Domiciliary carers are paid care workers who travel to the homes of older people to assist with personal routines. Increasingly, over the past 20 years, the delivery of domiciliary care has been organised according to market principles and portrayed as the ideal type of formal care; offering cost savings to local authorities and independence for older people. Crucially, the work of the former ‘home help’ is transformed as domiciliary carers are now subject to the imperative of private, competitive accumulation which necessitates a constant search for increases in labour productivity. Drawing on qualitative data from domiciliary carers, managers and stakeholders, this article highlights the commodification of caring labour and reveals the constraints, contradictions and challenges of paid care work. Labour Process Theory offers a means of understanding the political economy of care work and important distinctions in terms of the formal and informal domiciliary care labour process.