Arranging care for a loved one is one of the most important decisions a family can make, and in a city as large and varied as London it can also be one of the most confusing. There are dozens of care types, hundreds of providers and a funding system that is rarely straightforward. This guide is designed to cut through the complexity and give you a single, reliable starting point.
Whether you need a carer to pop in for an hour each morning, a live-in companion who is there around the clock or specialist dementia support tailored to a specific diagnosis, the information below will help you understand what is available, what it costs in London and how to take the first practical steps towards getting the right care in place.
What Is Home Care?
Home care, sometimes called domiciliary care, is professional support delivered in the person’s own home rather than in a residential care home or hospital. It covers everything from a thirty-minute morning visit to help with washing and dressing through to a full-time carer who lives in the property and provides continuous, one-to-one support.
The principle behind all home care is the same: the person receiving support stays in familiar surroundings, keeps their daily routines and retains as much independence as possible. For many families this is more comfortable, more personal and often more affordable than a move into residential care.
Home care in London is regulated by the Care Quality Commission. Any agency providing care directly must be CQC registered and inspected. Introductory platforms that match families with self-employed carers are not CQC regulated, so if regulatory oversight matters to you it is important to understand which model you are using.
Types of Home Care Available in London
London families can access a wide range of care types. The right choice depends on how many hours of support are needed, the complexity of any medical conditions and whether the person needs someone there all the time or only at certain points during the day.
Hourly Visiting Care
This is the most common and flexible form of home care. A trained carer visits at agreed times, helps with whatever is needed and leaves until the next visit. Sessions can last anywhere from thirty minutes to several hours, and many families start with just one or two visits a day before adding more as needs change.
Typical tasks include personal care such as bathing, showering, dressing, grooming and toileting, medication support including reminders, administering doses and keeping records for the GP, meal preparation, light housekeeping, laundry, shopping and general domestic help, in addition to companionship, conversation, accompanied walks and social outings.
Hourly care suits people who are broadly independent but need targeted help at specific times of day. Our guide to hourly home care in London covers this in full detail, including a breakdown of agency versus platform pricing.
Live-In Care
With live-in care, a professional carer moves into the person’s home and provides continuous support throughout the day. The carer handles personal care, meals, housekeeping, medication and companionship as part of one consistent arrangement. Live-in care is the closest alternative to a care home while keeping the person in their own environment.
Live-in carers are entitled to rest periods and sleep during the night. If the person needs active supervision overnight, a separate night carer or a rotating team is arranged alongside. Temporary live-in care is also available for short-term needs, such as recovery after a hospital stay or to cover a family carer’s holiday.
For a full breakdown of what live-in care includes, how to prepare the home and what it costs in London, see our guide to live-in care in London.
Overnight Care
Overnight care provides support during the hours when many people are most vulnerable. There are two main types; sleeping night care and waking night care. In sleeping night care, the carer stays in the home and sleeps but is on hand to help if the person wakes, falls or becomes distressed. However in waking night care, the carer stays fully awake throughout the night and provides active, continuous monitoring. This is more common where there is a risk of wandering, seizures or clinical needs that require attention through the night.
Overnight care can be combined with daytime hourly visits or live-in care depending on the level of support required. Our guide to overnight care in London explains the differences in more detail.
Respite Care
Respite care is temporary support designed to give a primary carer, usually a family member, a break. It can last from a few days to several weeks and is delivered by a professional who steps in and follows the existing care routine as closely as possible.
Respite care is available as hourly visits, overnight support or temporary live-in arrangements. Emergency respite can often be arranged at short notice when a family carer falls ill or faces an unexpected commitment. Read more in our guide to respite care in London.
Companionship Care
Companionship care focuses on social and emotional wellbeing rather than clinical or personal care tasks. A companion visits regularly to share conversation, enjoy activities together, accompany the person on outings and provide gentle encouragement to stay active and engaged.
This type of care is well suited to older adults who are physically capable but at risk of loneliness and isolation, which are significant health concerns in London where many elderly people live alone. Our guide to companionship care for the elderly in London explains what companionship care includes and how to arrange it.
Dementia and Alzheimer’s Care
Dementia care at home requires specialist training. Carers who support people living with Alzheimer’s disease, vascular dementia or other forms of cognitive decline are trained to manage behavioural changes, reduce confusion, maintain safe routines and communicate in ways that minimise distress.
Dementia care can be delivered through hourly visits, overnight support or full live-in arrangements depending on the stage of the condition. Families exploring this option will find detailed guidance in our guide to live-in dementia care in London.
Palliative and End-of-Life Care
Palliative care at home supports people managing a terminal illness and focuses on comfort, pain management and quality of life. It is coordinated closely with district nurses, GPs and hospital teams and often involves intensive scheduling or a live-in carer arrangement.
This type of care allows the person to spend their remaining time at home, surrounded by family, rather than in a clinical setting. Specialist palliative carers are trained in symptom management, emotional support and working alongside NHS clinical teams.
How Much Does Home Care Cost in London?
London is consistently the most expensive region in the UK for home care because of higher carer wages, the London Living Wage and greater agency operating costs. The table below summarises typical costs across the main care types.
| Type of Care | Typical London Cost | Best Suited For |
| Hourly visiting care | £25 to £40 per hour | Help with specific daily tasks at set times, personal care, medication, meals |
| Live-in care (standard) | £1,200 to £1,600 per week | Round-the-clock support for someone who wants to stay at home |
| Live-in care (specialist) | £1,500 to £2,000+ per week | Advanced dementia, Parkinson’s, palliative care or complex medical needs |
| Overnight sleeping care | £150 to £210 per night | Reassurance and on-hand help during the night |
| Overnight waking care | £200 to £260 per night | Active monitoring, frequent night-time support or clinical needs |
| Respite care | Varies by format | Temporary support while a family carer takes a break |
| Companionship care | £25 to £35 per hour | Social visits, outings and emotional wellbeing for those at risk of isolation |
These figures are guides based on current London market rates. The actual cost for your family will depend on the borough, the complexity of care needs, the time of day and whether you choose a managed agency or an introductory platform.
Managed Agency or Introductory Platform?
A managed agency employs carers directly, handles payroll, recruitment, DBS checks, training and supervision. If a carer is ill or on holiday, the agency arranges replacement cover. This is the more expensive option but it removes the administrative burden from the family.
An introductory platform connects you with self-employed carers at a lower rate, but you take on responsibility for scheduling, contracts, tax, insurance and backup cover. This route suits families who want more control over who provides care and can manage the day-to-day logistics.
If the person has complex or changing medical needs, or if the family lives far away, a managed agency generally offers more security. For straightforward companionship or light domestic support, a platform can work well and save a meaningful amount each week.
What Affects the Cost of Home Care in London?
Several factors push costs higher or lower within the ranges above. These include care complexity, number of carers, time of day, location within London and hours per week. In terms of care complexity, specialist conditions such as advanced dementia, Parkinson’s, catheter management or palliative care require trained carers and command higher rates. Also, if the person needs two carers for safe care provision, for example using a hoist as part of mobility transfers, the hourly cost effectively doubles.
In addition, bank holiday visits, late-evening calls and weekend care typically carry a premium surcharge. Furthermore, Central London boroughs tend to be more expensive than outer boroughs because of higher travel costs and the London Living Wage.
It is also important to note that once daily care exceeds five or six hours, live-in care often becomes more cost-effective than paying an hourly rate for each visit.
How to Fund Home Care in London
There are four main routes to funding home care. Many families use a combination; these include self-funding, local authority support, NHS Continuing Healthcare and Attendance Allowance.
If the person’s capital and savings exceed 23,250 pounds, they are expected to pay for their own care. Crucially, when care is provided at home the value of the family property is not included in the financial assessment. This is a significant difference compared to residential care, where the home’s value may be counted. If your savings fall below the 23,250 pound threshold, your London borough council may fund some or all of the care (local authority support). Between 14,250 and 23,250 pounds, the council pays a partial contribution. Below 14,250 the council provides maximum funding. The process starts with a free Care Needs Assessment followed by a financial assessment.
If the care need is primarily health-related, for example following a stroke or because of a complex neurological condition, the NHS may fund the entire package regardless of personal wealth (NHS Continuing Healthcare). Eligibility is determined by a clinical assessment carried out by a multidisciplinary team. Finally, Attendance Allowance is a non-means-tested government benefit for people over State Pension age who need help with daily living. The higher rate currently provides up to 114.10 pounds per week, which can be put directly towards care costs. You do not need to have paid National Insurance to qualify. Even if you are self-funding, it is worth requesting a Care Needs Assessment from your local council. The assessment is free, creates a formal record of the person’s needs and may identify support you were not aware of.
How to Get Started with Home Care in London
Taking the first step can feel daunting, but the process is straightforward when broken into stages. Firstly, assess the situation at home. Before contacting anyone, spend time noting the tasks the person struggles with, the times of day they need most help, any medical conditions or diagnoses, and how much support family members are currently providing. This forms the basis of every conversation you will have with providers and councils. Second, request a council Care Needs Assessment. Contact the adult social services department of the person’s London borough. The assessment is free and available to everyone regardless of financial circumstances. A social worker or assessor will evaluate daily living needs, mobility, safety and cognitive function. If the person is found to have eligible needs, the council must arrange or help fund a care plan.
Thirdly, decide between council-arranged and private care. If the person qualifies for council funding, the local authority can arrange care or provide a personal budget so the family can choose their own provider. If the person is self-funding, they can go directly to the private market. Many families who are self-funding still benefit from having a completed needs assessment on record. Fourthly, research and shortlist providers. Look for agencies that operate in your London borough. Check their CQC rating and read their most recent inspection report. Ask friends, neighbours or the person’s GP for recommendations. If you are considering a platform, verify that the carers listed have current DBS clearance and professional references.
The fifth step is to ask the right questions. When you contact a provider, ask how they match carers to clients, what training carers receive, what happens if a carer is ill or on holiday, whether they carry out regular care plan reviews and whether there is a minimum commitment period. In addition, arrange a home consultation. Any reputable agency will offer a free home visit before care begins. A care manager will meet the person, assess the home environment, discuss preferences and routines and produce a written care plan that everyone agrees on. Finally, confirm the care plan and start date. Once you are satisfied with the provider and the care plan, agree on the start date, confirm costs in writing and ensure you understand the cancellation and complaints process. A good provider will carry out an introductory visit so the person can meet their carer before the arrangement formally begins.
How to Choose the Right Type of Home Care
Matching the right type of care to the person’s needs is the most important decision in this process. If they need help at specific times of day (morning wash, lunchtime meal, evening medication), hourly visiting care is likely the right fit; if they need someone there around the clock but want to stay at home, live-in care is more appropriate.
If they wake frequently at night, fall or need night-time medication, overnight care is the most appropriate call of action; if a family carer needs a break, respite care is most suitable. In addition, if they are independent but lonely, companionship care is suitable; furthermore, if they have dementia or Alzheimer’s, specialist dementia care is most appropriate.
Many families start with a lighter level of support and increase it over time as needs change. Starting early gives the person time to build a relationship with their carer and adjust gradually rather than in a crisis.
Signs a Loved One May Need Home Care
It is not always obvious when the time is right. The following signs often prompt families to explore professional support. These can include missed meals, weight loss or a fridge full of expired food, difficulty getting in and out of the bath or shower safely, medication left untaken or taken at the wrong times, increasing isolation, low mood or reluctance to leave the house, a noticeable decline in personal hygiene or the cleanliness of the home, a recent fall, hospital admission or new diagnosis that has changed daily abilities, and/or family carers feeling exhausted, overwhelmed or unable to cope.
Any one of these may not be cause for alarm on its own, but if several apply at the same time it is worth having a conversation about what support might help.
About Tidal Living
Tidal Living is a London-based specialist home care provider offering hourly home care, live-in care, overnight support, respite care, companionship care and dedicated dementia care across London boroughs. Every care plan is built around the individual and delivered by trained, DBS-checked carers who understand what families are going through.
If you are exploring home care in London and are not sure where to start, we are happy to talk through your options. Visit tidalliving.co.uk or call us for a free, no-obligation conversation about the right level of care for your family.
Frequently Asked Questions
Is home care cheaper than a care home?
It depends on how many hours of support are needed. A residential care home in London typically costs between 1,200 and 1,800 pounds per week. Hourly visiting care of a few hours a day is significantly less expensive. Live-in care is comparable in cost but the person stays at home. For couples, live-in care is often considerably cheaper because one carer can support two people at the same address.
How quickly can home care be arranged?
Most managed agencies can start care within five to ten working days of a home consultation. Emergency or urgent packages, for example after a hospital discharge, can sometimes be arranged within 24 to 48 hours.
Will I get the same carer every time?
Managed agencies aim to provide a small, consistent team so that the person builds familiarity and trust. If you use an introductory platform, you choose a specific carer directly, but arranging cover for holidays or sickness is your responsibility.
What if our needs change over time?
A good care provider will review the care plan regularly and adjust the level of support as needs change. You can increase visits, add overnight care, move from hourly to live-in or reduce hours if the person’s condition improves. Flexibility is one of the main advantages of home care over residential alternatives.
Do I need to provide anything for a live-in carer?
Yes. You must provide the carer with a clean, private bedroom, access to a bathroom, Wi-Fi and meals. Live-in carers are legally entitled to at least 14 hours of rest per week. If the person needs supervision during these breaks, separate hourly care or overnight care can be arranged to cover those periods.
How do I check if an agency is safe?
Search for the agency on the Care Quality Commission website. Every registered provider has a public inspection report and an overall rating of Outstanding, Good, Requires Improvement or Inadequate. Look for agencies rated Good or Outstanding. If you are hiring a carer privately through a platform, ask to see their current Enhanced DBS certificate and at least two professional references.
