02 Types of live-in care. Are there different types of care?

In the same way that there are many types of visiting home care services, from companionship one a week to multiple visits to support with personal care every day, there are also different types of live-in care available to accommodate for different circumstances, requirements, wishes and budgets.

Levels of live-in care

You may come across many different names for different types of live-in care, but there are essentially two main types: managed and self-managed, and both require different levels of involvement.

Managed live-in care

With ‘managed’ live-in care, an agency will take an active role in all aspects of the care you or your loved one receives. A ‘managed’ live-in care service is regulated by the Care Quality Commission, which means the agency is regularly assessed to ensure that their practices, policies and procedures are compliant with standards outlined by the government.

Your care management team will usually visit you or your loved one at home to discuss your requirements, wishes and circumstances as well as conducting a risk assessment to ensure everyone will be able to live safely in the property. A bespoke support plan will then be created and your care management team will usually provide a selection of profiles for live-in carers who have been personally matched. You’ll have ongoing support and regular reviews to ensure everyone is receiving the right support.

Managed live-in care is usually offered within a certain radius of the care agency to ensure you’re your care teams are able to reach you to visit, review and respond to any alerts.

As well as assessing, organising and monitoring your care, the agency is responsible for interviewing, training, employing and paying your care assistant (including tax, national insurance and other legal obligations).

Self-managed live-in care

Self-managed live-in care is also known as ‘introductory live-in care’ because the role of the care agency is to introduce you to a self-employed carer. With self-managed live in care, the agency has less involvement than they would with a managed service. The care agency will usually conduct a telephone assessment to understand your needs and wishes before starting a comprehensive selection and vetting process on the self-employed live-in care assistants they introduce to you (including enhanced DBS/CRB certificate, right to work in the UK and full reference checks).

Once a care assistant has been matched to your needs and introduced to you, you will be responsible for arranging any ongoing amendments to the care plan with the live-in carer. You will also be responsible for paying the carer directly, and a fee to the agency for their introductory service. The self-employed live-in carer will arrange their own taxes and insurance.

The care management team at the agency will be in regular contact with you and your carer to ensure everyone is receiving the right support but they do not usually visit the home to conduct the reviews.

Given that you will have significantly more responsibility than with a managed service, introductory live-in care is best suited to families who would like to be as involved and ‘hands-on’ as possible.

Short-term and long-term live-in care

A short-term live-in care placement may be arranged for a number of weeks and is beneficial when returning home from hospital after an operation or recovering from illness, or to cover an extended break from your regular caregiver. Given that the placement for a short-term live-in care arrangement is for a number of weeks, it’s likely that you’ll have the same live-in care assistant for the duration of your care.

Longer term live-in care placements provide ongoing care and can last for any length of time from months to years. With longer-term live-in care placements, a live-in care assistant will usually stay for up to 8 weeks and then a new carer will be introduced to you. This is to ensure that your care assistant has an opportunity to rest between placements to ensure they are able to provide care to the best of their ability. After their break, the care assistant may return for another period of time with you or they may have another placement depending on the circumstances. Your care provider should always strive for consistency in carers wherever possible, which is particularly important for ongoing dementia care where consistency and familiarity is key.