Domiciliary care, live-in care or a care home: which fits?

Domiciliary care is the formal name for care given in somebody's own home. If the word is new, what domiciliary care is and how to arrange it explains it first. In everyday use it means visits: a carer comes at agreed times to help with getting up, washing, dressing, meals and medication prompts, and then leaves. Live-in care is also care in your relative's own home, given by a carer who lives there. A care home is the one option on this page that means moving.

You can start on one rung and move up as needs change, so the arrangement you choose now does not have to be the one you keep. If your relative is a younger adult, or a move into housing with support is being discussed, supported living is explained further down.

1. 1

   Walk through a normal day

   From getting up to going to bed

   Write down each part of the day where your relative struggles or is not safe alone: getting out of bed, washing, dressing, meals, tablets, the toilet, going out and getting ready for bed.
2. 2

   Put a time on each task

   An hour is the shortest visit

   Washing and dressing with breakfast usually fits in an hour. An hour is the shortest visit on PrimeCarers, unless a carer offers shorter visits at their own half-hour rate.
3. 3

   Add up the week

   Compare with 35 hours

   Multiply each day out and add any weekly jobs such as shopping. If the total is near 35 hours, or the help is spread through the whole day, live-in care is worth pricing as well.
4. 4

   Then think about the night

   Visits leave the nights uncovered

   Ask whether your relative gets up in the night, has fallen at night, or wanders. Visits leave them alone between the last call and the morning.
5. 5

   Ask the council for a needs assessment

   Free, whatever their savings

   Adult social care at your relative's council will assess their needs for free and say what help they are eligible for. You can pay for help privately while you wait.

How many visits a week your parent needs goes through this task by task and adds up the hours for you. The council's assessment is explained in the care needs assessment, including what to say so that it records the help your relative needs on a bad day as well as a good one.

Once you have a rough number of hours, you can search for carers near you and compare their rates. Every profile shows the carer's rate with our fee included, and you can message carers before you book anything.

It is worth being clear about what PrimeCarers is. We are an introductory service, not a care agency, and we hold no CQC registration. Carers on PrimeCarers are self-employed and the carer you choose works for your relative. Before a profile appears, we check the carer's identity and right to work, check that they hold an enhanced DBS certificate (or PVG in Scotland, or Access NI in Northern Ireland) issued within the last 2 years, and interview them online. We do not check qualifications, training or references. Reviews and references on a profile are not verified by us, so ask the carer about their experience and training before the first visit. Visits booked through PrimeCarers are covered by the carer insurance policy we arrange, within its terms.

Night care can be added to visits for some nights or every night. It is a good fit when the days are manageable with visits but the nights are where things go wrong, or when a husband, wife or adult child is doing the nights and cannot keep going without sleep. Waking night or sleeping night explains how to choose between the two, and overnight care covers how night care works.

A live-in carer covers the nights differently. They sleep in the house and can get up if needed, but they also need their own rest to work the next day. If your relative needs somebody awake most nights, a live-in carer on their own is not enough, and a waking night carer is added on those nights at about £148 a night on PrimeCarers. Live-in care also needs a spare room for the carer.

At 35 hours a week, which is five hours of visits a day, visits on PrimeCarers cost £630 to £875 a week, and live-in care starts at £1,050. Visits are still cheaper at that point, but the gap is small enough to price both, because a live-in carer is in the house between the visits and overnight. At £19.47 an hour, a week of visits costs the same as a typical live-in week of £1,120 at about 58 hours, or 8 hours a day. From an agency, the same 35 hours cost £980 to £1,225, which is already level with live-in care. When live-in care becomes cheaper than hourly visits works through the comparison hour by hour, and what domiciliary care costs prices a week of visits both ways.

Adding nights to visits pushes the cost up quickly. Two visits a day with a sleeping night every night comes to £1,162 to £1,365 a week, which is the same range as live-in care.

Council funding for care explains the means test and the savings limits, and the care cost calculator shows what each kind of care costs where your relative lives.

The NHS describes the two kinds of home: a residential care home gives accommodation and personal care, such as help with washing, dressing, medicines and the toilet, and a nursing home also has one or more qualified nurses on duty at all times. Domiciliary care against residential care is a comparison of the same personal care given in two places. What differs is the move itself, with other residents around and staff on duty through the night.

For a fuller look, care at home or a care home sets the two side by side, and when home care stops being enough goes through the signs and the conversations that come with them. A move does not have to be permanent from the first day, and trial stays and coming home again explains how a short stay first can work.

The Care Quality Commission draws the line by the agreements, not the building. In its guidance on housing with care, supported living means personal care given to people living in their own homes, under an agreement that is separate from the one for their housing. Where the housing and the care are under separate agreements, the CQC registers and regulates only the personal care provider, for the same regulated activity, personal care, as a domiciliary care agency. The NHS guide to supported living services says they can be run by councils, charities or private companies.

So "domiciliary care or supported living" is not a choice between two kinds of care. Supported living is a kind of housing, and the care in it is the same personal care a domiciliary care agency gives. The choice is whether your relative stays where they are with care coming in, or moves to a home built or set up for support. Supported living or care at home covers this for younger adults, including Shared Lives and how rent is paid, and housing options for an older parent covers extra care and retirement housing.