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At The Good Care Group, we know through our experience in helping many families to plan home care, that the cost of care is a significant consideration. Our friendly and expert care advisors are here to help you make sense of the costs involved in caring for someone living in their own home, so you can better understand everything you need to consider when making your decision. Call our team today on 0808 2380 3379. We are here to help you and your family every step of the way.
If, however you are considering long term care for the first time, we know that you probably want as much information as possible to help you consider all the different options – whether to receive care in your own home or care in a residential setting. What is the cost of care? This will be a question at the front of mind when making decisions about long term care. Our comprehensive guide below gives you useful information to help you to make the decision that is right for you and your loved one. We set out how you might fund or finance the cost of care you need, as this will have an impact on planning your care arrangements.
What is the cost of care?
Staying in the comfort of your own home
There are different ways in which you can receive care in your own home, and this is typically determined by personal choice, care needs and financial considerations. Here we set out the various options to consider.
Domiciliary care at home, sometimes called hourly care or visiting care is usually provided by a domiciliary care agency. A visiting carer from the agency you choose will visit you in your home, usually daily, sometimes twice or three times a day to support your care needs.
Carers will support you with personal care and will enable you to have meals as and when you need them. Domiciliary care is suitable for those with low to medium needs and for someone who does not need around the clock care.
Benefits of domiciliary care
- Daily care and support provided as and when you need it.
- No need to move from your home to get the care you need.
- A family carer who has been supporting you can have a break from their role as carer.
Limitations of domiciliary care
- Visiting carers will typically only spend 15-30 minutes with you when they come to your home. They will have several other clients they have to visit in the day, so care tasks may feel rushed.
- Generally, there is insufficient time for companionship or a strong relationship to be formed.
- Domiciliary care is not suitable for someone living with high needs, as there is limited time for quality complex care to be provided.
- Family members may still need to be involved in providing care depending on a person’s needs at other times throughout the day.
- Co-ordination of visits from other healthcare professionals is the responsibility you or your family.
- Family members may need to provide cover if a carer is sick or there is an unexpected absence.
Domiciliary care costs
Domiciliary care is charged at an hourly rate and will be paid directly to the domiciliary care agency. It is usually paid on either a weekly or monthly basis depending on the arrangement you have with the agency. Hourly rates for the cost of care range from anything from £15 to £30 per hour, depending where in the country you receive your care.
If overnight care is required the hourly rate is typically more, as it is for bank holidays, so it is prudent to consider the cost of care over a longer period, for example the cost over a year. Overnight care will start at £100 - £120 per night.
What is live-in care
Live-in care is when a professional carer comes and lives with you in your home to provide you with around the clock care, companionship and support so you can live a better quality of life, in the comfort and familiarity of your own home.
When families are faced with the realisation that their loved one or family member needs care and support, many feel the only option is to move into a care or nursing home. Live-in care is fast becoming the preferred choice for those who wish to continue to live-in the comfort and familiarity of their own home, whilst receiving the care and support they need to live a fulfilled life.
According to a survey conducted by the Live-in Care Hub, 97% of us given the choice would prefer to carry on living at home. Live-in care enables you to get the care and support you need without leaving your much-loved home and is focused on helping you maintain independence, choice, dignity and to live a purposeful and meaningful life. All of which are vital to health and happiness.
Benefits of live-in care
- One-to-one care and support around the clock – something other long-term care arrangements simply cannot provide.
- A uniquely developed, highly personalised plan of care designed to meet your care needs whilst addressing how you wish to live your life - none of the rigid timetables or set routines experienced in a care home.
- Specialist and complex care provided by highly trained carers delivered in the comfort of your own home. Familiar surroundings and routines are paramount in helping those living with specialist conditions, like dementia or Parkinson’s.
- No need to move out of your much-loved home, with all the upset and disruption that brings. The family home can then be kept in the family, instead of being sold to fund care home fees. Staying at home means you can keep control of your life, with all your treasured memories and possessions around you.
- With live-in care you can keep your pet and the carer will support looking after it, and if you have a dog will be happy to walk it for you.
- Considerable and proven benefits to overall health and wellbeing, with much needed peace of mind and reassurance for family members.
- Those who require couples care can stay together as a loving couple, whilst receiving individual care plans. Couples may be split up to be cared for in different areas of a care home.
Limitations of live-in care
- Like with anything new there will be a period of adjustment when the carer comes to your home. A good quality company will ensure you are matched with a carer who not only has the skills to provide you with the care you need, but with one who shares common interests so you feel as comfortable as possible with the new addition to your home
- You will need to have a spare room for your carers use. This private space is essential for the carer to have privacy, complete their care records and rest and recharge to ensure they maintain their wellbeing which is essential to the quality of care provided. The room must have a television and internet access.
Introduction agency vs. managed live-in care service
It is important when considering the cost of care for a live-in care service that you think about the differences in costs and benefits between using an introductory agency, who charge you a fee to introduce you to a carer who you employ and pay yourself and manage directly, or using a fully managed and regulated live-in care provider, who provide greater levels of management and service delivery to ensure you get the highest quality home care.
There are many reassuring benefits to using a fully managed service. As a fully managed service, The Good Care Group directly employs its professional carers – we never use agency staff. All carers go through a robust and rigorous recruitment process and are trained to the highest level before they are placed with a client. You will be supported by a dedicated regional manager and a care manager, with support from a central service centre. Our managers only look after a small portfolio of clients, which means you and our care teams get unrivalled levels of support.
The Good Care Group is a regulated service, which means the quality of its care is regulated by The Care Quality Commission (CQC), something introduction home care agencies are not. As a family you cannot be assured of the quality of the service the carer you are introduced to will provide.
We are proud to be the only live-in care provider in the UK to have achieved an ‘Outstanding’ rating in all five areas in our last inspection. Read our CQC report here. We are completely accountable for the care we provide, which eliminates worry and provides reassurance to families that their loved one is in safe hands and receiving the best care.
Once an introduction agency introduces a carer to you and you pay the one-off charge to them for that service, that is the typically the end of their involvement in the arrangement. Families are then left to supervise, manage and organise all aspects of the care for their loved one, which for most is time consuming, frustrating and sometimes unmanageable. Most people who require long term care will need a team of two carers to provide the support they need. This means you will be responsible for managing a rota, paying the carer and organising sickness and holiday cover. Carers introduced through an introductory agency are self-employed and have not necessarily had any training before being placed with a client.
With a fully managed and regulated service all these worries are simply taken away and you have all the reassurance you need about the quality of care being provided and the level of service you will receive – making life easier for all the family.
Live-in care costs
Live-in care costs are typically in line with a care home, and sometimes less. The cost of care in care homes can be much more if you need nursing care.
With live-in care you have the added value of being able to keep your family home and the fee you pay for your care is purely for the quality support you receive and not the room and board of a residential home.
If you are a couple live-in care really is a cost-effective option. In a care home the cost of care would be double for two bedrooms. With live-in care there is only a nominal cost of care if two people receive care at the same address.
Whilst the cost of care for a live-in care service is comparable with care home prices it does depend on the level of care provided.
Please call our care advisors today on 0808 289 3379 to see how we can help you – we can arrange an assessment of you or your loved one’s needs, so you can get a true understanding as to the cost of care at home.
Price is a factor in the quality of care provided and the level of service the provider offers, so should be considered with many other factors including:
- Whether the provider employs its carers directly, how they train them and develop their skills to ensure high quality care is provided
- How the service is managed – a fully managed service where you have around the clock support will generally command a higher weekly fee and overall cost of care, but you need to consider the drawbacks of not using a managed service and constraints of family time
- Whether the provider offers specialist care of conditions, nurse-led care where carers are trained to carry out the duties of a district nurse or whether input is provided from an expert Occupational Therapist – this will typically result in a higher weekly fee
- Whether they measure improvements in health outcomes of its clients and can evidence how they do this
- How the quality of care is monitored and measured – is there a focus and commitment to quality assurance? This will impact on the cost of care you pay.
- Is the provider regulated and inspected by the Care Quality Commission (CQC) – introduction agencies are not so you cannot be assured of the quality of the service you receive
- Does the provider optimise technology in the service it offers? This could be by giving the family a way to stay connected to the programme of care their loved one receives via a secure website. This allows family members, as well as healthcare professionals to access daily care records and care plans, providing a reassuring window for families who live away from their loved ones.
Residential care facilities
Assisted living facilities
An assisted living facility is a residential complex made up of self-contained apartments, bungalows or flats, although some do offer very small houses. With an assisted living facility there is 24 hours support from carers, and some facilities will have nursing care. The home you live in will have a call bell so you can call for help and support, or if there is an emergency. Assisted living facilities are generally considered by people at the very early stages when needs are low, usually if a person wants to remain as independent as possible, but is living with mobility problems for example, and just needs to know someone is on hand should they need it. Good assisted living complexes will have communal facilities, including shops, gyms and hairdressers so you can enjoy your own space and independence, whilst benefiting from a safe and contained community.
Benefits of assisted living facilities
- Ability to remain as independent as possible living in your own space, with 24-hour emergency support if you need it.
- The facility will be a community where new friendships can be formed with other like-minded people who you can share your life with if you wish.
- A wealth of facilities is available for you to enjoy life within a safe and secure environment.
Limitations of assisted living facilities
- They should only be considered if care needs are low. Whilst 24 hour call out support is available there is no plan of care to support your needs, so care provided with be reactive and not proactive.
- Complex and specialist conditions cannot be supported in an assisted living facility.
- Most do not accept pets, so you may have to find another home for your much-loved pet.
- If care needs increase, you may very quickly find you have to resort to another care arrangement, which may mean another move something which most of us wish to avoid in later life.
Assisted living care costs
An assisted living facility is typically rented, and the weekly fee charged will depend on the size of your dwelling and the other facilities on offer within the community, as well as location in the country. It is likely that if nursing care is offered then this will be an additional cost of care to the weekly accommodation cost. Some providers may also charge separately for use of the communal facilities, so it is worth looking at the cost of care over a longer period. Unlike care homes, you will still have to finance your current outgoings, for example food. Again, there is a broad cost range for assisted living depending on the quality of the facility and the level of care provided. For a small dwelling you can expect to pay £500 a week, but for a large complex with a range of facilities it can be anything from £1,000 to £2,000 a week, this may be with or without nursing care.
Residential care homes
Residential care is when you move out of your own home and move into a communal residence to receive the care you need. There are different types of residential settings – some only support general care needs, like companionship, personal care, mobility care (referred to as residential care), whilst others provide support for complex care and medical needs – these are nursing homes.
Most residential care operators provide homes that offer three levels of care, typically on three different floors – residential, nursing and specialist care for conditions like dementia.
Every resident has their own bedroom and en-suite, but there are communal areas to be enjoyed including lounges, dining rooms and outdoor spaces. Care is provided by a team of carers and other healthcare professionals around the clock within the care home.
Benefits of residential care
- 24-hour care in a safe and secure environment
- Care homes can accommodate low to high care and support needs, as well as nursing care generally all in one place.
- Most good care homes have many facilities for residents to enjoy, including lounges, garden spaces, a hairdressing salon and some even have a cinema.
- A range of social activities and events are run at set times each day, so residents are entertained and able to remain active if they wish.
- Some residents will be able to leave the care home and go out in the local community if they are independent and require no support.
Limitations of care homes
- Leaving your much-loved home and having to sell the house to fund care home fees can be very upsetting and sometimes traumatic for many, especially if you are living with a condition like dementia.
- One-to-one care cannot be achieved in a care home setting – each carer will typically care for up to 6 residents in a care home, sometimes more depending on the homes approach to quality of care.
- You will need to down-size from a large family home and move into a single room, which for some is very challenging and makes it difficult to retain possessions you hold dear.
- Life in a care home is driven by routines and it is difficult for you to choose things like when you eat your meals or get up in the morning. Fixed daily patterns can contribute to the feelings of losing independence and control over how you live your life.
- Care home residents are sadly more likely to have a fall or be admitted to hospital than if you were receiving one-to-one care in your own home. Reports also suggest that infection rates are rising in care home settings, where lack of mobility puts you at greater risk of pressure sores and urinary tract infections.
Residential care home costs
The cost of a care in a residential care home can vary significantly depending on the standards of care and the environment, as well as the location of the care home. Care homes are typically more expensive in the South East of England. If nursing care or specialist care of conditions is needed, then the weekly cost of care can be considerably higher. When considering a care home, it is important to ask them what is included in the weekly fee as there are generally optional extras, such as trips or hairdressing, all of which can add up over the course of a year. The costs of receiving quality, award-winning care in a care home can range from £1,600 to £2,000 per week, depending on the level of care provided and the room you choose in the home. Also, if you are a couple receiving care in a care home, the cost of care is typically double as you will be required to have two rooms.
Care home vs. home care
It is important to consider that if you move into a care home, part of your weekly cost of care will contribute to the accommodation you live in – so that means less of your fee goes towards the care you receive. With home care the total weekly fee is focused on providing you with a high-quality care at home service. In addition, receiving care in your own home brings the added benefit that the care is provided on a one-to-one basis, something even the best care home simply cannot achieve. It is prudent to make a direct comparison of overall yearly costs of care when considering care home costs. Most care homes will charge for additional extras which can be very expensive – trips and activities, visits to hospitals, hairdressing services, chiropody and hosting family meals or celebrations are generally chargeable. All adding to an overall increase in the cost of care, so make sure you are making a direct comparison over a longer period.
Another benefit of receiving care at home and not moving into a residential care home is that your much-loved and treasured home will not need to be sold to fund care home fees, keeping it in the family where it should be.
Cost effective couples care
If you are a couple who require care, live-in care really is a cost-effective option. The cost of care in a care home is double the price of receiving high quality, live-in care at home, as couples will typically live in two separate rooms. With live-in care there is just a small supplement for couples to receive care in their own home.
Home care costs for specialist conditions
We have over 10 years’ experience in supporting people to live well at home with several complex conditions, like dementia, Parkinson’s disease, Multiple Sclerosis or for those needing stroke care, cancer care or palliative care, that require specialist care and medical support. If a person has a more specialist plan of care this generally involves a higher weekly fee.
However, it is worth noting that live-in care from a fully managed and regulated provider who employs and trains its professional carers to provide specialist support for these conditions is far cheaper that using a domiciliary provider, who provides hourly or visiting care at home. If you are living with a condition that involves specialist medical or complex care and are receiving hourly care, there will be additional charges on top of the cost of care for the visit to support you, which quickly add up and can become costly.
Financing and funding the cost of care in UK
Care funding options explained
When faced with financing long term care, it is important to understand if there is any support you can get in terms of funding that can minimise the financial investment and cost of care needed for your chosen option.
Local authority funding
The Local Authority will only fund care at home (referred to as social funding) if your assets are worth less than £23,500 in England, which we know that sadly for many families their financial situation exceeds. The figure for differs across the country and in Scotland is £26,500. To understand if you are eligible a care needs assessment will be completed by your local authority to see understand your specific needs. In addition, you will be required to do a means assessment, so the local authority can better understand your financial circumstances and how this impact on your ability to meet care fees.
NHS continuing healthcare
Healthcare in the UK is free at the point of delivery. Therefore, if you have an identified healthcare need and are receiving care for this in your own home, you may be eligible for NHS Continuing Healthcare funding, which is arranged and funded by your local Clinical Commissioning Group (CCG). If you feel you are entitled to this funding, you need to visit your GP who will complete an initial assessment and refer your case to the CCG for consideration. They will then ask you to complete full assessment with a multidisciplinary team of healthcare professionals so they can understand the complexity of your needs.
Sadly, for many, specialist conditions like dementia are not in isolation considered a healthcare need so care for dementia is not necessarily funded by NHS Continuing Healthcare. It is always worth checking though, as funding can considerably contribute to the overall cost of care and in many cases will fund the total cost.
If you are successful in securing funding it is worth noting that funding is reviewed by the CCG annually, so if you needs decrease because you are receiving good quality care your funding may be at risk and you may have to start funding the total cost of your care.
NHS funded nursing care
If you have an identified nursing need, the NHS may pay the weekly cost of care for nursing care provided by a care home provider or for a registered nurse to visit you either in a residential home or when receiving care at home. The assessment process is the same as NHS Continuing Healthcare and is likely you will be offered this funding if you have failed to qualify for Continuing Healthcare.
If you are at pensionable age and require personal care in your own home, you will be eligible to claim Attendance Allowance benefit. This is a non-means tested benefit to support your overall cost of care at home.
If your savings are less than £16,000 you may qualify for reduced council tax payments. Some people living with dementia who have been diagnosed are eligible for a discount on their council tax bill, or may event be exempt from paying. If you already claim a single occupancy reduction on your council tax, you will not lose this entitlement if you have a live-in carer.
Financing long-term cost of care
Many families are faced with having to fund the cost of care they receive themselves (referred to as self-funding care). For these families there are options to help finance care at home, including a Care Fees Annuity, which is an insurance policy you purchase to cover the cost of your care, or by realising capital in your assets through an Equity Release scheme. Read the Live-in Care Hub’s guide to funding and financing care at home here.
Case study: Paying for care at home for Eric
Eric and Alma had been married for over 65 years. Sadly, Eric’s deteriorating health meant that a move into a care home seemed an inevitable end to their life together. Alma and the family wanted him to stay at home but knew that this would not be an easy decision, as Eric needed specialist personal care and Alma was unable to provide this. As a potential solution, the family considered having a live-in-carer and both arranged a meeting with The Good Care Group. Following our assessment, we knew we could deliver to a home care package to meet their needs.
To help them explore the best way to fund the care they needed, they talked through the option of equity release with the local advisor who suggested that the whole family became involved in the discussions. A key decision was how much money should be released. Did the family just take enough for one year and continue to draw down each subsequent year, until the maximum sum had been exhausted?
Exploring an immediate care plan
To help the family get the peace of mind they desired, the advisor suggested they explored an Immediate Care Plan. They calculated the income Eric and Alma received, by way of pensions and other investments and compared that to their expenses, which had to take into account not only the household costs, which largely remained unchanged, but importantly Eric's care costs. After assessing Eric’s health, the cost of the Immediate Care Plan, with a built in automatic 5% inflation was £92,000. Eric and Alma then used equity release to by the Care Plan. As their property was valued at over £500,000, the release of equity was just under 18.5% of the total value.
This meant that Eric was able to receive the high-quality care at home he needed and they both had the peace of mind that his needs would be provided for, for the remainder of his life. Much needed reassurance when they needed it.
Choosing a care provider
If you have decided that live-in care is the right choice for you and your family, you will need to do some research into choosing a live-in care provider. You will also need to decide whether you use an introduction agency, whereby a carer is introduced to you but you employ and manage them directly, or you use a fully managed service provider who is regulated and inspected by the Care Quality Commission (CQC) to ensure the highest standards of care are provided. The UKHCA (the United Kingdom’s Home Care Association) is a membership body of care at home providers, and is a good place to get information on high quality care at home providers you could consider when making your decision.
For those that feel a residential setting is the right choice, you will need to contact the care home to make an appointment to meet the care manager and visit the home. It is recommended that you visit up to five homes, so you really get a feel as to whether they will meet your needs before you make your decision. Again, always read their CQC report before choosing your home.