When hiring caregivers it is important to note that there will be a lot of hiring and firing. In other words you may have to kiss a lot of frogs before you find the right ones. Finding the right fit of caregiver to patient to family is a tough balance. My brother has gone through many care givers for my mother because someone doesn't do something right and so they are fired. Never given a chance to improve or to get it right... just fired and replaced because there is always someone right behind who needs the job. I'm not saying this is the right way to do it. My brother is a crazy person. It's hard enough to be his sister much less having to work for him. Some agencies have higher standards than others but you pay for that experience. Then, there are the independents who are friends of the patient or get recommended by a friend. They have no standards, no policies and work on a more human less professional basis which means that anything can happen and anything does happen. No rhyme or reason, they are the worst to get assigned to because you can be doing everything right but for some underlying reason they want you gone. My agency gets calls from independents to fill in shifts here and there which why I know about this. I have filled in for a few independents and I always feel like I'm walking into a lion's den. Independents are also less likely to screen whereas an agency, under law, must screen. Independents can be a wild card and families are taking a risk by operating through them, but.... families know best so you learn to stay out of it and once you're gone you just move on. I make mistakes from time to time. I am human. I get the job done just fine, my patients are never at risk... it's always everything else.