Home care costs
Hourly rates for managed domiciliary care range from around £20 to £35 per hour depending on location, with London and the South East at the higher end. Minimum visit lengths are typically 30 or 60 minutes — agencies that offer 15-minute visits are meeting a commissioning requirement, not a care standard. Weekend and bank holiday rates are usually higher. Live-out overnight care (a waking night) typically costs £100–£180 per night.
Care home and nursing home costs
Residential care home fees range from approximately £700 to £1,500 per week, varying significantly by region and whether the home is operated by a charity, local authority, or private company. Nursing homes, which provide on-site nursing, typically cost £900–£1,800 per week. These figures are weekly, not monthly. Check carefully what is included: some homes charge separately for incontinence products, hairdressing, or activities. Ask for a full written statement of what the fee covers before signing any agreement.
Live-in care costs
Live-in care through a managed agency typically costs £900–£1,400 per week for one person. For couples, the additional cost is lower because the carer is already present. This makes live-in care cost-competitive with residential care for couples in particular. Through an introductory agency or direct hire the cost is lower but employment responsibilities and oversight fall to the family.
Family carer and direct hire costs
Direct hire of a carer typically costs £12–£18 per hour plus employment on-costs — employer National Insurance (13.8% on earnings above the secondary threshold), pension contributions, and holiday pay equivalent. Families who employ carers directly must also hold employer liability insurance. The gross cost is lower than a managed agency per hour but the administration burden is real and the risk profile is different.
Funding and financial assessment
Local authority funding is available for people with eligible care needs and assets below the upper capital limit (currently £23,250 in England — check gov.uk for the current figure as this can change). A care needs assessment from the local authority is the starting point. This is free and anyone can request one. A financial assessment follows if needs are found to be eligible. People with assets above the threshold pay for their own care — this is called self-funding.
NHS Continuing Healthcare (CHC) is fully funded by the NHS for people whose primary need is health-related rather than social care. It is assessed using a specific framework and is separate from local authority funding. Many families are not aware of CHC or do not pursue an assessment. If the person needing care has significant and complex health needs, ask the GP or hospital discharge team about CHC eligibility explicitly.
What to ask
Before committing to any care arrangement, ask: What is included in the weekly or hourly fee? What is charged as an extra? What happens to fees if care needs increase? What is the notice period in the contract? For care homes: what is the policy if funding is exhausted? For agencies: what is the minimum weekly hour commitment?