works well inside structured self-managed programs that support it; done informally, the hourly saving buys you a second unpaid job.
The only published Canadian benchmark comes from Ontario's public home care contracts, which require service providers to carry commercial general liability of at least $5 million per occurrence and professional liability of $5 million per claim, over and above each nurse's college-required coverage. No province publishes a minimum for private-pay agencies, so treat the question as a disclosure test rather than a pass mark: a professional operator can produce a certificate of insurance on request and answer whether staff are bonded. Nova Scotia Health's advice to families hiring privately is to ask exactly that, about business insurance, police record checks, vulnerable sector checks, and bonding. An agency that hesitates on any of the four is telling you something more useful than the answer would have.
Numbers, not adjectives. The published terms that exist show what specific looks like: in BC's public home support system, a visit cancelled with less than 24 hours' notice is still charged; one Manitoba agency's published client agreement requires 72 hours' notice to change or discontinue service, bills statutory holidays at 1.5 times the hourly rate, and charges 3% interest on overdue accounts. None of those terms is wrong; what matters is that they are written down before you sign. Ask what notice you must give, what notice the agency gives you for rate increases, what a missed or late visit costs either side, and what ends the agreement. A contract that answers in numbers is a contract you can hold someone to.
More than a monthly invoice. Where governments fund home care they demand this: Nova Scotia's standards for funded agencies require a system to verify authorized visits and tasks against the visits and tasks actually performed. There is no reason to accept less as a private customer. A professional agency can tell you when the caregiver arrived and left, verified at the door rather than written down later from memory, and what was done during the visit, and can show you that record rather than asking you to trust the retelling. Families paying for hours have a plain right to know the hours happened; caregivers benefit equally, because verified records are what protect them when a client's memory of Tuesday differs from theirs.
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