Many people may worry that the cost of live-in care might be out of their budget. Live-in care – when a qualified carer moves in to the home to provide 24/7 support and care – is a great solution for elderly parents and relatives to remain living independently in their own home. Depending on individual needs live-in carers can provide companionship and general day to day support, or if required, full-time and intense medical care.
Why choose live-in care?
Live-in care offers many benefits for older people and reasons for considering live-in care include:
- Remaining independent at home for longer
This is the key reason to consider live-in care – the ability to stay in your own home with everything that is familiar in and around the home;
Particularly after the death of a spouse or partner, a live-in carer can be a wonderful companion as well as providing care and support;
- Personalised care
Live-in carers with specialist training can provide 24-hour care for a range of different needs. Whether it be round the clock care, to support someone living with Dementia, or after a stroke, or with specific medical needs such stoma care, the right skills and experience can be found.
How much does live-in care cost?
The cost of live-in care will in many cases be more cost-effective than moving into a care home. This is not necessarily the best comparison as there are often different reasons for consideration to a care home move. However the cost of live-in care will vary based on several factors including location, the level of care required, the carer’s qualifications and experience, and additional services that may be required.
For one person needing mostly companionship, with minimal assistance with daily tasks, the cost of a live-in carer will range from £700 – £900 per week. For a couple this could be in the range of £1100 – £1400 per week. This will include minimum overnight support – help with trips to the loo etc if required, but not overnight medical care.
Specialist live-in care
For an individual with more complex care needs such as a chronic illness, live-in carer costs may range from £900 – £1400 per week. This also includes minimum overnight support as above.
For specialist care, such as 24-hour round the clock dementia care, costs may range from £1,400 – £2,000 a week. For a couple, for whom one requires minimal support this full time carer cost may increase by £250 – £300 per week.
There may also be additional services which will be charged extra such as driving, own car, and maybe housekeeping services. So – very important to know what the “package” of live-in care includes before you sign a contract.
Home alterations for live-in care
Other costs of live-in care in the UK include any works that need to be done at home – to give the live-in carer their own bedroom as well as any alterations that might be needed to accommodate the changing needs of your elderly parent or relative, such as a stairlift or wetroom.
Hiring a live-in carer
The first step to hiring a live-in carer is to make a list of the requirements to determine the level of assistance that your parents or relatives may need. This should include personal care – washing and dressing etc, daily routines, meal preparation and shopping, hobbies and activities in addition to medication and condition-related needs – mobility requirements including lifting or wheelchair needs.
You should also include requirements regarding the live-in carer – a man or a woman, languages spoken, and any cultural or other aspects – such as ability to drive – that should be taken into consideration.
Care companies will carry out their own assessment of the needs, but it’s a very useful way to decide if live-in care is the right choice, and the kind of carer you need.
(Your parent or relative may already have a care assessment from the local authority – and follow-up care plan – which will make this process easier. It should be shared with the care company).
Three ways to hire a live-in carer
There are three ways to hire a live-in carer: by employing someone directly yourself; by contracting a care agency- managed care – to provide you with live-in carers employed by them; or by working with a care provider – introductory live-in care – who vet and train self-employed carers – you pay an introductory fee to the provider and employ the live-in carer yourself.
Regulation by the Care Quality Commission
Companies providing managed care – ie they are fully responsible for the live-in carers and the care provided – are regulated by the Care Quality Commission, so you can assess their rating through the CQC reports they must by law make available to customers. Organisations providing an introductory service are not delivering the care themselves, so are not regulated by the CQC. These organisations vet their carers and have processes in place to protect customers.
1. Hiring and employing a live-in carer yourself
Employing a live-in carer recommended by a friend or neighbour locally can be a good way forward particularly if your parent or relative is reluctant to have a stranger move in to their home. You should undertake the same consideration and assessment with a recommendation as you would if you were to advertise for a live-in carer.
Local noticeboards, organisations and local publications such as parish magazines might be a good way to advertise for the position. Or facebook groups and other online tools – as well as national magazines such as The Lady. Whichever way you choose to find a carer there will be considerations including questions to ask, references to take up as well as DBS security checks, should you decide to proceed, and the administration of employing someone.
If you become the employer, then you are responsible for the care provision all year-round. This will mean you need to ensure continuity of cover, holiday and sickness. So – you will need to consider the options for these situations.
One other consideration about hiring live-in carers yourselves will be the time off entitlement for the carer. This is on average 2 hours each day so you need to ensure that your parent or relative is ok on their own for that time, or if you may need to consider how this time will be covered – either by a relative, access to a daycare centre, or by visiting paid-for care. This may need to be negotiated with care agencies aswell, although they should factor it in to the contractual arrangements you have with them.
The cost of hiring and employing a live-in carer yourself may be a bit cheaper than going through an agency or a provider. But you will be responsible for all the administration involved – from placing the ads, to managing the payroll, so whilst it may appear to be a cheaper option you should factor in these other aspects.
2. What is Introductory live-in care?
If you are unsure about undertaking the whole recruitment process yourself then introductory live-in care can help. This is where you pay a recruitment fee/registration fee to a care agency who will have self-employed carers on their books. Agencies will vet the carers and undertake DBS checks and get references. Increasingly these agencies will provide training and support for the carers, as well as support for you, including employment administration if required. You can input your requirements and the agency will provide you with a list of suitable candidates to choose from.
Continuity of care also applies in this situation, but with an introductory agency you will be able to find additional carers through the same process.
The cost of live-in care quoted by care agencies will likely include the recruitment fee which will be in the region of 12.5% of the quoted cost of live-in care.
3. What is fully managed live-in care?
The third option is to enter into a contract with a live-in care provider who will take on all the responsibility of recruitment, managing and paying the live-in carer, arranging holiday cover, sick cover or care rotas as appropriate. You will get to choose the carers, but candidates will be limited to those they employ themselves.
This is the more expensive option for live-in care, from around £1250 per week, but this is because providers assume all the responsibilty including employment, payroll, holiday and sick cover.
What a live-in carer needs to live in
There are practical considerations for a live-in carer. First and foremost is their own room and access to bathroom, ideally for their own use, but not essential. They will probably want/need wifi access, and a place to relax. Shared use of the kitchen and living areas is standard practice.
Access to public transport will be important for those without a car or where the location is more remote.
Managing Live-in carers
Aside from the employment and administration of a live-in carer, there are practical aspects of hiring a live-in carer to ensure a harmonious existence for all, including family members. At times a difference of opinion can occur over everyday things such as food and meals, activities, the daily schedule. It is important to try and ensure that all of this is discussed before a carer starts, and is then revisited as and when necessary. At the end of the day, the carer is in your employ either directly or indirectly so you are fully entitled to question behaviour or attitude that gives you cause for concern.
Needing more support at home
Regular reviews should be undertaken to ensure that the care being given is what is required. If the health of your parent or relative declines then more care may need to be given, even specialist care. If you are directly employing the carer this can leave you with no choice but to select different carers or even make different decisions about care. If you are working with a care agency or provider then they will be able to help you to alter the live-in care arrangements that are already in place.
Is Live-in care right for my parent or relative?
Deciding on live-in care is a big decision. Having a stranger move in to a much-loved family home is not everyone’s first choice. The prospect of someone taking over and taking control of a life someone has happily organised and managed for decades is not very appealing either. The implicit admission that your Mum or Dad can no longer cope at home takes some getting used to for all parties. But, live-in carers provide companionship, support and care and are there to help maintain and even enhance quality of life. It is more cost effective than moving into a care home, and will enable peace of mind for everyone.
FAQs on live-in care costs
How much does live-in care cost for a couple?
The cost for live-in care for a couple will depend upon the level of care needed for either or both of them: it can range from £1100 per week for couples who need minimal care, upto £2300 for couples who need intense medical support and care.
How much is specialist live-in care for someone living with Dementia?
The cost of specialist live-in care for someone living with Dementia ranges from £1400 - £2000 per week.
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 and 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 of course to the kitchen and living areas.
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. Based on an underlying health need, NHS Continuing Care is very hard to be eligible for, but worth looking into.