Recent UK government policy has advocated the development of case management to provide more coordinated care at home for vulnerable people. This paper describes a service model whereby case managers, with devolved budgets, employed by the social services department, were located in a geriatric multidisciplinary team to provide an alternative for patients requiring long-stay hospital care. As well as co-ordinating packages of care, case managers were responsible for deploying the time of home care assistants, multi-purpose workers who assisted health care staff and undertook home help tasks. The role of case managers within the multidisciplinary team is explained and the tasks undertaken by home care assistants are identified. Home care assistants undertook a wider range of activities than either home helps or nurses, covering both personal and domestic care tasks.