Why choose a private carer in London? The essential guide

What are the care challenges older people in London face? 

Older adults who live in London boroughs may face a combination ofcare challengesthat make accessing and arranging care more difficult than in other areas of the country. This is due to several factors, including:

High living costs and financial pressures 

Older people living in London may struggle to pay rent and bills due to the rising cost of living, or may be forced to move far from family members or their community to ease financial worries. Data from Age UK’s 2022/23 survey found that 22% of Londoners over the age of 50 were living in poverty, which is 4% higher than in the rest of England. With London care homes and nursing homes having some of the highest costs in the country, live-in care can be a much more affordable option for people who reside in the city.These financial pressures mean many older adults feel unable to pay for the care they need, but ironically, financial pressure can lead to increased anxiety and sleep issues, which can result in the need for more care due to ill health – a vicious cycle. Age UK’s survey found that many older Londoners say they are not receiving help to pay energy bills despite asking for this, and financial pressures sometimes force them to be a caregiver for a spouse or relative, or to return to work after pension age.In an Age UK 2024 poll, 91% of respondents said that they were worried about the cost of living, and this can impact the level of care they can afford. For those struggling with the cost of living in London, you may find advice on the London.gov website, but live-in care could be a surprisingly affordable option that many older adults choose due to the personalised service they receive.

Cultural diversity

There are a range of cultural backgrounds in London; the 2021 Census found London to be the most ethnically diverse region of England and Wales, with 46.2% of residents identifying with Asian, black, mixed or ‘other’ ethnic groups, and 17% with white ethnic minorities. This means many Londoners require a caregiver who respects their customs and beliefs, understands their dietary needs, speaks their language, and is sensitive to their preferences. With home care arranged through the local council, you will be assigned a caregiver, so it is not always guaranteed that older adults will be matched with a professional carer who understands these needs – this can cause substandard care in some cases. Private care offers more flexibility, and often goes the extra mile to ensure clients are paired with a caregiver they trust. For example, at Home Instead we take time to match each client with a carer who not only understands their health needs, but who complements their personality.

A fast-paced lifestyle

An estimated 7.8% of London residents provide some amount of unpaid care, according to 2021 data, with 3.8% providing 19 hours of unpaid care per week or less, and 2.3% providing 50 hours of unpaid care or more per week. In addition, 1 in 10 survey respondents said they had caring responsibilities that “significantly impacted their finances”.In London, arranging care may not be easy due to busy work schedules in the city. For this reason, professional caregivers must be more flexible and adaptable in order to offer care outside of typical hours.

Isolation

Despite London’s busyness and fast-paced nature, it can be a lonely city. A 2022 report from the Campaign to End Loneliness found that 1 in 12 Londoners (around 700,000 people) said that from 2018 to 2019, they were severely lonely, with 61% identifying as single and living alone, and 41% identifying as long-term disabled. Isolation affects older adults at a disproportionate rate throughout the country, but this could be more of a problem in London, leading to a need for more companionship care offerings. You can read more about loneliness in older people in our guide to signs of loneliness in the elderly.

Inability to make home adaptations

Older Londoners with financial worries may find it difficult to make the necessary adaptations to their home, which can make a significant difference to their quality of life, particularly if they live with reduced mobility or another health issue. Research has found those aged 75 and up were more likely to report issues with the affordability of home repairs and adaptations, and an increased need for this may mean council-funded adaptations take longer to implement. You can read more about what might be required in our guide to home adaptations for disabled elderly people.It is important to keep in mind that London is made up of many boroughs where older adults might have different experiences with health and social care. You can find your borough council by visiting the gov.uk ‘Find your local council’ website page, or find each London borough council’s health and social care website below: Barking and Dagenham – Barnet – Bexley – Brent – Bromley – Camden – City of London – Croydon – Ealing – Enfield – Greenwich – Hackney – Hammersmith and Fulham – Haringey – Harrow – Havering – Hillingdon – Hounslow – Islington – Kensington and Chelsea – Kingston upon Thames – Lambeth – Lewisham – Merton – Newham – Redbridge – Richmond upon Thames – Southwark – Sutton – Tower Hamlets – Waltham Forest – Wandsworth – Westminster

What do private carers do?

Private carers can provide either visiting care or live-in care for older adults in London who need support to live safely and comfortably in their own home. The job of a caregiver differs depending on the individual health and care needs of an older person, but might include:

• Assistance with daily tasks like personal care (getting washed and dressed) and meal preparation
• Managing medications
• Helping with housekeeping 
• Providing specialist support for conditions like dementia or Parkinson’s disease
• Running errands in the local area – in London this might be more difficult for older people, so carers can take on this strenuous and sometimes stressful task
• Assistance with transport to and from appointments or social engagements – in London this might involve navigating busy public transport or booking taxis 
• Companionship to avoid loneliness and support emotional wellbeing 
• Acting as an advocate at GP and hospital appointments by ensuring their best interests during treatments, and taking notes to help older adults fully understand their health needs
• Help support and facilitate home adaptations for London properties that are more challenging to adapt than others, such as small flats – the Mayor of London has set out a plan with goals that include providing more accessible and adaptable homes
• Arranging and helping with outings in the local area to support their wellbeing, such as visits to London museums like The British Museum or the Natural History Museum, or to green spaces like Hyde Park or Kensington Gardens

What is private care in London likely to cost?

With the cost of living issues older adults in London face, the cost of care may be a worry for them; research found Londoners over 50 living in social housing are more likely to live in poverty than other people their age in other types of housing.Care fees in London are typically more than elsewhere in the UK due to the higher living expenses, and care homes and nursing homes are often the more expensive option. For example, the average UK care home fee is around £1,266 per week, while the average care home fee in London is £1,545 per week. Similarly, the average UK nursing home fee is £1,529 per week, while the average nursing home fee in London is £1,800 per week. The cost of home care depends on the services you need and how often you need them, but at Home Instead, the average hourly rate in central London is around £45 per hour, and live-in care rates are around £1,800 per week. The benefit of paying higher prices in London for hourly care or live-in care is that families will only pay for the hours of care they actually require, rather than moving into a 24/7 care facility where you might be paying full-time rates for services you may not need. You can learn more in our guide to live-in care vs nursing and care homes.Private care is typically paid for by the individual or their family, but keep in mind there are funding options available, as some older adults will be eligible for support through their local authority, NHS Continuing Healthcare, or benefits. A Care Needs Assessment will help to ascertain what care is needed and what funding might be available for this. At Home Instead we are always upfront about our cost structure and remain fully transparent to ensure you get care that fits within your budget, so you never need to worry about hidden costs. You can read more in our guides to the cost of home care and paying for care.

How can I choose the best private care for my loved one? 

In a busy city like London, we understand that families want to ensure their older loved ones are safe and comfortable in their home, and able to get around as needed. Choosing an appropriate private care arrangement can feel like a big decision, so we are always happy to help you with your research by answering any and all questions you might have. Some of the questions you may wish to ask when finding a private caregiver include:

• What type of care does my loved one need? (If you are unsure about this, a Care Needs Assessment can help, or speak to our friendly team)
• Do they have any specialist needs (such as dementia care) and can the care agency provide this?
• What training and experience do the carers have? 
• Will my loved one receive continuity of care with the same care team? 
• How will their care be monitored and reviewed? 
• What support is available should we need it? 
• How easy is it to adapt care to my loved one’s changing needs?

Private carers can be found through managed live-in providers like Home Instead, or through introductory agencies. Introduction agencies can be more affordable for some people, but it is important to keep in mind that while this type of agency could find an appropriate carer for your needs and set up their employment with you, they may not be registered with the Care Quality Commission (CQC), and will not be involved in the ongoing care. If you use this service, you may still be required to arrange and manage your carer’s daily tasks, workload and payment from the moment they are employed with you, with little or no ongoing support. For this reason, many people find managed live-in providers to be a better fit as they can help with the ongoing care arrangements, including finding respite care if a usual carer is off for any reason. Managed live-in providers like Home Instead typically do all of the background checks and initial work needed to ensure the person you are bringing into your home can offer the highest possible level of care, and cover all of your needs. We would advise against hiring a carer privately without the help of an agency, but if you do decide to do this, watch out for red flags such as:

• Unclear pricing that could lead to hidden costs 
• A lack of personalisation in the Care Plan
• A high turnover of care staff
• Poor communication
• NoDBS check (a basic check of someone’s criminal record) 
• Being vague about qualifications or training (always double check what they have listed is a real qualification) 
• Negative reviews online
• Not being registered with the Care Quality Commission (CQC)

A reputable care provider will always listen to your needs, ask questions, and take the time to match you with the caregiver who best fits your circumstances, care needs and personal priorities. Don’t be afraid to ask questions if you have concerns about care in London. At Home Instead, our Care Professionals have local London knowledge to help you navigate transport and access specialist services available in each borough. We can also help you find the best London hospitals for any care needs or emergency services, and if ever your regular caregiver is absent, we arrange prompt and reliable respite care in London to make sure you always have someone nearby. If you need to arrange private care quickly in London, we often secure this for clients in as little as 24 hours to make implementing a care routine for yourself or a loved one in London simple and efficient. Our experienced, supportive Care Professionals can provide the help needed within an older person’s own home, where they feel safe and at ease. For support in London, reach out to your local Home Instead office to discuss your options.We’re an award-winning home care provider and part of a worldwide organisation devoted to providing the highest-quality relationship-led care for older people in their own homes. Arranging care for yourself or your loved one shouldn’t be stressful, so whatever questions you would like answered, feel free to reach out to the Home Instead team to discuss your needs.