Families should avoid the ‘common mistake’ of arranging live-in care based on headline price alone and plan ahead for live-in care costs that can reach £100,000 a year or more, according to a new expert guide that aims to demystify the process.
Private live-in care – where a carer lives in the home of the person they are caring for – typically costs between £1,000 and £1,800 a week, but within that is a range of services and levels of care that may or may not be right for each individual’s circumstances.
For many families, the annual investment in live-in care is in the region of £70,000 to £100,000 or more, and may form part of wider financial and estate planning, involving trusted advisers from wealth managers to private client lawyers, rather than being considered only when a crisis arises.
Private care is funded by individuals who wish to remain at home, but some adults with acute care needs may be eligible for state-funded live-in care through NHS Continuing Healthcare, the Attendance Allowance (for pensioners only), or their local authority. Access Care, which has been arranging live-in care for families since 1994, has produced The Complete Guide to the Cost of Live-in Care, breaking down the options for families looking to arrange private live-in care, their costs and benefits.
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Live-in care allows people to remain in the comfort of their own home and the familiarity of their surroundings while continuing established routines and keeping close to friends, neighbours and local communities.
‘These are benefits that families often tell us are difficult to place a monetary value on,’ says Tiggy Bradshaw, chief executive of Access Care and author of the guide. She adds that a decision can often come down to a question of what live-in care makes possible for a person to keep doing, rather than a question of cost alone.
Private live-in care largely falls under three main approaches:
- A family contracts a self-employed carer directly, with no agency involvement. This is often the cheapest option, as it does not include agency or provider fees, but requires the family to be wholly responsible for the arrangements.
- An introductory care agency matches families with vetted, registered self-employed carers. Once a suitable match is made, the family contracts directly with the carer while the agency continues to provide customer service and support.
- A managed live-in care provider takes charge of everything for the family and recruits carers directly as employees. As such, the family enters into a contract with the care provider itself rather than the individual carer.
Introductory agencies are often described as ‘unregulated’ purely because they do not fall within the scope of the Care Quality Commission (and its equivalents in the nations), but this is a legal designation only and does not relate to the standard of the carers themselves, the guide explains. Care providers are regulated by the CQC (and its equivalents in the nations).
Care in which families contract a carer directly costs upwards of £1,000 per week on average, while care arranged through an introductory agency costs upwards of £1,300 per week, per the guide. A fully managed care provider charges upwards of £1,600 per week.
No one way is better than the other, according to Bradshaw, but she cautions families that ‘the best outcomes rarely come from choosing on price alone’.
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‘Over the past three decades, we’ve found that families are generally happiest with their decision when they choose the care arrangement that best suits their circumstances, rather than simply comparing weekly prices,’ says Bradshaw.
‘Understanding how each model works, how the fees are structured and where responsibilities lie usually leads to more confident decisions and better long-term outcomes.
‘The most common mistake we see is comparing the weekly price without first understanding what is included. Two providers may appear to charge very different amounts, but they may also be providing very different services.
‘Before comparing costs, always ask how the care is arranged, what support is included and who is responsible for each part of the care arrangement.’
The alternative to live-in care in the UK is a residential care home or nursing care home, depending on the level of care required. According to current UK averages, residential care homes cost about £1,300 per week and nursing care about £1,500 per week, with both more expensive in London. Figures vary by the service offered and level of care required.
A care home will almost always charge two people as separate residents, whether a couple or not, meaning they pay for two rooms and two individual care packages, the guide
explains. A benefit to live-in care is that one carer can care for two people at a time in their own home, when care needs can be safely met by a single person, keeping costs down.
Equally, there are situations where a residential or nursing care home may be better suited to a person’s care needs, particularly if they require frequent assistance from multiple carers, specialist nursing interventions throughout the day or night, or access to equipment that is more readily available within a care-home environment. Bradshaw says she wrote The Complete Guide to the Cost of Live-in Care because she believes families should know how the cost of their live-in care arrangement is structured.
‘Ultimately,’ says Bradshaw, ‘choosing the right form of care should be based on the individual’s needs, wishes and circumstances, rather than the weekly cost alone.’
Click here to read Access Care’s Complete Guide to the Cost of Live-in Care
