The complete guide to live-in carers for care seekers.

If you’ve not heard of live-in care before or are considering hiring a live-in carer this guide should help you decide if it’s right for you and answer any questions you might have about it. We’ll cover how it works, your responsibilities, the costs, how to finance it, the three ways to find a care service and other common questions about live-in care.

Chapter 1: Basics of live-in care

A live-in carer might be the right option to help your elderly parents.

What is live-in care?

Live-in care is a way of providing home care whereby a professional carer moves into the same house as the person/people requiring care and is present 24/7. While the carer is in the house they can support the individual with their needs and help them to live as much of a normal life as possible, giving everyone peace of mind knowing that someone is there to take care of any issues that might arise.

Who is live-in care for?

Live-in care can be a very cost-effective way to provide elderly care to an older person that whishes to stay in their own home . A live-in carer can also support someone with a physical disability. Live-in care might be right for people with some of the following requirements:

  • Personal care (washing, dressing, toileting, etc)
  • Taking medication
  • Specialist Care, including PEG feeding, catheter or ventilator care.
  • General housework and domestic duties
  • Cooking
  • Companionship, including reassurance and emotional support.
  • Caring for a pet
  • Trips out
  • Supporting hobbies
  • Supporting physiotherapy and recovery

What are my responsibilities when hiring a live-in carer?

When you hire a private live-in carer, they work as a self-employed individual, so you won’t be liable for their national insurance and other employer costs, so long as you are not their only client that year. There are however some requirements that you must meet. Sometimes a carer might go by the name of a personal assistant or support worker.

Bedroom

You must provide the carer with their own comfortable, private room where they can sleep and relax in during their downtime. It’s essential that they are able to recuperate while your loved one is asleep.

Breaks

By law, the carer must be allowed a two-hour break each day when they can leave the house and not be responsible for your loved one. The carer will usually schedule these at a convenient point in the day, at a time they would not be needed anyway. At the discretion of the carer, they may agree to group those two-hour breaks into a single afternoon off once a week but that is a discussion you should have with the carer directly.

DBS Certificate

Anyone working with a vulnerable individual must have an enhanced DBS certificate to show that they have not been barred from working with the vulnerable. Any carer you hire should be able to show you this on request, and ideally have this certificate registered on the update service to catch any recent developments.

What other types of care should I consider?

If you’re not sure about live-in care or think you might not be able to meet all of the requirements to support a live-in carer then there are other options you can consider:

  • Family Care – If you have lots of relatives you may be able to all chip in to provide your family member with the care they need or to handle most of the day to day tasks. Many families prefer to look after their loved ones themselves but get a carer in a few times a week to help them have a bath. You can also move parents into your own home.
  • Hourly care – When you bring in an hourly carer (sometimes called domiciliary care) they’ll be paid by the hour but will often give a discount for longer shifts. You could organise for two visits a day instead of a single one or another combination. Hourly care can be a great option if your family member doesn’t require continuous supervision throughout the day and more of a helping hand.
  • Residential Care – If your loved one does require intensive care, struggles to sleep through the night or requires nursing care then a care home may be a better option for them they will have staff on hand 24 hours a day and it can be more economical allowing your loved one’s house to be sold.
  • Assisted living – As an alternative to live-in care, assisted living offers access to a community of people in the local area. To access this, you often have to sell the house to buy an apartment in the development and pay a hefty service fee, however, the benefits are evident and can work out to be more cost-effective than live-in care.

We’ve written an article on all the different types of care available to you so if you are still looking for the correct arrangement then that might be worth a read.

How does food work?

It is common practice for the carer to purchase, prepare and eat food with your loved one. Lots of carers are excellent cooks and will be able to craft a menu to fit your loved one’s dietary requirements, just be sure to ask them upfront. Some carers may like to eat a few of their favourite foods, in which case you can just allow for this in the weekly food shop or give them a small budget directly.

Occasionally families and carers prefer to keep food separate, in which case, a weekly food budget of £30-£40 for the carer is normal.

How does travel work?

Most live-in carers are willing to travel long distances for work since placement can last weeks at a time. This is great for choice but it can mean that a face to face interview isn’t always possible.

In general, a live-in carer won’t charge for the travel expense of getting to the job, or between the job and home when they take longer breaks, however, it is normal that they charge for travel whilst on the job, for example, whilst taking your family member out and about.

Chapter 2: The cost of live-in care

Understanding the costs of live-in care and how to find funding is important to making a decision.

How much does live-in care cost?

Prices for live-in care will vary depending on how you find your live-in carer as well as a number of factors around your individual needs that control the price of live-in care, we’ve listed them below:

  • Private vs Introductory Service vs Agency – All these options will offer additional layers of management on top of the carer so it depends on your requirements.
  • Individual vs Couple – If the carer will be caring for an individual or a couple. Generally, carers will charge more for couples as there is more work involved.
  • Sleeping through the night – If your family member wakes less than twice in a night then a single carer may be able to help but if the carer is unable to sleep they will need relief from a night carer regularly.
  • Care Intensity – If the work is more physically demanding and the carer is unable to find much time for a break they may ask for more money for the job.

Costing Examples

Example 1: Simple

An elderly person needs looking after, he’s on his own and generally needs companionship, some help around the house and some personal care. You should expect to pay:

  • Private – £700 to £840 / week
  • Introductory Service – £770 to £910/week
  • Agency – £910 to £1050 /week

Example 2: Complex Care

In this scenario, an individual is either physically very demanding, requiring a lot of assistance and hoisting to move around and/or is suffering from mental health problems making them difficult to manage or abusive at times.

  • Private – £900 – £1100 / week
  • Introductory Service – £950 – £1150 / week
  • Agency – £1100 to £1500 / week

Example 3: Restless sleeper

In this scenario, the individual is not able to sleep through the night so a second carer is required to provide support two nights a week.

  • Private – £1000 – £1100 / week
  • Introductory Service – £1050 – £1150 / week
  • Agency – £1300 to £1600 / week

Example 4: Complex Couple

In our final scenario, you are seeking care for both your parents and one of them can’t sleep through the night. In this scenario, live-in care may no longer be the best option for you and you should consider 24 hour care with a team of three carers rotating 12 hours shifts.

How can I fund live-in care?

There are a number of potential funding routes for live-in care depending on your loved one’s financial situation. In general the more of your own money you have available the more choice you will be left with. The local authority does have a duty of care to its residents but it won’t always recommend the same care plan as you would prefer and in these cases, your family member may end up only being offered a place in a care home.

With that in mind, here are some of the options:

Local Authority Funding

Your local authority (council) is obligated to offer support to those who need help if their total savings drop beneath £23,250. To find out if you are eligible for funding the first step is to request a Needs Assessment.

A care needs assessment is free and anyone can ask for one. If the council determines that you do have a need for care then they will carry out a financial assessment of your loved one’s situation.

The financial assessment will determine if the council will pay all costs, some of the costs or none of the costs. The financial assessment is again free and will be arranged following your initial needs assessment.

If the council does determine that you are eligible for funding support then they will distribute the money to you in one of three ways:

  1. The council pays for your care
  2. The council provide you with a direct payment paid to your bank account or spendable from a pre-paid card.
  3. A combination of both.

Option 2 will offer you the most flexibility when selecting live-in carers so is what most people prefer but if the council determine your home care needs are too intensive they may recommend residential care and you won’t have a choice.

You can apply for a needs assessment here or read more about how the process works here.

NHS Reablement Care

The NHS provides a form of temporary care called reablement care for up to six weeks following discharge from the hospital if you need support to return to normal life. If your loved one is due to leave hospital soon you should discuss reablement care with your discharge co-ordinator.

The care will be provided by a care agency and will probably be a form of hourly care where a care worker will visit your home multiple times a day.

NHS continuing healthcare

If your loved one has a long term and complex health condition they may be eligible for free social care funded by your local clinical commissioning group (CCG). The NHS will organise the healthcare on your behalf so you will have limited choice.

Continuing healthcare support can be a long and tricky process to acquire but it may be worth investigating for your loved one. Have a read of the NHS information to see if you are eligible.

Self-funding

If your loved one has the resources you can self-fund your home care until you meet the local authority requirements for support at which point they will take over. In these scenarios, making money last as long as you can is essential and opting for a private carer may be a sensible way to go as they are both better and less costly.

Equity Release

If your goal is to keep your loved one the home that they love, then equity release may be an option for you. Companies will purchase your loved one’s house at a discounted rate with the provision that they can only take control of it if your loved one passes away or moves to a care home. You should be wary of companies in this space and seek expert advice as the industry has had a history of bad actors and may not always be the best option for you.

Downsizing

Moving into a small more manageable home, in a less pricey part of town or in a more rural setting, not only makes life easier and more relaxing but also frees up cash to pay for care, holidays and grandchildren. Just makes sure that there is a spare room for the carer. You could also consider a granny annexe.

How can I handle expenses?

When a live-in carer takes on responsibilities they will often incur various expense from food to caring supplies and other necessities for your loved one. When dealing with expenses your carer should return a list of receipts to you. You can also look into getting a carer shopping card if that would make you more comfortable.

Who pays for food?

It is common practice for clients to provide a carer with a budget for shopping or to refund the carer for shopping expenses.

Chapter 3: Finding a live-in carer

There are three ways to find a live-in carer with varying levels of management to suit you.

If you’ve decided that you would like to explore the live-in carer route further then the next step will be to decide how you would like to hire a care provider and begin a conversation to see if it’s right for you.

Ways to find a live-in carer

There are three main ways you can organise a care service. Which one you choose will be a balancing act between your appetite to manage things yourself and your price sensitivity. If you’re keen on having a very personalised care plan then it’s more likely a private carer will be able to help.

Privately

You can ask friends and family for a local recommended carer, check out classified ads on sites like gumtree or use sites like care.com to find a local live-in carer.

Once you’ve found the carer you should check their qualifications and ensure they have an up-to-date enhanced DBS certificate and are qualified to work with vulnerable people. You should also seek out references for the individual from previous employers and ensure you have suitable plans to cover their shifts when they take a holiday. Once you’ve agreed on a price and a start date you can begin with your new carer.

Pros:

  • Potentially the cheapest option
  • Complete control over what you want

Cons:

  • Limited choice and hard to track down the good carers to find the right one.
  • Additional work background checking your carers.
  • You have to handle contracts, expectations and getting money to the carer.

Through an Introductory Service

When you use a site like primecarers.co.uk you can search and filter for carers in your local area. All the carers on the platform have already been DBS checked, professionally interviewed, had their references checked and been insured. You still have the benefit of a dedicated carer, as you do privately, but with less hassle and risk.

Once you’ve found a few carers that meet your requirements you can reach out and contact them to ask them questions or set up a free interview. Upon finding your ideal carer you can book and pay for your visits online so cash isn’t exchanged. If you run into any difficulties then PrimeCarers is always available to provide support and mediate disagreements.

Pros:

  • Lots of choice of carers
  • They are already background checked
  • Still good value for money
  • No cash in hand and contracting handled
  • 48 hours cancellation policy and no lock-in with a carer

Cons:

  • More expensive than finding your own carer.
  • Need to be aware of carer holidays and find cover.

Through an Agency

When you use an agency you’ll probably be visited by a care manager who will determine your care requirements. Once you have approved the care service package they recommend you’ll be assigned a rota of carers that will be supporting you. While this service is fully managed by the agency they can swap out carers at short notice and generally the actual care staff are paid the least here of all the options in some cases as little as £500 a week.

Pros:

  • Fully managed service, don’t worry about shifts etc.
  • Agencies are required to keep their carers training up-to-date.
  • CQC Registered

Cons:

  • Most expensive option
  • Carer often paid the least of the three options so is less motivated.
  • No say over which carer you get
  • Carers can be swapped out without warning

What qualities should you look for in a live-in carer?

Finding a live-in carer is not as simple as picking anyone with the correct qualifications, this is a person that is going to be spending large portions of time with your family member and finding a good fit is essential for companionship and a long-lasting quality working relationship.

With that in mind here are some questions that you should be asking yourself about any potential live-in carer you are considering or interviewing.

  1. Personality – Does my loved one get along with them at the interview or did they give signs that they weren’t keen on them?
  2. Responsibility – Is the carer trustworthy and do they take the responsibility of looking after your loved one seriously?
  3. Technically Competent – Is their training up-to-date and do they know what they are doing?
  4. Special Background – Many carers have come to care from a variety of backgrounds and may have held nursing or other roles in the past.
  5. Cultural Fit – Is there a need for a cultural fit with your carer? Maybe there is a type of food your loved one prefers or a language they’d prefer to speak rather than English, or an interest the two might share.

How should I interview live-in carers?

Depending on how you found your live-in carer the interview can be a great time to nail down their technical competency or to simply find if there is a good personality fit.

Interviews can be stressful for both the interviewer and the interviewee so it’s worth taking a moment to put both of you at ease and get to know each other a bit. If it’s an in-person interview make the carer a cup of tea and have a chat for 5 minutes.

After that, it’s worth getting into the details of what tasks you will specifically require and what care your loved one needs. Many carers will be able to offer advice on the best way to handle certain situations and what specific equipment you need, and it can be a good way to determine if a single live-in carer will be able to meet your care needs or if other solutions may need to be found.

For our full guide on the interview process, you can read our article here.

Chapter 4: Frequently Asked Questions

People have lots of "other" questions about live-in carers. In this chapter we'll cover as many of them as we can.

Can my live-in carer take my loved one out in the car?

In order for your carer to take your loved one to the shops, they will need business insurance on their car. You should ask your carer and check this otherwise it’s likely they will be uninsured when using it for their care work.

Take a look at this government health and safety executive guide to driving at work for more information: https://www.hse.gov.uk/pubns/indg382.pdf

What’s the difference between live-in care and a nursing home?

The difference between live-in care and a nursing home (residential care) is that the individual remains in their own home instead of being moved into a building with others that also require care. Live-in care can be practical and help individuals to feel more comfortable in their own home but it might not always be right. If someone requires intensive nursing care 24 hours a day it might not be economical or sensible to continue caring for them at home.

Stay at home can often be preferable though. Not only is this what the person being cared for will normally prefer but the very act of moving can be stressful and bad for their health. In addition, their objects and the arrangement of those objects can be incredibly important for memory, so it is no surprise that people often deteriorate soon after moving into a nursing home.

My loved one is unsteady on their feet, can a live-in carer help?

Understanding what kind of support your loved one needs with their mobility is important as a live-in carer may be able to help. If they just need a little steadying as they walk and obstacles cleared from their way then that should be fine. If they require further support then a floor or ceiling hoist can be used. Another great piece of equipment is a Sara steady or equivalent. This allows the patient to be moved easily, even when their mobility is greatly reduced. There is regulation surrounding what carers are and aren’t allowed to do though.

Your loved one may be able to get by with just some additional support rails.
Rails in a bathroom
A portable hoist is a portable way to move your loved one but requires two people to operate it effectively.
A portable hoist
A ceiling hoist costs more to install but it can allow a carer to move your loved one on their own and may save money in the long run.
A ceiling hoist

For the full HSE guidance on moving and handling, you can take a read here, the summary of the guidance is this.

Carers can’t prevent falls

This surprises lots of people but a carer cannot actively stop your loved one from falling, the risks of helping and damaging themselves or your loved one further have meant that it has been disallowed.

Two carers are required to operate a mobile/floor hoist

As a general rule, a floor hoist must be operated by two carers, this can present a serious issue for families meaning that a second carer needs to be present at various points in the day which can be expensive and logistically challenging.

A single live-in carer can operate a ceiling hoist

As a general rule, it is acceptable for a single carer to operate a ceiling hoist. The cost to install a ceiling hoist is not insignificant but it can help reduce care costs in the long-run.

For more information on moving and handling, you can read our article: Moving elderly parents safely.

How should I prepare my house for live-in care?

Beyond the preparations, you should make for the live-in carer’s room, including, a comfortable private bedroom with ideally a TV and internet access. You should also consider how you can make your house safer for your loved one and to smooth the experience for your carer.

The first things to do are:

  • Making common items more accessible – Re-arranging belongings to make the most used ones easily accessible to your loved one can prevent them from hurting or straining themselves trying to retrieve them from difficult places.
  • Consider installing additional aids – For many older people, some additional handrails in the bathroom or a stairlift to help them access the upstairs of their house may be useful.
  • Keep the house warm and dry – Keeping the house warm and dry is especially important for old people as they are at greater risk to colds and illnesses. You can run a dehumidifier or investigate insulation grants.

For more information on making your home safe have a read of our article on the subject.

Does the house need to have internet access?

This will depend on the carer but in general most carers prefer to have access to a reliable internet connection to communicate with their own family and friends.

Can we have a pet in the house with a live-in carer?

If your live-in carer is happy to look after an animal alongside your loved one then that should be fine. One of the advantages that sway people towards live-in care is that care homes won’t allow pets to be bought into them. For many elderly people, this is a shame because the advantages of animals in easing loneliness and depression can’t be understated and saying goodbye to a furry friend can be distressing for anybody.

Am I eligible for free social care if I have dementia?

Generally, you are not eligible for free social care if you are diagnosed with dementia but if the symptoms are severe enough you may be eligible for NHS continuing healthcare. You can read about continuing health care here.

I want to go on holiday with my parent. Can a live-in carer come with us?

Yes, you’ll have to discuss it with your carer but many families have done it. You’ll need to pay for additional accommodation for your carer as they would have normally. Sit down and discuss what you want to do with your carer, they’ll be able to help you come up with a plan to look after your loved one while on holiday.

Can I hire a live-in carer on a temporary basis?

Yes, you can, we usually class this as respite care and it can be a great way to relieve the usual caregiver.

Chapter 5: Conclusion

We hope that this article has been informative to you and left you with all of your questions regarding live-in care answered. We have done our best to be as unbiased as we can and to lay out all the options for you.

If you are interested in exploring how we can help you further then you can give our team a call on 0203 369 3624 for a no-obligation chat about your needs. Our advisers try to be impartial, so frequently recommend other forms of care. If you’d rather jump right in and see what carers are available in your area there is a search box above to see what carer options we have in your area.

Author: James

I founded and manage PrimeCarers, a Platform that connects Private Clients with Private Carers near them.