Thursday, 10 August 2017

Live in Care: Know Your Options

What Is Live-in Care?

Live-in care is where a carer lives with you to help you with your care needs. Though it may not suit everyone, live in care is undoubtedly an alternative to residential care that is worth considering. Quite typically, your carer will live with you seven days a week, although variations are possible. You might, for example have a live-in carer during the week and stay with your family at the weekend. Often, live-in care will be a permanent arrangement; it is possible, though, to have live-in care for a short period of time; for example, while you are recovering from an operation.

The Benefit of Live-in Care

I have written previously about the benefits of live-in care; therefore, I shall mention just one; one benefit that, I should suggest, far outweighs all the others. As with all home care, the aim of live-in care, is to help you maintain your independence and remain living in your home. For many of us, the thought of having to leave our homes is unbearable.

Our homes are part of us; and we are part of our homes. They often reflect our identities and the identities of other significant people in our lives. They are our tranquil sanctuaries from the disorder and confusion of a turbulent world. Our homes hold our dearest memories and are where we are most comfortable. Is it any wonder that we don't want to give them up?

How Do You Find a Live-in Carer?

The safest way to receive live-in care is through a domiciliary care provider. It must be said that there are alternatives to using a home care provider. I will say a little about the alternatives, below. These alternatives have their advantages; not the least of which is that they will be cheaper than using home care or residential providers.

To find a home care provider you can try a google search; an excellent website is one belonging to, where you can type in your postcode and search for local providers. Bear in mind that not all home care providers will offer a live-in care service. There is also a specialist live-in care website, the live-in care hub, that is well worth a visit.

What Does Live-in Care Involve

In a sentence, live-in care should be able to provide you with a full range of domiciliary care services, including: personal care, medication support, help with domestic tasks, companionship, shopping and meal preparation. Your carer will also be able to go out with you.

It is, perhaps, more important to appreciate what may not be included in a live-in care package. I'll just mention a disclaimer, here. What I explain refers to a care package provided through a home care provider. The alternatives available may well differ. Also, what I explain below is influenced by the services that I have experience in providing; other companies may offer variations on this.

Let us, then, concentrate on what may not be included in a live-in care package. You will sometimes see live-in care described as "24 hour live-in care": It is not (usually). You may well have a carer living with you, but it is improbable that he or she will be providing 24 hour care. It is unreasonable to expect a carer to work much in excess of nine hours a day (for seven days a week). Twenty-four hour care is available; however, you must expect to pay for each hour of care you receive. If you have round the clock care, you will have at least three carers, I should suggest.

The Alternatives to Live-in Care provided by a Home Care Company

There are two principal alternatives: first you employ a carer directly; second, you engage a carer who is self-employed. The major advantage with both of these options is that they are likely to be considerably cheaper than contracting with a domiciliary care company.

Employing your own carer

The first option, employing a carer yourself, may seem a little daunting. However, if you do your research and take a few basic precautionary steps, employing a carer yourself may not be quite as difficult as it first appears. I should suggest that you pay particular attention to the following points. This is by no means an exhaustive list.

First, make sure you take up references and insist on carrying out an enhanced DBS (Disclosure and Barring Service) check. The DBS certificate will tell you if the certificate holder is barred from working with vulnerable adults and whether he or she has convictions for criminal offences. You certainly would not want to employ someone on the barred list. You will use your judgment about employing someone with a conviction.

Second, remember that you are an employer. If you want to avoid any awkward dealings with HMRC you must ensure that you pay your employees at least the minimum wage (£8.21 at the time of writing). You will also be responsible deducting and paying to HMRC your employees income tax and national insurance. You will also be responsible for paying employer's national insurance, which is currently 13.8%  anything earned above the national insurance threshold (at the time of writing this threshold stands at £719 per week).

As an employer you, you may also be responsible for ensuring that your carer is enrolled into a pension scheme. You will contribute to your carer's pension. There is a minimum contribution of 3% of your employee's income if they qualify to be enrolled in a pension scheme.

HMRC get a bad press quite often; however, they do have a wonderful tool that simplifies working out PAYE. I have written about this previously.

Third, you will need to think ahead about how you will cover the periods when your carer takes holidays. All employees are entitled to 28 days paid leave. A related point, is that you will need to make provision for periods when your carer is unable to work because of illness. It is highly probable that you will be responsible for paying statutory sick pay during these periods.

Fourth, if you are looking for long term care, it is inconceivable that you will be able to cover this with only one person. Live-in carers may well have a preference for a pattern of working - for example, three weeks working and one week off; or two weeks on and two weeks off. Realistically, therefore, you will be looking at employing two or three people.

Fifth, you will be responsible for ensuring that you are correctly insured. You have a duty to provide you employee with a safe place of work, which is your home. You also have a duty to ensure that any equipment provided for use by your employee is safe to use and that your employee is competent to use it.

Sixth, it goes without saying that you will want to be confident that your carer is competent to carry out whatever care services are required. As an employer, it may well be your responsibility to provide training for your employee.

Engaging a self-employed carer 

The second option is to engage a carer who is self-employed. The main advantage with this option is that you will not be responsible for deducting taxes, paying holiday and statutory sick pay, nor ensuring that your carer is enrolled in a pension scheme. Again, there are some simple checks to make.

First, you are strongly advised to carrying out the same checks with regard to references and DBS checks.There are companies who act as agents to find carers for you. They will, of course, charge something for doing this.

Second, As explained above, you will need to think about how you will cover periods of sickness and holidays. However, see my third point below on this. Once again, it is improbable that you will only have one person who provides your care. Both employed and self-employed carers will have their preferred working patterns.

However, if your carer is self-employed, they are in business. It is, thus, arguable that it is his or her responsibility to ensure that any periods of sickness and holidays (and periods of unavailability because of a preferred working pattern)  are covered. Your carer is effectively in the same position as a home care provider. The fact that he is just one person is neither here nor there. Your carer, to use the correct legal term, is a sole trader. You could, of course, if you so wish, negotiate on this and place the burden on yourself of covering these periods of absence. If you do this, I should strongly urge you to negotiate a lower price for your carer's services.

Third, as with employing a carer, ensuring that insurance cover is in place is critical. Your carer will be responsible for ensuring that she has liability insurance in place.

Fourth, you need to be absolutely certain that your carer is self-employed. If your carer is providing services for you and only you, it is highly probable that he or she is not self-employed but employed by you. If this is the case, you need to know as soon as possible. You do not want to discover, someway down the line, that you are an employer and responsible for backdated tax deductions, national insurance and pension contributions.

Fifth, as above, you will want to be confident that your carer is competent to carry out his or her tasks.

In Summary

Broadly, there are three options: contract with a domiciliary care company, employ a carer yourself or engage a self employed carer.

Garry Costain is the Managing Director of Caremark Thanet, a domiciliary care provider with offices in Margate, Kent. Caremark Thanet provides home care services throughout the Isle of Thanet. Garry can be contacted on 01843 235910 or email You can also visit Caremark Thanet's website at

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