Objectives  This study investigated the use of In-home services of the Public Long-Term Care (LTC) Insurance System by foreign residents in Osaka city to serve this population better.Methods  Using information from the WAMNET database, questionnaires were sent to 1,800 care managers (CMs) affiliated with 1,106 In-home Care Support Office and Community General Support Centers in Osaka city (1-4 CMs/site), and collected between February and early March 2011. The data collected were analyzed quantitatively, focusing on descriptive statistics. And fisher’s exact tests were used to evaluate the relationship between the Japanese communication skills and age, sex, and family structure.Results  We obtained answers from 460 CMs (collection rate 25.6%). The total number of foreign residents covered under the service by CMs was 590, and we analyzed the valid data of 312 foreign user’s information.   Home-Visit LTC and Day Care for LTC were most frequently used. 34.3% of CMs had difficulty communicating in Japanese, there was a higher proportion of people who had difficulty in communication with older age group (p<0.05), and noticed that nearly 60% faced economic hardship. Conclusion  Our results suggest that careful communication is required with older age groups. This indicates that there may be difficulties in communication and understanding the clients’ needs, which are necessary to create care plan and to ensure optimal utilization of the services. And it is possible to reduce the service required user charge due to the insufficient economic status. The support system should be strengthened to address communication and economic difficulties faced by foreign users of In-home services, from the standpoint of the service fairness.