When live-in care becomes cheaper than visits

The gap between the two numbers is where most of the argument happens at the kitchen table. One person is looking at the invoice, which says visits are still cheaper. Another is looking at the week, which says somebody is driving over every evening to cover the bit the carer does not. Both of them are right. What settles it is writing down every hour of the week that is currently covered by a family member and pricing that too, because live-in care replaces those hours as well as the paid ones. Our needs to hours guide is the quickest way to get an accurate hour count before you compare anything.

The bottom two rows are worth reading together. At 35 hours the paid gap is only £420 a week, and that is before anyone counts the family's own time. At 56 hours the two are level and live-in care is covering another 112 hours of the week for the same money. Nothing changes suddenly at one particular number, but it only moves in one direction: every hour of visits you add narrows the gap, and no hour of visits covers the night.

Three good visits a day is real care and it works for a great many people. It stops working when the person cannot be left, and the test of that is simple: if you would not go away for a weekend without arranging cover, the gaps are the thing that needs covering, and visits cannot cover them. That is when overnight care a few nights a week, or live-in care every night, becomes the cheaper answer rather than the more expensive one.

The same 35 hours costs £700 on PrimeCarers and £980 to £1,225 through an agency. At the top of that range a family is already paying more for visits than a live-in carer would cost, while still getting nobody overnight and often a different face each day. If you are currently with an agency, there are two separate questions to ask, and it helps to take them in order: whether the same visits cost less booked directly, and whether visits are still the right shape of care at all. The hourly cost guide answers the first, and this page answers the second.

Once both columns are complete, the comparison is usually less close than it looked. The cost of care hub has the same figures laid out for every kind of care, and what live-in care costs goes through the live-in column line by line. If you would rather answer a few questions and be sent a figure, use the care cost calculator.

The short and improving case deserves its own line. After a hospital stay most people need a lot of help for two or three weeks and much less after that, so a heavy week of visits that tapers is usually better value than a live-in placement you have to end. Care after a hospital stay covers how that taper normally goes. The opposite case is a slow decline over a year, where visits creep up a step at a time and nobody ever stops to reprice the whole thing.

1. 1

   Write down the week you need covered

   An evening

   Every task, every hour, including the ones a family member currently does. This becomes the care plan a live-in carer works from, and it is what you will send to the carers you shortlist.
2. 2

   Sort the room

   A weekend

   A bed, a wardrobe or chest of drawers, somewhere to put a suitcase, wifi, and a door that closes. It does not need to be big, but it does need to be theirs.
3. 3

   Shortlist two or three live-in carers

   Free

   Search by postcode and read the profiles. Every carer is interviewed online, and we check their identity, their right to work and an enhanced DBS before they appear. Carers are insured while they work. Each profile shows their weekly rate, their experience and their reviews.
4. 4

   Interview them, and ask about the handover

   This week

   Ask what a normal day looks like, what they do about their two hours off, and how they would want the first week to run. Most families choose on the call rather than the profile.
5. 5

   Overlap the first few days

   Week one

   Keep the morning visits running for the first two or three days while the live-in carer settles in. It costs a little extra and it makes the handover far easier on your relative.
6. 6

   Review after a fortnight

   Week two

   Check the rate still matches the work. If nights turn out to be broken rather than settled, that is the moment to talk about a waking-night carer or a different arrangement, not six months later.