What is live-in care?
Live-in care is when a professional carer lives in their client’s home to enable their needs to be met. This means they’re available to help throughout the day and at night, if necessary – although they are obviously entitled to breaks by law. Some carers live in all the time, while others work a rota pattern of, for example, two weeks on, two weeks off.
Live-in care is an increasingly popular alternative to moving into a care home – especially for those who have higher support needs. It enables you to stay in your own home and meet your changing needs. For some people it offers a way of continuing to live as independently as possible at home in their local community.
Mum liked the fact that someone would bring her a cup of tea in the morning, check she was all right and ask if she wanted any breakfast.
Who might be suited to live-in care?
Live-in care might suit you if you need help with:
- personal care, such as washing and dressing
- taking medication
- support to manage the risk of falls and other risks at home
- caring for a pet
- trips out, such as to the doctor or hairdresser
- continuing to enjoy lifelong hobbies.
This option is also attractive to people who may become confused by a new environment and find it difficult to adapt to change. This particularly applies to people living with dementia, where continuity, routine and familiar surroundings are very reassuring, important and improve quality of life. Live-in care also provides the supervision that someone living with dementia might need to keep them safe.
You may decide, too, that you only need a live-in carer for a short time, perhaps if you’re recovering from an illness or an operation.
Pros and cons of live-in care
If you’re unsure whether live-in care would suit you, we’ve put together the pros and cons of having live-in carers to help you consider both sides.
Advantages of live-in care
- Dedicated care: the main advantage of engaging a live-in carer is the dedicated one-to-one care by a team of typically two carers.
- You stay in your own home: surrounded by your possessions, in a completely familiar setting. While residential care can offer a valuable service, most people prefer to stay in their own home if they can.
- Peace of mind: you have the reassurance that someone is available to help you if there’s a problem. Live-in care also offers companionship, reducing the risk of you feeling isolated and lonely. A professional carer can also support you in your interests and hobbies, encouraging you to continue with them wherever possible. This can have positive effects on confidence, happiness and wellbeing. If the carer is happy to drive you or accompany you on journeys, it even makes keeping in contact with friends and the local community easier.
- Keeping pets: the carer can (provided they agree) help to look after a pet that might otherwise be put up for adoption or sent to a new home if you were to move into residential care. Many care homes and sheltered housing do not allow pets.
- Less pressure on relationships: if a relative or friend spends time with you to help out, having a live-in carer can ease that relationship as they can then be with you in a more relaxed way rather than being drawn into being your full-time carer, which can be stressful and time-consuming. This practical and emotional benefit takes the pressure off your family feeling that they need to be available to you all the time.
- Holidays and way of life: if you’re still able to travel for holidays, this may only be possible if you’re able to take a full-time carer with you. Having a live-in carer allows you to continue your way of life with as little restriction as possible.
- Specialist training: many live-in carers are specially trained to deal with such conditions as dementia, Parkinson’s, stroke, MS or palliative care. Some providers also offer live-in nursing staff.
- Staying together: for couples, the cost of live-in care can be significantly less than a residential setting and loving partners are able to stay together. In some cases in residential care, where one has dementia, they are separated.
Disadvantages of live-in care
- Finding the right person: the key is to find the right carer/care team who is properly trained and sympathetic to your needs. This can be a challenge. If you have complex or demanding medical needs, it may be difficult to find suitable carers with the correct experience and training, although most live-in care companies provide very good training, including qualifications.
- Lack of residential home benefits: some people also enjoy the social benefits of being in a residential home where they are constantly in contact with others, and may welcome giving up some of their privacy, so they can be freed from the sense of responsibility for managing their own home, even when they have help.
- Cost: it isn’t cheap to have live-in carers on call 24 hours a day, seven days a week, although with the introduction of personal budgets and direct payments it can be possible for live-in care to be state-funded, depending on eligibility. Also, live-in care fees can be lower than the price of a residential home. The arrangement can be particularly cost-effective for couples, because they only have to pay once for a live-in carer, but twice for a place in a care home.
- Living arrangements: not everyone is comfortable with having a stranger living in their home and there could be tensions about living arrangements, depending on how it works in practice.
- Available space: the live-in carer must have their own bedroom with a television and internet access. They will be required to have a space they can call their own and where they can escape the inevitable stresses of the role and have some time to themselves. This may not be possible if you live in a small home, or would like to keep free space for your family and friends to stay.
- Needs of the carer: carers will need breaks, including holidays, and to spend time with their own families. So the personnel will change occasionally, and some will be better than others. If you engage live-in carers via a managed service, this will be less of a problem as the provider can organise short-term cover when necessary.
If you’re not sure whether live-in care is the right option for your needs, read about more more home care options to consider.
How to arrange live-in care
You can organise live-in care:
- Privately, through your own advertising, in which case you would be the employer and responsible for paying the carers’ tax and National Insurance contributions as well as their wages (for more information, see how to employ private carers).
- Through an introductory agency, which matches you with suitable self-employed carers and you then manage and pay for their services directly. Most carers from introductory agencies are responsible for paying their own tax and NI contributions.
- Via a home care agency that employs its own professional carers and manages the service for you. With this arrangement, the agency employs and trains the carers, finding replacements for cover periods. This service is particularly valuable for people whose informal caring network isn't close at hand.
Both introductory agencies and managed services are also likely to be able to choose from a wider pool of carers, possibly choosing someone with similar interests to your own so you’re more likely to get on. They will also have a team on call around the clock to support both clients and carers alike.
The big lesson for us was that you can't just pay the bill and forget about it; you've got to take an interest, get to know the carers as human beings.
It’s vital that the carers are well-briefed if you’re living with any conditions such as dementia, Parkinson’s, MS, if you’ve suffered a stroke or need other specialist care. A good agency and managed service will organise for a manager to fully assess your needs, and support you and your family with choosing the carers.
We have more advice in our article on choosing a home care agency:
Where to find a live-in carer
Use our care services directory to find home care providers, anywhere across the UK. Simply enter your postcode or search by town or county, and select the 'home care' filter during your search. This will give you a list of registered domiciliary care agencies who operate in your area – many of these will provide a live-in care service (sometimes referred to as 24-hour care).
Make a shortlist of suitable companies and contact them to discuss your requirements.
Many live-in care companies will be members of the United Kingdom Homecare Association (UKHCA). You can find a list of UKHCA members who offer live-in care on their website.
Another source you can use to find selected live-in care providers is the Live-in Care Hub, an alliance of more than 20 live-in care providers around the UK.
You can also use an introductory agency to match you with suitable self-employed carers who are willing to provide live-in care. Read our guide to introductory care agencies for more information.
If you’re finding it difficult to manage, home care can provide the support you need to stay independent at home.
Use our step-by-step guide and checklist to help you find the best home care provider for your needs.
Guidance on employing personal care assistants, with information about legal issues and financial matters.