Care at home – often called home care or domiciliary care – covers different levels of support, from a few hours of companionship a day to daily personal or medical assistance or 24/7 live-in care.
The cost varies and is dependent on where you live and which provider you choose, but include daily home care visits at around £32 per hour for visiting, companion or personal care support; overnight and live-in care generally from around £1,095 per week for 24-hour support, rising higher with more complex needs.
These services can be tailored – from companionship and household help to full-time care — and may be funded privately or, after assessment, partly supported by local authorities or the NHS in some cases. Read on for a more detailed breakdown of all the home care options.
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What level of care do your elderly parents or relatives need?
| Type of support/care | Description | UK Average cost (2026) |
| Home care/ domiciliary care | General name for all care at home options | Dependent on area and provider |
| Visiting Care | Support provided by carers who visit the home daily. | £32 per hour |
| Companion care | Non-medical or health care, offering social or emotional support and help with everyday tasks. This sort of support might also be provided by “home help” organisations. | £32 per hour |
| Personal care | Help with personal hygiene and grooming. This may be delivered by more than one carer, depending on needs. | £32 per hour |
| Overnight care/sleeping care | Evening to morning care to ensure overnight safety, medication assistance and/or personal care. | From £1,095, as part of a live-in care package |
| 24 hour care | A rota of round the clock carers who don’t live in. Often provided by organisations that generally offer day care services (not live-in care). | £32 per hour x 24 |
| Live-in care | Carers who move in to the home to provide round the clock 24/7 care and support. They will often live in for weeks/months at a time. | £1,095-£1,779 per week |
| Respite Care | This may be needed in a range of different situations: following discharge from hospital when a period of recuperation is needed; after a period of illness at home; or to relieve a family member who needs a break. | Depending on the requirements |
How different care needs are met
Home care can be arranged in a variety of ways, depending on the individual’s needs and circumstances. Common arrangements include:
- Hourly care: care provided for a set number of hours per visit. Some care providers may require a minimum number of of hours per week or per visit.
- Multiple daily visits: care delivered at specific times of day, such as morning, lunchtime and night time. These visits are likely to be carried out by more than one carer.
How care is funded can also influence the type of care arrangement. When care is arranged or funded by a local authority, the most common options are visiting or hourly care, based on assessed needs and available budgets. People who fund their own care generally have greater flexibility to choose how care is delivered, depending on their preferences and financial resources.
How is home care paid for/funded?
Currently in England and Wales anyone with more than £23,250 in savings and cash will be paying for their own care. Those with funds between £14,000 – £23,250 will be eligible for some funding support for their care, and those with less than £14,000 will receive fully funded care by the local authority.
The NHS will fund some elements of care which is not means tested, but based on health and medical needs. This may include six weeks of nursing care following a hospital discharge, or in some circumstances all care needs will be funded whether at home in a care home. This is called NHS Continuing Care.
Who recruits, trains, employs and manages carers?
This is where things get a little complicated…..
Local authority funded care
Local authority funded care will be arranged with care companies in the area. Due to current budget constraints, care companies will have agreed a set rate from the local authority, negotiated in “bulk” to fulfil the care needs in the area. These will most likely be private companies (or charities), although some LA employed carers and organisations may still work in your area.
The individual carers may be employed directly by the care company who will be responsible for their recruitment, training, payment and management. Or they could be self employed and be contracted and managed by the care company.
Self-funded care
These same companies will also provide carers for self-funders, and those in receipt of direct payments from the local authority to pay for their own care. This is more likely at higher rate than the rate paid by the local authority to the same care company.
Self-funders have a wider choice of care companies, and different ways of working with carers including deciding whether or not to employ the carer themselves.
How are carers employed, managed and paid?
Traditionally, day care/domiciliary care was offered and provided by companies different to those providing live-in care. However, many organisations are now offering the full range of care solutions – from hourly care to full-time live-in care.
Introductory care agencies
Predominantly for live-in carers, but increasingly for day care services, companies will either provide “introductory” services or managed care. Introductory services are essentially recruitment services – for clients to find self-employed carers vetted and checked by the introductory company. The client will pay a recruitment fee and will then become the employer of the carer, responsible for their salary, NI and pension contributions, sick pay and holiday cover.
Increasingly it is also possible now for clients to pay an additional fee to the introducing agency to not only vet and train the carer, but also to assume responsibility for the carers contract, payroll etc.
Managed care agencies
Managed care is when a care company (or charity) employs, trains and manages its own carers, and is fully responsible for the scope of all the care provided (rotas, holiday cover, sick pay and cover etc).
You will enter into a contract with the company to provide the agreed level of care and support.
What are the differences between introductory care and managed care?
Introductory live-in care | Managed live-in care |
The customer is directly in full control of the carer and decides what needs to be done and how. | A live-in care provider employs, trains and manages the carer. They can move the carer around or not offer you certain choices. They can be slower to change how care is delivered. |
Not regulated by the Care Quality Commission (CQC). | Regulated by the Care Quality Commission, which incurs greater costs that are passed to you. |
Customer manages the care – including holiday cover, sick cover – which may involve more than one carer. | The care has to be delivered in a framework that might not please you. |
You only pay for the services you use. | You pay for the central costs of more complex organisational needs. |
The role of the Care Quality Commission in monitoring care
The Care Quality Commission (CQC) regulates all care in England (there are equivalent bodies in the nations). They do not regulate introductory care agencies – I.E. recruitment companies – because the company itself does not actually provide care.
Before entering into a contract with a care company, you should review their CQC report as part of your due diligence.
What is the best solution for your elderly parents or relatives?
If the local authority is funding the care your parents or relatives, they will have little choice as to the carers provided and the combination of the care given. The local authority and the care agency selected will carry out their own assessments, and endeavour to match carers with customers, but with limited resources and ever-increasing need, it may not always be a perfect fit.
Arguably the local authority will also manage the amount of care and time associated closely. For care companies, there is increasing pressure to provide a level of service within significant budget constraints agreed with the local authority.
Self-funders have more choice. However some of the same constraints may apply: lack of carers, squeezed resources etc., so it is a good idea to consider all the options and shop around as much as possible. Questions to consider as you navigate through this include:
- What level of care are we looking for? (companionship/support or medical care)
- What kind of care are we looking for? (hourly visits, live-in full-time care)
- What skills and qualities does the carer need to care for my relative? (specialist dementia experience, lifting, ability to play scrabble)
- How much care are we looking for (full-time/hourly/other)
- Do we want to employ an agency or to recruit and employ a carer directly?
- If we recruit a carer do we want to be responsible for payroll, holiday cover, sick pay etc?
An example of a situation you might need to consider could be:
Mum needs someone for a couple of hours in the morning to help her get up, washed, dressed. To give her breakfast and to see she’s ok for the day. She needs the same in the evening, cook her a meal and help her go to bed. We don’t want to be responsible for the payroll. Mum wants a consistent carer, the same face every day. We can cover the weekends.
Selecting the right care can seem a daunting task. The best companies make it their business to make it as straightforward as possible, with a commitment to providing the best fit in terms of skills and personality for the client. It may well be that the arrival of a carer – even for an hour a few times a week – has a hugely positive impact on your parent and relative.
Things do go wrong. It is also important to know your rights, so that should you feel the care is not right, sub-standard, that you can either complain, or work with the provider to improve the situation. It can feel hard to complain amid the fear that the care given declines further – but equally, an elderly relative suffering in silence is not a solution either.
FAQs on home care options
What is the difference between day care and domiciliary care?
Domiciliary care and day care are one and the same thing: care provided in the home.
What is the hourly rate for domiciliary care?
The cost per hour will vary depending upon the type of care given and the location. There is often a minimum weekly amount that a care company will be prepared to contract for. The average cost is in the region of £32 per hour.
Is live-in care as expensive as moving into a care home?
Live-in care can be less expensive than moving to a care home. It comes with the additional benefits of being able to stay in your own home, surrounded by all that is familiar.
What is managed live-in care?
Managed live-in care is where you/your parents or relatives have a contract with a care company who recruits, trains and employs the live-in carers. They are responsible for employment, payment, holiday and sick cover.
What is introductory live-in care?
Introductory live-in care is where you employ the carers directly, hired through an introductory agency. The carers are self-employed so you are responsible for pay, NI contributions etc.
What is the difference between care agencies and care providers?
Care agencies predominantly broker between self-employed carers and customers. You will pay a recruitment fee to a carer hired from them.
Care providers will recruit carers, employed by them, to deliver a live-in carer package as agreed with you.
Does a live-in carer need their own bedroom, bathroom and living area?
A live-in carer must have their own bedroom. They do not require their own bathroom, although that would be a bonus, nor do they need their own living area. They do need access to the kitchen and living areas, of course.
Will the NHS pay for live-in care?
The NHS will only pay for live-in care if it is agreed by them as part of a NHS Continuing Care package. This is care provided "free" by the NHS. NHS Continuing Care is based on an underlying health need and is extremely hard to be eligible for, but it's worth looking into.
- NHS.UK, paying for your own care (self-funding), August 2022.
- NICE.ORG.UK, home care for older people, June 2016.
- ACAS.ORG.UK, work time rules, March 2025
- Homecareassociation.org.uk, paying for care at home, May 2025
- Data taken from Age Space live-in care partners.
Find out more about the cost of live-in care and why it may be more affordable to support your parents at home.
