Alternative to care homes

When you are faced with the realisation that your loved one or family member is struggling to cope alone due to mobility or frailty concerns or is living with a condition like dementia or Parkinson’s, many assume the only choice is for them to move into a residential care or nursing home. This is not the case and there really is an alternative to care homes.


Home care is fast becoming a preferred alternative to care homes. According to a survey conducted by the Live-In Care Hub in 2017, 97% of people surveyed would choose to stay at home to get the care they need.

There are different ways in which you can receive care in your own home as an alternative to residential care, and this is typically determined by personal choice, care needs and financial considerations. Here we set out the various options to consider.

Alternative to care homes

Domiciliary care – a care home alternative

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 10-30 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, when compared as an alternative to care homes 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.
  • Coordination of visits from other healthcare professionals is the responsibility of you or your family.
  • Family members may need to provide cover if a carer is sick or there is an unexpected absence.

Live-in care as an alternative to care homes

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 as an alternative to residential and nursing homes.

So, what does live-in care include:

A compassionate and professional care team

An expert, professional and compassionate carer will move into your home to provide you with one-to-one care and support around the clock, giving you peace of mind and reassurance that you are receiving the highest quality care.

A perfectly matched care team

A live-in care arrangement usually involves two carers providing care working on a two-week rota pattern. They will be carefully matched working with you and your family to ensure they are able to meet not just your care and support needs, but are closely aligned with how you wish to live your life, sharing common interests and backgrounds.

A personalised plan of care and support

The carer who comes and lives in your home will provide a highly personalised plan of care. The comprehensive care plan will be created with input from not just the person receiving care, but with vital input from family members and other healthcare professionals involved in your care. It will cover not just your care needs, but your choices on how you live your life, your preferences and social and emotional support required. It is a holistic approach that is focused on enhancing health and well-being, whilst improving overall quality of life.

Benefits of live-in care as an alternative to care homes

  • One-to-one care and support around the clock – something residential care homes cannot offer, making live-in care a real alternative to care homes.
  • 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 well-being, 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 well-being which is essential to the quality of care provided. The room must have a television and internet access.

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Home care agency vs. managed service

It is important when considering care at home as an alternatives to residential homes 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 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.

Home care costs as an alternative to care home costs

Live-in care costs are typically in line with a residential care home, and sometimes less. Costs 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 you would be charged double for two bedrooms. With live-in care there is only a nominal cost if two people receive care at the same address, making it a very good alternative to care homes.

While the costs for live-in care 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, 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
  • 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.

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 domiciliary 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.

Talk to us about your live-in care needs

Find out more about the compelling benefits of live-in care as an alternative to a care home - call us today. We will help you every step of the way.

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