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Is there a place for 24/7 live-in care in new social care world?

Updated: Mar 20

According to the consumer champion ‘Which’, live-in care is becoming an increasingly popular alternative to moving into a care home – especially for those who have higher support needs. It enables people to stay in their own home and meets their changing needs following.

To some people it provides a means for a person to continue to live as independently as possible at home in their local community.

Does live in care provide a viable alternative to a care home? The coronavirus has placed a great deal of pressure on care homes through the restrictions on admissions and the exposure of many of our residential care homes to cross-infection which despite the heroic efforts of their staff and management, has tragically amounted to a substantial number of deaths. As a result, many potential residents have turned to other forms of care including home care and live in care.

What is live-in care

Live-in care is when a professional carer who has undertaken CQC registration 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.

Advantages of live in care

One-to-one live-in care provides health and wellbeing advantages evidenced by academic research included in the ‘Better at Home’ Report 2020, as well as other benefits, including:

  1. Instead of selling family homes to fund residential care, with the resultant funds earning little or no interest in the banks, clients retain their own home in whole or in part (subject to lifetime mortgage/equity withdrawal funding) which tends to appreciate over time to the benefit of the next generation.

  2. Older clients remain in their own home with familiar surroundings, and their memories and routines.

  3. It is 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.

Disadvantages

  1. Finding the right person can be a challenge. If a person has 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

Costs

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.

Lifetime mortgages and equity release products are now far more competitive and offer more flexible options for many families to retain the benefit of keeping the family home for the next generation as well as funding care.

Summary

Live in care offers an alternative to care home provision. It has the advantage of supporting people to live in their own home, and to retain their independence. It comes at a cost however that may be outside some people’s budgets and the space for carers. It does however offer an alternative to care homes, and forms part of a mixed economy of care provision as we move forward in social care.

Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy

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