The short answer
- One carer covers the hours between the visitsThe nursing visits are short and scheduled. A live-in carer does the washing, the mouth care, the position changes and the meals across the rest of the day, and is there at night.
- A live-in carer is not a nurseDressings, catheters, syringe pumps and injections stay with the district nurses. PrimeCarers introduces self-employed carers and does not record or check nursing registration.
- Booking nights alone leaves the days uncoveredA carer sleeping in the house is £130 to £145 a night. A live-in week starts at £1,050 and covers the days as well.
- It can start in days, and ending it has a notice periodCarers set their own start dates and many can travel within the week. Once a placement has run for 168 hours the notice each side gives is seven days, and 48 hours before that.
Care figures are what families pay on PrimeCarers, with our fee included. Agencies charge from £1,400 a week for live-in cover. Notice periods come from the client and carer contract.
What a live-in carer covers
What one carer living in the house does, and what the NHS team does
Families are told the district nurses will be coming, and hear that as the care being arranged. The nursing is arranged. The hours in between are not, and they are most of the day.
Early morning
Around 6am to 9am
Nobody scheduled. If something has changed overnight, the number to ring is the out of hours service or the district nursing team, depending on the hour.
Awake with your relative. Washing and dressing in bed or in a chair, mouth care, a change of position, clean sheets where they are needed, and the morning medicines prompted and written down. Breakfast offered in small amounts.
Mid morning
A window rather than a time
The district nurse may call. Community nursing visits are usually given as a part of the day rather than a booked slot, because the round is reordered around whoever needs seeing first.
In the house to let them in, describe the night, and point out anything on the skin. Whatever the nurse asks for afterwards, such as a different turning schedule, starts the same day.
Midday and afternoon
Around 12pm to 5pm
Nobody scheduled. The GP surgery and the community palliative care team can be rung, and a hospice at home team visits in some areas.
Position changes on the schedule the nurse has set, with the skin looked at each time. Drinks and small amounts of food offered. Laundry, the room kept clean, and sitting with your relative so the house is not silent.
Evening
Around 5pm to 10pm
The surgery closes and the out of hours service takes over. Ask for that number in advance and write it somewhere everybody can see it.
Settling for the night: a wash, nightclothes, mouth care again, the evening medicines, a last change of position, the doors locked. This is also the part of the day families find hardest to keep doing alone.
Night
Around 10pm to 6am
Nobody is in the house. A district nurse can be called out, and an injectable medicine already prescribed and kept at the house is given by them rather than by anyone else.
Asleep in the house and up when needed, once or twice. Where somebody needs turning every few hours, or watching continuously, a second carer awake through the night is booked on top of the live-in week.
What stays with the nursing team, whatever hours are booked
- Dressings and wound care
- Catheters and stoma changes
- Setting up or refilling a syringe pump
- Injectable medicines for sudden symptoms
- Prescribing, and deciding what to do about a symptom
An example day rather than a schedule. Which services visit, and how often, is decided locally and by what your relative needs, so ask the district nurse what to expect in your area. A live-in carer is not a nurse and does not carry out any of the tasks in the band above.
Source: NHS, end of life care at home.
The NHS part of end of life care is free wherever somebody is looked after, and it is delivered by people who visit: the GP, the community nurses your GP arranges, the community palliative care team, and a hospice at home service where your area has one. What is not provided is a person in the house for the rest of the time. Who is in the team goes through everybody who may be visiting.
A live-in carer does personal care rather than nursing. They can prompt or assist with medicines already prescribed and write down what was taken and when, and can a private carer give medication? sets out where prompting ends and administering begins. They cannot give an injection, change a dressing or touch a syringe pump. PrimeCarers introduces self-employed carers and does not introduce nurses. We do not record or check nursing registration, and there is no way to search the site for it. If your relative needs a registered nurse living in, that is a different arrangement, and can you get live-in nurses? explains how to find one. The Nursing and Midwifery Council's register is public, so you can check anyone who says they are registered.
What a carer does at this stage goes through the personal care task by task, and live-in care for someone who is bedbound or hoisted explains what a second carer adds where a transfer has been assessed as needing two people.
Live-in care or nights
Why some families choose a carer living in rather than booking nights
Nights are what a family usually runs out of first, so overnight care is often the first thing they price. It is the right answer where the days are still manageable. Where they are not, paying for nights still leaves the days uncovered.
| What it covers | What is left with the family | On PrimeCarers | |
|---|---|---|---|
| Visits, two or three times a day | Help at agreed times: getting up, meals, medicines prompted, settling for the night. | Everything between the visits, and the night. | £18 to £25 an hour |
| A carer sleeping in the house at night | The night, with the carer getting up once or twice when needed. | The day, including the morning, which is the longest job. | £130 to £145 a night |
| A carer awake all night | A night where somebody needs turning every few hours, or watching continuously. | The day. | £150 to £160 a night |
| One live-in carer | The day and the evening, with the carer sleeping in the house and getting up when needed. | The carer's break each day, and the nursing. | From £1,050 a week, typically £1,120, and from £1,260 where care is complex |
| A live-in carer with a second carer awake at night | Somebody awake and alert at night, and somebody rested for the day. | The nursing, and covering the daily break. | A live-in week plus £148 for each waking night |
Visits, two or three times a day
- What it covers
- Help at agreed times: getting up, meals, medicines prompted, settling for the night.
- What is left with the family
- Everything between the visits, and the night.
- On PrimeCarers
- £18 to £25 an hour
A carer sleeping in the house at night
- What it covers
- The night, with the carer getting up once or twice when needed.
- What is left with the family
- The day, including the morning, which is the longest job.
- On PrimeCarers
- £130 to £145 a night
A carer awake all night
- What it covers
- A night where somebody needs turning every few hours, or watching continuously.
- What is left with the family
- The day.
- On PrimeCarers
- £150 to £160 a night
One live-in carer
- What it covers
- The day and the evening, with the carer sleeping in the house and getting up when needed.
- What is left with the family
- The carer's break each day, and the nursing.
- On PrimeCarers
- From £1,050 a week, typically £1,120, and from £1,260 where care is complex
A live-in carer with a second carer awake at night
- What it covers
- Somebody awake and alert at night, and somebody rested for the day.
- What is left with the family
- The nursing, and covering the daily break.
- On PrimeCarers
- A live-in week plus £148 for each waking night
Figures are what families pay on PrimeCarers with our fee included. Carers set their own rates, and rates for complex or palliative work sit higher. Agencies charge £28 to £35 an hour and from £1,400 a week for live-in cover. Bank holidays are charged at one and a half times the carer's rate and Christmas Day at twice it.
Two things push families towards a carer living in rather than a block of nights. The first is that the day stops being predictable, so a visit booked for one o'clock is in the wrong place when help is needed at eleven and again at two. The second is that one person sees the whole pattern. Somebody who has been in the house since Monday notices that your relative has eaten less each day, or that a heel has changed colour, and that is the observation that gets a district nurse there sooner.
Live-in care is not automatically the answer. It needs a bedroom the carer can have to themselves, and somebody in the house is a large change for a household that values its privacy. Overnight care at this stage sets out what the free night services cover, waking night or sleeping night helps you decide which kind of night is needed, and the cost of live-in care breaks down what a week includes.
How quickly it can start
How quickly a live-in carer can be in the house
This is usually days rather than weeks, and the slowest part is rarely the carer. It is the room, the equipment and, where the NHS is paying, the paperwork.
- The day you decide
Search where your relative lives, and message several carers
Look at carers near the house rather than near you. Say what is happening, what hours you need covering and the date you would like somebody to start, because that is what a carer needs to answer.
- Within 48 hours
Where fast track funding has been agreed, a package should be in place
The NHS says a care and support package should be put in place as soon as possible, usually within 48 hours. Ask about a personal health budget in the same conversation, because that is what decides whether your family chooses the carer.
- Two to five days
Talk to two or three carers and agree the start date
A carer who is free may still be finishing another placement and travelling a long way to reach you. Agree the weekly rate, the start date and the daily break, and confirm it in writing.
- Before the first night
Get the room and the equipment ready
The carer needs a bedroom of their own and meals while they are with you. Ask the district nurse or the occupational therapist about a hospital bed, a pressure relieving mattress or a commode, because delivery is slow.
- The first week
Tell the GP surgery and the district nurses who is in the house
Give them the carer’s name and the fact that somebody is now there day and night. It changes how they plan their visits, and gives them somebody who can let them in and describe the night.
Attendance Allowance is worth claiming whatever else is arranged, and it is not means-tested. Under the special rules for people nearing the end of life a medical professional completes an SR1 form instead of the claimant answering the usual questions: claiming benefits under the special rules on gov.uk sets out who can do that, and Attendance Allowance explained covers the claim.
Choosing the carer
What to ask a carer before you agree a start date
You are choosing somebody to live in your relative's house at a hard time, so the conversation matters more than the profile. These questions tell you whether this is familiar work to them.
Questions worth asking on the call
0 of 9 ticked
Their experience of this kind of placement
What they will and will not take on
The practical arrangement
When you are ready to look, you can search for carers near you and compare their rates, read the palliative experience each one describes, and message the ones you would like to speak to. How to interview live-in carers has a fuller list of questions, and current rates lists what each type of care costs.
When the placement ends
What happens when the placement comes to an end
A placement may end because your relative goes into hospital or a hospice, because the care needed has changed, or because they have died. The contract between your family and the carer treats all of those the same way, and it is worth reading before you need it.
Notice is in writing, and its length depends on how long they have been there
48 hours, then seven days
Days you cancel inside the notice are still payable
Three exceptions
The carer needs a time to move out, not only a last day of care
Agree it early
Tell the people who have been ringing the carer
The same week
A carer who has been in the house for weeks knows things written down nowhere: which side your relative prefers to be helped up from, what they will drink when they say they want nothing. Ask for that in writing early in the notice. Ending live-in care goes through the notice, the final invoice and the handover in full, and when your parent goes into hospital covers pausing a placement rather than ending it. The terms are in the client and carer contract.
Two charities are worth knowing about. Marie Curie gives information and support to people with a terminal illness and their families. Hospice UK is the national charity for hospice care, and its site finds the hospices near you.
Questions
Questions families ask about live-in care at this stage
No. Injectable medicines kept at the house for sudden symptoms are given by a district nurse called out, at any hour. A carer can prompt or assist with medicines already prescribed, and write down what was taken and when. Can a private carer give medication? sets out the difference between prompting, assisting and administering.
No. PrimeCarers introduces self-employed carers and does not record or check nursing registration, so there is no way to search the site for a nurse. A live-in nurse is a separate arrangement, and can you get live-in nurses? explains how to find one. The Nursing and Midwifery Council register is public, so you can check anyone who says they are registered.
Usually within days. Carers set their own start dates and many can travel within the week, though somebody finishing another placement may owe notice on it. Where the NHS is paying through the fast track route, it says a care and support package should be put in place as soon as possible, usually within 48 hours. The room and the equipment often decide the date.
Yes. The nursing stays with the NHS whoever else is in the house: dressings, catheters, syringe pumps, injectable medicines and symptom control, with the GP prescribing. Telling the district nursing team that a carer is living in helps them plan their visits, and means somebody is always there to let them in. Who is in the team goes through everybody who may be visiting.
It depends on whether the days are manageable. If the family can cover the day, a carer sleeping in the house is £130 to £145 a night and a carer awake all night is £150 to £160, and you can book two or three nights a week rather than seven. If the days have also become hard, a live-in week from £1,050 covers both and gives your relative one familiar person. Night care at end of life covers the overnight option in full.
It can, through NHS continuing healthcare. Where somebody has a rapidly deteriorating condition, a doctor or registered nurse can complete the fast track form, which has no means test and no assessment panel. To choose the carer rather than accept whoever the integrated care board has contracted with, ask about a personal health budget early. Fast track continuing healthcare covers how to ask.
The arrangement ends, and the carer is paid for the days worked up to that point. Tell them as soon as you are able to, by phone and then in writing, and check the bookings on the platform match the days worked before the final invoice is compiled. A carer who has been living in the house for weeks will be affected too. Ending live-in care covers the final week in full.