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Anybody had any experiences of getting live-in care for the elderly (elderly previously coping in their own home but now needing live-in care to manage). I seem to now be facing the possibility of needing to find some and I can find some agencies but I've no idea what to look for, what pitfalls to avoid, etc.

I see many challenges that I've no idea about how to deal with e.g. finding a reputable agency, how to ease the strain/shock for those being cared for (must be terrible strain given they previously lived and managed and now have some stranger living in their home on whom there are totally dependent, some stranger helping with intimate things ...), etc.

Seems so easy to get it "wrong" so any thoughts or experiences very welcome (or by PM is better).

Many thanks
Ian

not much to add but my sister arranged things when my father became frail due to parkinsons, so he had meals delivered thru a local service ( basic not very nice ones though ) and his bed was moved to the ground floor so he didnt have to go upstairs too often, as he kept falling over. Also the local nurse would visit as he had a catheter.

Psamathe wrote: e.g. finding a reputable agency,

CQC (Care Quality Commission) lists all registered domestic care (ie personal care at home) agencies (in England), inspects and reports (all reports available on line) It is an offence for a domestic care agency offering personal care not to be registered with CQC. Individuals providing personal care do not need to be registered but all organisation for their attendance/employment must be organised by the person/relative/household requiring the care

Well it is expensive relative to residential homes as you are paying for at least two people working on a shift system. There are rules about how long they can work for and times they have off. The house really needs a self contained or at least a bedroom that they have sole possession of. There are also rules regarding driving and insurance issues. We looked into it for a dementia situation but in the end it wouldn’t work for our situation.

my sister came back with these people to contact --

"He can get help from his local social services or maybe speak to Age
Concern. He may be able to get financial help as well so its always
useful to have an assessment from social care. He could go through the
quality care commission for advice as well.

There's recently been a successful back-dated pay claim for people whose duties include "sleeping nights." This is the system whereby some of the night staff in some care homes sleep but are available, if necessary, get up and work. I didn't look at it too closely, but the backdating has cost some organisations a lot of money. I suspect that live-in care must involve sleeping nights. ie, put the client to bed, eventually the carer goes to bed but is available as necessary and then gets client up in the morning etc. If the carers are agency staff, I could imagine that just at present, agencies are having to readjust their fees to cover paying more for night shifts.

Many thanks for all the input. On top of the practicalities, making decisions even harder are the emotional aspects as well as knowing whether live-in care is adequate or if a care home is the right answer.

Ian

As a Community Nurse I've seen a few clients do this & would say it can be a good option. Obviously there's more cost involved than Carers visiting 2-4 times daily, but the Care provided is going to be more comprehensive. It looks from your post as this for an elderly couple, rather than an individual, in which case it becomes more cost effective + if it works no need sell a property to pay Residential of Nursing Home fees.

Using an agency will ensure the Carers are competent and vetted, but I've seen people make private arrangements without obvious problems. AFAIK it is an area of employment that is exempt from sex discrimination rules so you can specify gender if you wish.

The live in Carers I've encountered mostly seem to be from overseas. I suspect the fact it's a weeks work in one go with board and lodging included makes it an attractive option for people without family commitments.

Other things to consider:

Social Services are obliged to complete an assessment of needs if you request it, but they well need nudging and prompting.
Ensure they are claiming benefits they are entitled to which may include attendance allowance, this may well offset some of the costs of Carers
If they have Nursing needs, and are housebound, Community Nurses will be able to assess and visit if required for things carers are not able to do.

You also mention the relatives adjusting to having Carers in their home. I agree with this, but I would also say families and the client have to be realistic and consider the alternatives. Too often people choose not to have Carers and the result can be injury, illness, hospital admissions and ending up in a Care Home. Often in life we have too choose the less preferred option to avoid the option we definitely don't want.

Hope this helps.

Psamathe wrote:Many thanks for all the input. On top of the practicalities, making decisions even harder are the emotional aspects as well as knowing whether live-in care is adequate or if a care home is the right answer.

Ian

1. Their GP &/or Community Nurse may well be able to provide a professional opinion on this.

2. If you try live in Carers and it doesn't work that leaves Care Home as the next option. It would be less practical/more complicated to do it the other way round although I have seen it done.

tod28 wrote:.............CQC (Care Quality Commission) lists all registered domestic care (ie personal care at home) agencies (in England), inspects and reports (all reports available on line) It is an offence for a domestic care agency offering personal care not to be registered with CQC. Individuals providing personal care do not need to be registered but all organisation for their attendance/employment must be organised by the person/relative/household requiring the care

I have only come across 2 people working for CQC......to say that they were stupid, arrogant, and hoplessly inept barely scratches the surface....**

Fact of the matter is that this is a 24/7 job 52 weeks of the year. The agency can't supervise the workers, the CQC can't supervise the agency.
We used to do a late shift, followed by a "sleep-over" (when you are still on call) followed by an early shift next day, when you could still be called upon to drive the mini-bus.
How good is that?
That's in a staffed house with multiple service users/multiple staff. In a private house, the one member of staff in attendance can't go home until somebody shows up to relieve them.

**One of these women put her lunch in the fridge. In a house with multiple residents, each resident has a shelf in the fridge. She picked the shelf belonging to a resident with a head injury and terribly bad short-term memory........so he ate it. He didn't remember buying it, but then he didn't remember buying stuff he had actually bought, anyway. How we laughed!

Vitara wrote:

Psamathe wrote:Many thanks for all the input. On top of the practicalities, making decisions even harder are the emotional aspects as well as knowing whether live-in care is adequate or if a care home is the right answer.

Ian

1. Their GP &/or Community Nurse may well be able to provide a professional opinion on this.

2. If you try live in Carers and it doesn't work that leaves Care Home as the next option. It would be less practical/more complicated to do it the other way round although I have seen it done.

Many thanks (all posts).

The degree of challenges has (probably unusually) meant that all the family (other than those needing the care) agree it's time for professionals but we're all unsure whether live-in or Care Home. I'm inclined to start with live-in as we have several local family friends who already call in several times a week (and would happily do more) who are more than happy to report progress and/or problems. I'm also assuming that a professional carer would feedback if the support required was beyond that manageable by a live-in carer.

We were originally thinking of visiting care 4 times a day but there is not always a lot of "common sense" when left alone so we've all pretty well rejected that path (plus the additional complexity of many different carers, backup for when one is sick, etc..

Interesting about the live-in->Care Home is easier than Care Home->live-in as we'd been thinking of the Care Home as "respite" that would likely become long term.

Many thanks.
Ian

If you employ a live in carer you may have to also provide a workplace pension. I don't know the rules but you will need to check.

531colin wrote:CQC can't supervise the agency.

Their role is not to supervise the agencies - that is for the providers (of the agencies). CQC are regulators - checking whether health and social care services comply with the Health & Social Care Act etc.

I'd recommend treating anything from the Care Quality Commission with circumspection on something so important to you as the well-being of members of your family.

rjb wrote:If you employ a live in carer you may have to also provide a workplace pension. I don't know the rules but you will need to check.

If you become the "employer" you take responsibility for annual leave, sick pay and all the rest.