A live-in carer lives in your relative’s home and provides personal care, meals, medication support, household help and company, in line with a written care plan. They are there through the day and available at night, but they are not working every minute. Their duties are agreed in advance, and that agreement matters more than any general list.
This guide explains what is normally included, what is not, how breaks work and what to settle before anyone moves in.
The job is built around the routine of the person receiving care. Most days follow a pattern like this, though the detail changes from home to home.
Morning. Helping the person wake, wash, use the toilet, dress and groom. Preparing breakfast, prompting or assisting with morning medication where the plan allows, and tidying the bedroom.
Midday. Cooking lunch, supporting eating and drinking, light cleaning, laundry, and any shopping or errands. This is also when appointments, walks, social visits or hobbies tend to happen.
Afternoon. Companionship, activities, a rest period for both people, and perhaps a few phone calls to family or professionals.
Evening. Preparing dinner, helping the person get ready for bed, evening medication support, and settling them for the night.
Night. Being in the house and available if the person needs help. Some people sleep through. Others need turning, toileting or reassurance, and that changes the package (more on this below).
This mirrors what Skills for Care describes for care workers generally: supporting eating and drinking, social and physical activities, appointments and personal care. The difference with live-in care is that the same person does it all, consistently, in one home.
This is usually the core of the role. It covers washing, bathing or showering, dressing, oral hygiene, continence care, skin care and help getting in and out of bed or a chair. CQC defines personal care as care for someone who cannot manage it themselves because of old age, illness or disability, delivered where they live.
Good carers do this with the person, not to them. They offer choices, let the person do what they can and protect privacy. Our guide to personal care routines goes into the detail.
Planning, shopping for and cooking meals the person likes, following any dietary needs, and watching how much they eat and drink. A change in appetite or fluid intake is often the first sign that something is wrong, so carers are expected to notice and report it.
This is the area where families most often assume too much. Under Skills for Care’s medication guidance, support with medicines is only appropriate when it is part of the person’s role, written into the care plan, consented to and backed by suitable training. Records must be kept where they apply. Some tasks, such as certain creams, drops or injections, must not be done until the carer has completed the required training.
If you want a carer to remind or help with tablets, read our five checks before carers start medication reminders.
Light cleaning, washing up, laundry, changing the bed, taking out the rubbish and keeping the kitchen safe and tidy. The aim is a safe, comfortable home for the person receiving care. It is not a full housekeeping service for the whole family. We cover where that line sits in live-in carer boundaries.
Helping the person walk, transfer and move around the home safely, spotting trip hazards, and responding to falls. If a hoist or two-person transfer is needed, that must be assessed and planned. Read manual handling at home and what mobility support means for the basics.
Conversation, cards, music, gardening, short walks, church or community visits, keeping in touch with friends. This is not an extra. For someone who lives alone, a familiar person every day often makes the biggest difference to mood and confidence.
Going with the person to GP, hospital or dentist appointments, collecting prescriptions, shopping and posting letters. Whether the carer drives, uses the person’s car or uses public transport should be agreed beforehand, including insurance.
Carers keep daily notes and tell the agency or family about changes: a new bruise, a cough, confusion, poor sleep. Skills for Care notes that care workers may also monitor temperature, pulse, respiration and weight where their role and training allow.
When the person has dementia, the same tasks look different. The Skills for Care dementia resources describe the carer’s role shifting from prompting and reminding to giving more help with eating, washing, dressing and using the toilet as the condition progresses.
In practice a live-in carer for someone with dementia will also:
Safe dementia care depends on preparation more than goodwill. Skills for Care points to person profiles, detailed risk assessments, support plans, incident logs and clear escalation routes. The plan should record triggers, what calms the person and what to do in an emergency. Our guides to dementia personal care and dementia behaviour management help you prepare.
A clear “no” protects both the person and the carer. A live-in carer should not:
The HSE’s guidance on care in people’s own homes expects risks to be assessed, suitable equipment supplied and carers to be competent for higher-risk tasks. If a task is not in the plan, the answer is to review the plan, not to ask the carer to “just manage”. The 2025 Care Certificate standards also set out that workers must show competence before carrying out specified tasks.
Nursing tasks, such as wound care or injections, belong to a registered nurse or to a carer who has been formally trained and delegated the task. Ask the agency exactly how that works.
This is the question families raise most, and the answer is often not what they expect. Live-in care means the carer lives in the home and is available. It does not mean they work 24 hours without rest.
Public-sector commissioning documents show how this is handled. Surrey County Council’s home care specification describes live-in care as a full-time personal service and sets requirements for breaks and replacement cover. Suffolk’s home care schedules say off-duty periods should be agreed between the provider, the person receiving care and, where relevant, the social care practitioner. Your arrangement is private, so these are not rules that bind you, but they show what good practice looks like.
Before you sign, settle these points:
| Question | Why it matters |
|---|---|
| When is the daily break and who covers it? | The person may need someone present during that time. |
| Does the person need help at night? | Frequent night calls may mean a second carer or a waking-night arrangement. |
| Who covers days off and holidays? | A rota of carers swapping over should come with a proper handover. |
| Who can the carer call in an emergency? | Carers work with little immediate backup. |
| Is the person’s need for two carers ever likely? | Some transfers cannot be done safely by one person. |
We explain break rotas and handovers in our live-in carer break schedule guide. The carer also needs somewhere suitable to rest, covered in live-in carer room requirements.
A live-in carer’s duties should come from an assessment, not a template. CQC Regulation 9 requires care in England to be appropriate, meet the person’s needs and reflect their preferences. The person, and where appropriate their representative, should be involved in planning and review.
A sound plan will usually include:
If needs grow, the plan should be reviewed, not stretched. For more on tailoring care, see how to personalise home care and personalised care for independence.
Many families searching for hourly care tasks are weighing visits against live-in care. The tasks are largely the same. What differs is how often and how consistently they are delivered.
| Hourly visits | Live-in care | |
|---|---|---|
| Presence | Set times, often 30 to 60 minutes | Someone in the home day and night |
| Best for | Help with key parts of the day | Higher needs, dementia, night-time support, or avoiding a care home move |
| Continuity | Several carers may rotate | One main carer at a time |
| Night support | Not included unless arranged | Available, as agreed in the plan |
| Companionship | Limited by visit length | Part of daily life |
Some people start with visits and move to live-in care when needs rise. Others use live-in care for a short period, for example after hospital or to give a family carer a rest.
After more than 30 years supplying home care in London, we see the same pattern. Families rarely ask for too little. They ask for something vague, then discover in week two that nobody agreed who does the laundry, who covers the afternoon break or what happens at 3am.
Our advice is to write it down. A good duty list is specific, reflects how the person actually lives and says plainly what the carer will not do. It protects the person receiving care and the carer, who needs rest and clear limits to do the job well.
We also think the best test of any list is whether it supports independence, dignity and choice. If a task makes the person more passive without need, ask whether it belongs there. If it lets them keep doing things their own way, it probably does. All our carers are DBS checked and we are regulated by the CQC, but regulation is the floor. The care plan is what makes the care feel like theirs.
— Dan
We provide live-in care and call-in visits across London, along with dementia care, respite cover, palliative care, medication assistance and companionship. You can see the full range on our home care services page. We start with an assessment, build the duty list with you and the person receiving care, and review it as needs change. For a first read, download our free home care guide or contact us to talk through what your family needs.
A live-in carer helps with personal care, meals, medication support, light housework, mobility, appointments and companionship. They stay in the home and are available at night. Exactly what they do is set out in the person’s care plan.
They should not carry out moving, medication or healthcare tasks without the right training and a place in the care plan. They should not manage finances informally or do heavy household work for the wider family. If a task is not in the plan, the plan should be reviewed.
They live in the home, but are not on duty every hour. They need daily breaks and rest days, and the person’s needs during those times must be covered. Agree the break pattern and who provides cover before the package starts.
Only if it is part of their role, written in the care plan, consented to and supported by training. Records should be kept. Ask the agency how it handles this.
Usually a live-in carer is available at night, but frequent or physical night needs may require extra arrangements, such as a second carer. Tell the agency how often the person wakes and what help they need.
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