There are a myriad of live-in care models of care, and hundreds of care companies providing carers who are very happy to live with their clients -it’s a competitive business – particularly since the doors were opened for sponsorship from Commonwealth countries. To help you make an informed choice about which sort of company to choose, the following chapter gives you some insight into how the live-in care sector works.
Carers on Sponsorship
Since Brexit, the care sector has been allowed to make up the deficit of live-in carers by bringing in sponsored carers from the Commonwealth on special (but expensive ) visas. The companies are supposed to have allocated work for them and once settled, they can bring in their families who will have full settlement status in the UK. This led to a huge increase of carers coming into the sector. However, a loop hole in the law emerged whereby the carers were forced to work on less than the living wage as they paid back the cost of their visa to their employer plus a recruitment fee– The care companies had such a huge choice of carers that many (not all of course) kept their costs very low by paying their carers equally low wages on account of the supposed reimbursement of costs. They are some cases of modern slavery allegations in this regard going through the courts.
As of April 2024, the number of sponsored carers will significantly reduce as the planned stop to immigration of families to sponsored people comes into force.
Self Employed Carers
Companies that provide self-employed carers are not required by law to be regulated by CQC. There are many self-employed carers who prefer not to work for regulated companies and who join the many carer data bases and their agencies. This may work well if there is another person living in the house who can keep an eye on the carer. It is a real risk however when the older person is vulnerable and living on their own- there are no checks on whether the care delivered is safe and acceptable. A note here is that care is not a simple sitting type activity – it is complex and requires special training and constant quality checks for competency. The self-employed carer is only answerable to him/herself.
These agencies have large numbers (1000s) of carers on their books- they cannot possibly know them all irrespective of whether the carer provides a video or not. Because of the huge numbers, they tend to work just a few (2-3) weeks on and one week off in order spread the workload to as many carers as possible. There is little opportunity to get to know your carer and to have any consistency in named carer. The carer will arrive at your loved one’s house, never having met anyone from the company nor having been though any selection process.
Cost may seem lower at first sight – but there will be a number of add-ons – for example – extra for driver/carers, extra if the carer gets up at night, plus weekly agency fees.
CQC regulated managed care.
This may seem very biased, but I can’t stress loudly enough how important it is to have a CQC regulated company provide care for any vulnerable loved one living on their own. As a live-in care company owner, I am very tempted to set up a data base of self-employed carers – it is a much less costly option than providing managed care where we are required to employ a registered manager and field supervisors, plus a quality control expert. However, we will continue to provide regulated, managed care as our reputation is built on word of mouth. We select and employ all of our carers. We do not have a huge data base of unknown carers – our carer bank consists of people whom we know and trust and who have usually worked for us for many years. The new carers are trained by Arbour Care in our own training facility in Bagshot and quality checked before we allow them to live with clients on their own.
Managed care means that:
- A comprehensive care plan with a full suite of risk assessments is in place, based on a needs assessment agreed with the client and which is continually updated.
- Daily goals and tasks are defined and progress towards these goals are monitored and reported on.
- Quality standards in care provision, as detailed by CQC, are strictly followed and demonstrated.
- Care plan required activity is recorded and updated throughout the day and should be available to clients and their loved ones in real time.
- Any deviation from meeting the required standards is reported directly to CQC and or social services who will follow up with a thorough investigation.
- Carers have UK employment protection rights and are more likely to be properly supported by their company, especially in terms of their health and wellbeing. A tired carer is certainly not a competent carer.
- The training is provided by fully qualified trainer and will be to at least to NVQ 2 standard. Cares undertake continual assessment for competency.
Arbour Care has recently received the testimonial below from Mr A from Esher, an ex BP oil senior executive. We cared for his wife over a period of 6 years. He is happy to talk with prospective new clients of Arbour Care.
Arbour provided live-in carers for my wife for six years from 2017 to 2023 which included the Covid pandemic. My main impression is of a very professional organisation in which owners and staff worked all the time to provide the support the client needed at as high a standard as possible. They gave equal attention to statutory requirements, care plans and staff training and never cut any corners. They are well aware of the difference between carers who are just there to do a job and those who identify with the client. Their fees are a fair reflection of the service they give, the staff are all very pleasant to deal with and I would recommend them to anyone in need of assistance.
Christina Sell December 2023.
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