Missed calls in home care: where they come from and how to count them

Missed calls in home care are rarely counted, which is why they are rarely fixed. Most agency owners know the feeling of a client saying, "I rang and nobody answered." Few can say how often it happens, at what hour, or what became of the call. This guide shows where missed calls come from and how to count them in a week with records you already hold.

Counting matters for two reasons. It turns a vague worry into a number you can improve. And as home support moves under HIQA, a record of how you handle contact will count for more than a promise.

What counts as a missed call in home care

Most people think of a missed call as one that rang out. That is the most visible kind, and it is only one of five.

1. Unanswered. The phone rang and nobody picked up.
2. Answered, not recorded. Someone took the call but wrote nothing down, or wrote it in a place nobody reads.
3. Recorded, not passed on. A message went to voicemail or to a colleague who never saw it.
4. Passed on, not actioned. Someone saw it and meant to deal with it.
5. Actioned, caller not told. The issue was fixed but the person who rang never heard back.

Families experience all five as the same thing: the agency did not respond. Your phone log, however, only catches the first. The other four live in notebooks, inboxes, group chats and memory.

Where missed calls come from

When agencies do look closely, the causes tend to cluster in six places.

• One line, many callers. The office has a single number. Carers, clients, families, hospital staff and sales calls compete for it.
• Peak times. Early morning, when carers report in, and early evening, when families ring after work, push calls past what the team can answer.
• Phones that follow people. A mobile in a handbag, a car or a pocket during a client visit does not get answered.
• Handover gaps. A call arrives at 4.55pm. The office closes at 5pm. The out-of-hours number starts at 5.30pm.
• Voicemail without an owner. Nobody is responsible for emptying it and nobody checks at the weekend.
• Calls from carers. A carer who rings to say a client is unwell or unreachable is easy to treat as routine. These calls can be the most urgent of the day.

The last point deserves attention. The Department of Health's Strategic Workforce Advisory Group report records stakeholder concerns that care workers must travel between different locations and often work alone. A lone carer who cannot reach the office is more exposed than one who can.

Why it matters more than it seems

Consider what a call can contain. A 2026 TILDA study in BMJ Open found that 1 in 8 people aged 70 and over needed medical attention for a fall in a year, and 1 in 16 attended an emergency department. Some of those falls will be reported to a home care agency first. A missed call about a fall is a missed chance to send help.

Waiting times raise the stakes. BDO's July 2026 snapshot says the HSE home support waiting list stays above 5,000 people. Families who have waited a long time for care are less patient with an agency that does not answer.

And there is regulation. The draft HIQA standards describe an outcome where concerns and complaints are "listened to, recorded, and managed in a timely way" (draft Standard 1.4, in HIQA's draft National Standards). The final standards may differ. The direction is clear.

You cannot manage a missed call you have not counted.

How to count missed calls in one week

You need seven days, a spreadsheet and about two hours of set-up. Do not buy anything new.

Step 1: Gather every source

List each number people ring and where its records live. Typical sources are your office phone system or provider portal, itemised mobile bills for any on-call phone, an answering service report if you have one, voicemail boxes and the email inbox that receives messages.

Step 2: Create one shared log

Use a simple sheet with these columns. Ask everyone who answers the phone to fill it in for the week, even for routine calls.

Step 3: Pull the carrier logs on day eight

Export the phone log for the same seven days. Match each entry to your sheet. Any call in the log that is not in your sheet is a call nobody logged. That gap is your first finding.

Step 4: Classify each gap

For each call that fell through, tag it with one of the five types above. A call that rang out is type 1. A call answered but not in your sheet is type 2. And so on.

Step 5: Work out five numbers

• Unanswered rate. Calls unanswered as a share of all calls, by hour of day.
• Unrecorded rate. Calls answered but not logged.
• Median time to callback. How long between the call and a response, for calls that needed one.
• Calls from carers. What share came from staff, and how many of those were answered quickly.
• Out-of-hours gap. Calls between 5pm and 9am with no named person informed.

You will probably find the picture is uneven. The pain tends to sit in a few hours of the day and a few types of caller.

How to read your log

Look for three patterns before you decide anything.

• Hours. Plot unanswered calls by hour. A cluster at one time of day points to staffing or phone routing. A scatter across the day points to habits.
• Callers. Split by caller type. If carers' calls go unanswered more than families' calls, your internal routing is the issue.
• Subjects. Group the reasons. If most calls are about visit times, a confirmation process may remove the volume. If many are about complaints, your service is telling you something.

Be cautious about averages. One bad night can hide in a good week, so read the worst ten calls as well as the totals.

Setting your own targets

Because we found no public benchmark for Irish agencies, set targets from your baseline. Choose a goal for each of the five numbers, share it with the team and review it monthly. A realistic aim is to improve one number at a time and to hold the gain before you move to the next.

What to do with the numbers

Resist the urge to fix everything at once. Choose the single biggest gap and change one thing.

• If most missed calls fall at peak times, add a second line, a call queue or a first layer that answers and records every call.
• If calls are answered but not recorded, put a short template next to every phone.
• If voicemail is the problem, assign an owner and a check time.
• If the gap sits out of hours, look at your after-hours cover options.
• If urgent calls are being treated as routine, write escalation rules so nobody has to improvise.

A service that answers every call and writes a clear summary can close much of types 1 to 3 in one move. Hettie is built to do that for after-hours calls, as the Care Centre page explains. It does not remove the need for people to act on what it reports. Types 4 and 5 are always about your team's follow-through.

Count again four weeks later. If the numbers move, keep going. If they do not, you have chosen the wrong fix, and the data will tell you.

A word on data and trust

HSE reporting on home support is limited. The Medical Independent reports that committee members were told data is limited without a single ICT system, and that the HSE is running a competitive dialogue to buy one. Until that exists, your own records are the strongest evidence you have of how your service behaves. They will help in a tender, in an inspection and in a conversation with an upset family.

Keep personal data in your log to a minimum. Names and health details in a shared sheet are special category data under the GDPR. Restrict access and delete the working copy once you have your numbers. If you want to see how a call tracker feeds your wider governance, our companion article on satisfaction surveys without more office workload shows how to pair what clients say with what your logs show.

Sources

1. Department of Health: Report of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Healthcare Assistants (September 2022)
2. TILDA / Trinity College Dublin: One in eight older people in Ireland require medical attention for a fall each year (BMJ Open, 11 February 2026)
3. BDO Ireland: The homecare sector in Ireland, July 2026 snapshot
4. HIQA: Draft National Standards for Home Support Services (November 2024)
5. Medical Independent: HSE meeting raises reliance on private providers for home support services (20 April 2026)

Frequently asked questions

What is a normal rate of missed calls for a home care agency?

We have not found a reliable public benchmark for Irish agencies, so we will not quote one. Your own baseline is more useful. Count one week, change one thing, then count again.

Does a missed call have to be reported to HIQA?

Not as a missed call. HIQA will regulate home support once the Act commences, and the regulations will set out what must be reported. In the meantime, treat complaints, incidents and safeguarding concerns that arrive by phone as you would any other, and keep the record.

Who should answer carers' calls?

Someone with authority to act. A carer who reports a client unwell or unreachable needs a person who can escalate. Decide who that is for every hour of the week.