10,000 people in NI depend on private sector care workers
Karen Irvine is one of thousands of local care workers.
Employed by the independent sector, she's part of a growing industry which helps keep the health service running.
One of several house calls she makes each day is to a young man called James.
He is 27-years-old and has severe learning disabilities.
Within a year of each other - both his parents passed away.
But with Karen's help, a care package was put in place which allows James to stay in his Belfast home.
Despite his difficult condition, Karen's visits ensure he is safe, warm and well looked after.
"I think James would have ended up in a nursing home or a home of some sort which wouldn't suit James at all, as he needs his own space," she said.
"He needs his own time alone, quietness and just basically being alone on his own."
At a recent gala ball, Karen was one of ten people whose good work was acknowledged in the Independent Health Care Awards.
Judges said they were chosen as their dedication showed that every day they went above and beyond the call of duty.
While winning domiciliary carer of the year means a lot, Karen says helping people is just something that comes naturally.
"I enjoy all my clients," she said.
"I've got to meet some lovely people in the years I've been here.
"I enjoy helping people out as best I can, especially whenever they're someone alone and they don't see anybody all day."
Over 23,000 people here receive domicillary care or are in daily contact in their own home with carers like Karen Irvine and Joan Telford.
Joan is manager of Mears Care Northern Ireland.
She leads a team of over 200 care staff, who bathe, dress, feed and basically provide that human touch to someone who desperately needs care.
"The most challenging aspect for myself is that we've seen domicilliary care move on greatly," she said.
"Ten years ago, the carers would have been going in, lighting fires, making meals and things like that.
"Nowdays there are certainly more complex needs out there, so we need a very highly skilled, highly trained team of staff.
"That's the most challenging thing, making sure we recruit and train and retrain."
Joan's award was in the Domiciliary Care Manager category.
The Lisburn-based branch she works from now delivers more than 5,000 hours of care per week to almost 500 clients.
"I really love working with people, I care about them as individuals and I think that really does make a good manager," said Joan.
There's growing momentum and debate that the health service will have to depend more on the independent sector to provide home care packages.
Last year, of the clients who received home help, almost 16,000 received services from the statutory sector and over 10,000 from the independent sector.
According to Joan Telford, effective management is necessary, not only to hear the voice of the patient, but also the voice of the carer.
"Some carers may feel that they haven't got a voice, but I would like to think that with our branch and with our company, the carers do have a voice," she said.
"We have invested very heavily in employing senior care assessors to support the carers in the community so that they can have one to one's with them, because sometimes carers don't want to come to management and discuss problems and concerns. But if you have somebody there working alongside them everyday who they can talk to they can then advocate for them."
By 2020 it's estimated that the number of people aged over 75 living in Northern Ireland will have increased by over 40%.
That means thousands more people needing help.
If that help is to be provided at home rather than in hospital, those in the health service will need to plan ahead in order to attract and keep workers like Joan and Karen.