Live-in care options

[Boulevardier]

I am considering a live-in carer for my mother (who has dementia) and am looking at options. The "full-service" agencies I have contacted all seem to be very expensive (>£1,400 pw) and have very aggressively-worded contracts which allow them to load on extra costs for almost anything (e.g. disturbed sleep). In addition, they expect indemnification in the event of losses caused by the carer which includes dishonesty. I would expect at the very least that anyone they put forward would be properly vetted and they would have insurance against such eventualities.

So I am considering setting up a limited company and going out into the market to hire one myself. Does anyone have any experience of this and what is required? I have founded companies before, so that bit is easy, but any advice on particular considerations for the care industry would be warmly welcomed, as well as a link to any sample carer contract(s) that might be available. For example, how does one work with minimum wage and 48 hour working week regs?

 

[Jessbow]

27/7 is very costly
168 hours a week, x 10= £1680.
If you only pay minimum wage- and you have to pay tax &NI on top of that,( as well as annual leave)you wont get anyone well qualified
Do you need someone at night? you might consider a waking night sitter, seperate to the day carer. Its unrealisitic for one person to work 24 hours anyway- they have to have breaks- for which you may need cover
Its unrealistic to expect a day carer to wake at night as well

 

[Violet Jane]

It is standard for live-in care contracts to have provisions about working hours, breaks and a reasonable night's sleep. Without them, the carer would be on 24-hour call seven days a week. Live-in carers do not replicate what an exhausted family carer does.

I urge caution unless you are aware of what your legal duties would be.

More practically, carers come and go and you will need to be able to cover the gaps. Do not assume that you will have the same carer for weeks or months on end. You may need to find replacement carers at short notice.

 

[Boulevardier]

27/7 is very costly
168 hours a week, x 10= £1680.
If you only pay minimum wage- and you have to pay tax &NI on top of that,( as well as annual leave)you wont get anyone well qualified
Do you need someone at night? you might consider a waking night sitter, seperate to the day carer. Its unrealisitic for one person to work 24 hours anyway- they have to have breaks- for which you may need cover
Its unrealistic to expect a day carer to wake at night as well

Breaks are fine. To be honest, most of the time there'll be nothing to do. But the point is that they'll need to be available to help when required, as mum's decision making is becoming somewhat irrational. I see job ads for live-in carers in the £550-800pw range, so clearly they are not being paid minimum wage for all the hours in the week. I don't understand how the minimum wage/48 hour working week regs apply to these roles.

 

[Boulevardier]

It is standard for live-in care contracts to have provisions about working hours, breaks and a reasonable night's sleep. Without them, the carer would be on 24-hour call seven days a week. Live-in carers do not replicate what an exhausted family carer does.

I urge caution unless you are aware of what your legal duties would be.

More practically, carers come and go and you will need to be able to cover the gaps. Do not assume that you will have the same carer for weeks or months on end. You may need to find replacement carers at short notice.

Thanks. The purpose of the post is to hopefully get some advice on what my duties would be, perhaps from someone that has set up a similar arrangement. What I do know is that if these care agencies can make a (very significant) margin charging £1,400 pw with all their overhead, with a bit of research and work, I ought to be able to do a better job at a more reasonable price.

 

[Jessbow]

I see job ads for live-in carers in the £550-800pw range, so clearly they are not being paid minimum wage for all the hours in the week. I don't understand how the minimum wage/48 hour working week regs apply to these roles.

where?
If you want someone there , and on call 24/7, even if there isnt a lot to do, it isnt a realistic wage
£800 aweek, £ 114 a day, to be on call 24 hours? £4.70 an hour? AND broken nights?
£550 = £78 a day, £3 .27 an hour?
Setting up a company , sounds almost like exploition!

You would have to pay minimum wage
you'd have to pay tax and NI
Holiday and breaks ,pension and such as maternity benefits too

 

[Boulevardier]

where?
If you want someone there , and on call 24/7, even if there isnt a lot to do, it isnt a realistic wage
£800 aweek, £ 114 a day, to be on call 24 hours? £4.70 an hour? AND broken nights?
£550 = £78 a day, £3 .27 an hour?
Setting up a company , sounds almost like exploition!

You would have to pay minimum wage
you'd have to pay tax and NI
Holiday and breaks ,pension and such as maternity benefits too

It's not letting me post a link, but a cursory search on homecare.co.uk or indeed.com for live-in carers will show that range.

You can claim employer's NI contribution allowance up to £5k
You're right pension contribution needs to be added at 3% of salary and holiday and maternity benefits paid. Still works out a lot cheaper than £1,400 pw.

 

[SAP]

Mum had live in carers a couple of years ago. The company was well covered with staffing at the price was around £1000 a week . There was a main care for a fortnight on and a fortnight off with 2 two hour breaks a day covered by other carers. Mum had to provide food for them and of course her bills went up with more usage. There was several changes in carers due to Covid and fortunately the company was able to cover this. There was extra payment for bank holidays.
This wasn’t my first choice but the best way forward due to the lockdowns. Mum is now in a care home and much better catered for in-terms of being with other people and having health support.
The care agency was very good and I had no issue with the care but I still had so many issues to deal with in-terms of looking after mums property.
In terms of employing a team of carers, the initial output would be considerable. The carers will need to have a good level of training in dementia care, dealing with medication and the ability to de escalate any challenging behaviour. They would need DBS checks , you would be responsible for NI, pensions , holidays etc. as has been stated. Regular training in safeguarding will need to be provided.
Some people do hire their own careers via direct payments and find it easier to use an agency to manage all the employment details like NI etc as it can be a minefield.
I

 

[Boulevardier]

Mum had live in carers a couple of years ago. The company was well covered with staffing at the price was around £1000 a week . There was a main care for a fortnight on and a fortnight off with 2 two hour breaks a day covered by other carers. Mum had to provide food for them and of course her bills went up with more usage. There was several changes in carers due to Covid and fortunately the company was able to cover this. There was extra payment for bank holidays.
This wasn’t my first choice but the best way forward due to the lockdowns. Mum is now in a care home and much better catered for in-terms of being with other people and having health support.
The care agency was very good and I had no issue with the care but I still had so many issues to deal with in-terms of looking after mums property.
In terms of employing a team of carers, the initial output would be considerable. The carers will need to have a good level of training in dementia care, dealing with medication and the ability to de escalate any challenging behaviour. They would need DBS checks , you would be responsible for NI, pensions , holidays etc. as has been stated. Regular training in safeguarding will need to be provided.
Some people do hire their own careers via direct payments and find it easier to use an agency to manage all the employment details like NI etc as it can be a minefield.
I

Thanks so much for this really helpful post. Would you mind naming the agency you used? They sound very good and reasonably priced. I'm in a situation where mum still has a large degree of independence, but is making some dangerously irrational decisions. She refuses point blank to go to a care home, so that pretty much leave live-in care as the only option...

 

[Violet Jane]

We are happy with the agency that we use but live-in care still involves quite a lot of input from us. As has been said above, you are still having to deal with things to do with the house and garden and the paperwork which arises from running a house.

You have certain responsibilities as a landlord / employer (eg gas and electrical safety checks, carbon monoxide monitor and smoke detectors in the house, insurance).

In our experience, even if you have one primary carer who stays for a while there are still quite a few other people who will be providing care, not just during the daily two hour breaks (which are standard) but also during the carer’s holidays or weeks off. Often, the longer breaks are covered by more than one person because it’s not been possible to find one carer who is available for the whole period. We are coming to the conclusion that there would be more continuity of care in a care home.

Live-in care is not an easy or a cheap option. Carers must have breaks and must be able to have a reasonable night’s sleep (ie not more than two interruptions a night). In our experience, carers will leave if they are not happy because they can always find another placement. We are very relieved that we are using an agency because it has been quite difficult putting cover together. When carers have left at short notice or needed more help the agency has had to find people. That is what we are paying for (amongst other things).

 

[Boulevardier]

We are happy with the agency that we use but live-in care still involves quite a lot of input from us. As has been said above, you are still having to deal with things to do with the house and garden and the paperwork which arises from running a house.

You have certain responsibilities as a landlord / employer (eg gas and electrical safety checks, carbon monoxide monitor and smoke detectors in the house, insurance).

In our experience, even if you have one primary carer who stays for a while there are still quite a few other people who will be providing care, not just during the daily two hour breaks (which are standard) but also during the carer’s holidays or weeks off. Often, the longer breaks are covered by more than one person because it’s not been possible to find one carer who is available for the whole period. We are coming to the conclusion that there would be more continuity of care in a care home.

Live-in care is not an easy or a cheap option. Carers must have breaks and must be able to have a reasonable night’s sleep (ie not more than two interruptions a night). In our experience, carers will leave if they are not happy because they can always find another placement. We are very relieved that we are using an agency because it has been quite difficult putting cover together. When carers have left at short notice or needed more help the agency has had to find people. That is what we are paying for (amongst other things).

Thanks for your perspective. I agree a care home would be the easiest option for me, but the ones I've visited have been dreadful and mum is fully against such a move. Plus she is a smoker and none (that I have found) take smokers. I already cover all admin aspects of running her home (including preparing frozen meals for her daily care visits), which I am happy to continue to do.

 

[SAP]

Talking point does not allow naming of service providers and I agree with this policy . They were a local company not a national one and social services found them for me initially following discharge from hospital.
For us this was best for mum as I lived a long way away and I needed eyes and ears to assess her day to day with was getting more chaotic. Mum hated it by the way .
Remember , as you mums dementia progresses you may have no choice but to have her placed in a care facility as many agencies will not be able to manage challenging behaviour or insist on a 2 to 1 , so double the cost. Or your mum may need medical care which may be out of the capabilities of care agencies as she may require qualified nursing care.