WHAT EXACTLY IS IT?
It seems there are many different ways people describe Live-in Care
Some people see it as 24 hour care, some as companionship, some as palliative or end of life and more.
We see Live-in care as a solution to a number of people’s needs which varies as does any person centred care plan. However we would clarify there is a difference between 24 hour care and Live-in.
Our Live in care typically ranges from providing a “Companion”, with care training, to a full and more complex care package, sometimes with more support than just 1 person. They will live-in your house 24/7.
Companions will carry out a range of duties that relate to the Care our client needs, which is often around 8-10 hours care a day. In some cases our Companions are in the background providing essential support a few times a day and sometimes they are very involved with the care This is usually scheduled around early mornings and breakfast, Lunch, Tea and Bedtime. Within those duties we perform personal care, help with medicines, cooking and generally keeping our clients company. In many cases we will do the shopping, sometimes with the client and usually have plans to make sure our clients get out and about, this could be from Doctor Visits, family visits, to simple going to the garden centre or shops. It’s about helping people retain as much independence as they can and ensuring they are happy within their limits. We can even help with holidays.
As you might guess these are long hours for 1 person to manage for a number of weeks and so they must have breaks and some free time. For many clients and families this isn’t an issue and when it is we can supplement care cover through our Home care team.
Although we limit the Companions time officially on duty [ see below] it’s important to know they are there 24 hours a day, providing security and comfort that if there is a problem at any time, someone experienced is there to look after your loved one. Occasionally they will be needed during the night, which is manageable, however if this becomes a regular need then the care package needs to shift more towards 24 hour care.
24 hour care then, is as it suggests, providing “care” 24 hours. Of course you cannot expect 1 person to do this and remain fresh and alert enough to perform effectively over a period of weeks. Apart from being illegal it would be poor care provision. Therefore you might expect this requires more than 1 carer or specific support for “waking nights” which can be managed a few ways. Hence the need for a considered care package to start and to be reviewed over time.
WHERE DO THE CARERS COME FROM
We did significant research before we offered Live in care, as the way it works and the type of people that do it are quite different from our domiciliary care team.
Live in carers come from many places. Usually they have significant care experience, if they don’t we train them. We find Live in carers are quite special in that they really love to get involved with their clients over a longer period. They also like to work around their lifestyle and so we have a number of carers who live abroad and fund that lifestyle by working 2-4 weeks a time at a job they love then they go back to the sun! Often they like to work closely with only a few clients and so may switch every few weeks. The other aspect is that many of them also love to travel and see new places and meet new people, quite a nomadic life. There is also a mix of nationalities which can work really well and we always make sure language and culture are a fit for our clients. Our task is to select people that have the skills and values we need and that they are a good fit for our clients.
WHY DO I NEED TO FIND CARERS THROUGH A COMPANY, I SEE SOME INDIVIDUALS OFFER THIS
Indeed they do and we were surprised at the apparent lack of control of Live in care opposed to the highly regulated domiciliary care world we live in. It is quite easy to find someone on the web that has care experience and is willing to work for a much lower fee.
We found this a bit scary as we happen to believe standards and professional support are essential when dealing with vulnerable clients. We are bound by the requirements of the regulations which are managed by the Care Quality Commission; this applies to any care service we provide. You might say it puts us at a disadvantage, we don’t think so.
What are the risks?
If you decide to employ an independent carer [technically you could be employing them] here are some things to consider
- Do they have full indemnity insurance [if something gets broken or damaged, who pays?]
- Will they make available evidence they have paid taxes, if not you as the “employer” could be liable, in care terms this is seen as a safeguarding issue.
- Do they have up to date and appropriate training? Do not underestimate the value of this. They should be aware of the Care standards, they should know about manual handling, medicines management, safeguarding and first aid as only a few key training needs
- Have they got a DBS [criminal records check] are you sure?
- Who will do the formal assessment of the person they are to care for? Are they trained and experienced in a range of risk assessments? And over time who will do ongoing assessments to consider if care needs have changed? And it will change.
- How do they propose you audit them to be sure they are doing the right things?
- What will happen when they are sick or need time off, who will provide care cover at short notice? Or is that pushed on to the family [hoping you are not on holiday?]
- If they don’t work out how will you manage the gap? And are you experienced enough to select someone?
There is an issue around pay and minimum wage in that when a carer’s hours are not specified or measured, it can quickly be calculated that they are being paid below minimum wage, which is illegal and a risk for any employer. We must be concerned carers do not get time abused and undervalued.
As you can see there are risks in going with independents, although we recognise there will be excellent independents out there.
Then what are the costs?
These will vary depending on the level of care required. In many cases it will be around the same as moving to a care home, which is a good rule of thumb [see below for more on care homes] the big difference being we know for many people A care home is not the ideal option.
The main cost of a Live in carer is their salary, for a 24 hour responsibility. In December and January  we spoke with over 50 experienced Live in Carers, the average weekly pay ranged from £650 to over £1200. Bear in mind this doesn’t account for taxes and significant overhead costs to provide a professional service. Therefore we would say when you hear Live in offers at £700 a week be very careful that the standard of the carer and support is appropriate or there are many hidden costs
So why are we a better solution?
As you will guess from the above list we cover all of those issues, you have no financial or insurance risks; our care companions are trained and supported. We are skilled in ensuring the right levels of care are provided and we can cover and support at short notice, which isn’t always easy for us!
For us it’s always about the client’s needs first and then providing a professional and appropriate level of care, so they and their families don’t worry and can take comfort in that level of care.
So just to be clear our care companions are
- Carefully selected and interviewed by an experienced care team
- Vetted for DBS/ criminal checks
- Training certifications are checked and where needed relevant training is given
- We pay according to legal requirements and well above minimum wage, Companions are highly valued and although only formally working set hours, do commit themselves to be there for our clients if needed.
- We are insured, you are protected
- We regularly support and meet with our Companions as they sometimes need to chat to someone outside the family who will better understand the care issues and their personal issues. The happier our Companions are the better the job they do.
- We will do a full assessment of the client’s needs and prepare a care plan to meet those needs. We will keep daily records from our companion and will regularly visit the client and re assess to be sure the care plan is appropriate
- If the Companion doesn’t fit we will find a replacement and ensure continuity of care and that does happen.
You should expect to have 2 Live-in carers.
We know after a few weeks most Live-ins will want to return home to family or simply need a break. Therefore we will always work to find 2 Carers. They will share the care and share information about what works best. So effectively you will have 2 people with your interest in mind. This can also be valuable should sickness or another event mean a carer has to leave.
When would we choose Live-in care, instead of a Care Home
Live-in is a great solution for some clients and Companions can be very visible and involved or purely in a support role. It is often a good way to keep people living independently at home when a “home care “package becomes too complicated or expensive.
For many people a Care Home is not a solution of choice. Research consistently shows 95% of us want to stay at home as long as we can. Even though there are some great Care homes to choose from, for some elderly it’s a last option and indeed it is for many families too. However if you are thinking about a Care home it may well be you have reached a stage where the family just can’t provide the level of support that’s needed and often a Care Home is seen as the only solution.
With Live in Care you will have 2 carers who will spend most of the day with our clients and so really get to know them very well, the little things that make a difference and they build on the companionship as well as consistent care. In a care home you will have a number of staff looking after you, typically they will work on a ratio of 6 or 7 to 1 resident and so you don’t get the depth of relationship or consistency of care. This does mean care homes can share costs across a number of staff. Live in really builds closer relationships.
However there may come a time even with a Live-in solution that our assessment shows a Care home actually is the best solution. We will tell you if that happens.
We can’t offer a check list of when you need Live-in care as often it’s an emotional decision and sometimes it’s a real issue for family. Like it or not funds and costs do play a significant part in peoples decisions around care. Therefore we would say call us and let us talk with you to understand what your needs are and how we can best support them.
We hope this overview helped you through this quite complicated issue, it’s what we do and so if you have any questions simply call us and we can meet. We believe we can make this much easier for you to manage.