Overnight care at home: sleeping, waking or live-in?

There are five main options for overnight care at home. A sleeping night carer can be woken. A waking night carer stays up all night. A live-in carer can help with an occasional call. Telecare alarms and sensors call for help. A night sitter lets a family carer sleep. Which one fits depends on how often your parent needs help at night and what kind of help it is. A two-week record of their nights usually settles it.

What are the options for overnight care at home?

The NHS says paid care at home can mean help "for only an hour a week or for several hours a day, or at night". Most night-time arrangements are one of the options below, or two of them used together.

How much does overnight care cost?

No official or standard price for a night of care is published. Each agency sets its own price per night or shift, and we give ours only after a free home assessment. The NHS says that if you are paying for yourself, an agency should be able to give you a clear price list, and suggests asking which services are charged as extras.

The one fixed figure is the legal floor for the carer's pay. From 1 April 2026, the National Living Wage for workers aged 21 and over is £12.71 an hour (2026/27), and GOV.UK lists £13.21 from 1 April 2027. That is background, not a price: it is the least a carer can be paid for each hour that counts as work, and it is not what an agency charges you.

These are the things that move the price:

• Sleeping or waking. A waking night is paid as a full working shift, a sleeping night is not. The next section explains why.
• Night-time pay. The Homecare Association publishes a minimum price for homecare each year. Its 2026/27 price leaves out "any enhancements for unsocial hours working", so a daytime hourly rate is no guide to what a night costs.
• One carer or two. If your parent needs two people to move them safely, two carers have to be there for the night.
• How often the carer is woken. If a sleeping night turns into regular broken nights, expect the agency to suggest a waking night instead.

Compare written quotes, not figures from adverts, and ask what would make the price change. To help pay, look at Attendance Allowance, council funding after a needs assessment, and NHS continuing healthcare. All three are covered under "Who pays for overnight care?" below.

Sleeping night or waking night: what is the difference?

A sleeping night carer arrives in the evening and helps your parent get ready for bed. They then sleep in a bedroom of their own and help if called. A waking night carer stays up all night. They check on your parent, help with the toilet or with turning in bed, and are there straight away if your parent gets up.

Why sleeping nights cost less

The government's minimum wage guidance covers sleep-in shifts in the care sector. It follows the Supreme Court judgment of 19 March 2021 in Royal Mencap Society v Tomlinson-Blake. Sleep-in workers given suitable sleeping facilities are entitled to the minimum wage only for the time they are "awake for the purposes of working". Time when they are allowed to sleep does not count.

The same guidance says that if a worker is expected to be busy for most of the shift, and can only nap between tasks, the minimum wage is likely to be due for the whole shift. A waking night is paid as a full working shift, which is one reason it costs more.

What happens if the carer is woken a lot?

This is the question to settle before you sign anything. A sleeping night only works if the carer actually sleeps. If your parent's needs grow and the carer is up again and again, the arrangement has become a waking night in practice. Ask each agency:

• How many times can the carer be woken before they suggest a waking night instead?
• Do they record each time the carer gets up, and will they show you those records?
• Will the price change, and how much notice will they give?

Get the answers in writing.

Can a live-in carer help at night?

Yes, with an occasional call. A live-in carer has their own room and sleeps in the home, so they are close by if your parent needs the toilet at 3am or wakes up frightened. They are not employed to be up all night as well as all day. Like other workers, they are entitled to rest. The government's rest-breaks guidance gives workers a right to 11 hours' rest between working days, although there are exceptions.

So the honest test is how often the nights are broken. Occasional waking is the exception a live-in carer can cover. Regular broken nights mean the carer is not getting the rest they need, and is soon too tired to work safely the next day. If your parent needs help most nights, you need a separate night carer as well, or a different setting. Our page on 24-hour care at home in London explains what round-the-clock live-in care does and does not cover, and our guide to live-in care vs a care home covers the wider decision.

Live-in care also needs a spare bedroom. In a London flat without one, live-in care is not possible. A waking night carer does not need a bedroom, because they stay up.

Where does telecare fit in?

Telecare is the name for alarms and sensors that alert someone when there is a problem. The NHS lists the main kinds:

• Personal alarms, worn on the wrist or round the neck, or a pull cord, which call for help when pressed.
• Fall detectors, built into an alarm or worn as a separate device.
• Sensors that notice movement, doors opening, flooding, incontinence, smoke or gas.
• GPS alarms, which show family where someone is if they go out.

Telecare works best alongside a person. Wandsworth Council's service, for example, offers a bed sensor that raises an alert if someone leaves the bed and does not return within a set time. It can also turn on a lamp when they get up, or alert a pager carried by a carer in the home. With a sleeping night carer, that means they can be woken when your parent gets up.

The limits

• An alarm only calls for help. Someone still has to get there, so ask who will come and how far away they live.
• Some pendant fall detectors cannot be worn in bed. Wandsworth notes that its tilt-type pendant fall detector cannot be worn in bed.
• The NHS warns that an analogue alarm may not work properly with a digital landline or an internet connection. If your parent's phone line has been switched to digital, check with the alarm provider.

Who pays for telecare?

The NHS says some councils provide monitoring systems, usually basic ones. Ask adult social services; if they offer one, they will arrange a home assessment. Private systems usually have an installation charge and then a monthly fee. In Wandsworth, for example, the council's Telecare service is for people referred by social services, and its WATCH Lifeline alarm is open to anyone.

Why is your parent awake at night? Check this first

The NHS lists long-term pain, many medicines, and conditions such as Alzheimer's or Parkinson's disease among the causes of insomnia. It says to see a GP if trouble sleeping has gone on for months, or is making it hard to cope.

If your parent has dementia, Alzheimer's Society lists common reasons a person with dementia sleeps badly. These include pain, bladder problems that mean frequent trips to the toilet, and side effects of medicines. Some dementia drugs can cause vivid dreams. Alzheimer's Society says taking them in the morning instead of at bedtime may help, but ask the GP or pharmacist before changing when your parent takes any medicine.

The NHS says dementia can upset a person's body clock, so they may get up again and again at night without realising it is night time. Its suggestions include plenty of activity and daylight during the day, a comfortable bedroom with a nightlight or blackout blinds, and less caffeine and alcohol in the evening. If evenings are the hardest time, read our guide to sundowning in dementia.

How to decide, step by step

1. Keep a night log for two weeks. Write down each time your parent wakes, what they needed (toilet, drink, reassurance, turning, wandering) and how long it took. Note any falls.
2. Ask the GP why they wake. Take the log to the appointment. The section above covers common causes of broken nights.
3. Sort the needs. Is it hands-on help, or someone being there? Is it predictable, or random? Does one person do it, or does it take two?
4. Ask for a needs assessment. The NHS says the council's needs assessment is free and anyone can ask for one. Show the assessor your log.
5. Match the option to the log. Use the diagram below. Keep the log going and look at it again every few months, because night-time needs often change.

Who pays for overnight care?

The council

The council funds care only for needs it has assessed, and a financial assessment decides how much your parent pays towards it. When night-time needs are eligible, the care plan should say how they will be met. That could be through telecare, a night carer, or a direct payment, which lets you choose and buy the care yourself. The care and support plan sets out your parent's personal budget and any direct payments. Our guide to paying for care in London explains the means test.

Attendance Allowance

Attendance Allowance is for people who have reached State Pension age, and it is not means-tested. The lower rate, £76.70 a week, is for "frequent help or constant supervision during the day, or supervision at night". The higher rate, £114.60 a week, is for "help or supervision throughout both day and night", or for someone nearing the end of life. These are the 2026/27 rates. Your parent must need the help because of an illness or disability, and must usually have needed it for at least 6 months, unless they are nearing the end of life, when different rules apply. Your night log is good evidence for the claim form, but two weeks of bad nights will not on their own lead to a payment. See our guide to Attendance Allowance rates.

The NHS

Where your parent's needs are mainly health needs, they may qualify for NHS continuing healthcare. The NHS says this can be provided in your own home. Near the end of life, Marie Curie nurses and healthcare assistants provide hospice care at home, "day or night", where the service is available in your area. Your parent's district nurse, GP or hospital team makes the referral, and will talk with you about whether it is right and how much care would help.

If a family member does the nights

Carers UK lists a night-sitting service as one kind of respite, "where someone will come into your home to allow you to have a proper night's sleep". Alzheimer's Society says care agencies may also provide night-time care, if asked, so that you can get some sleep. The NHS says councils only fund respite for people they have assessed, so ask for a carer's assessment for yourself as well as a needs assessment for your parent.

Questions to ask any provider about nights

• Is this a sleeping night or a waking night, and what exactly will the carer do?
• What time does the shift start and end? Does it include helping my parent to bed and getting them up?
• Where will the carer sleep or sit? Do you need a spare bedroom?
• What happens if my parent falls and the carer cannot get them up alone?
• Who covers the night if the carer is ill?
• What is written in the care plan about nights, and how often is it reviewed?

Agencies that provide personal care, such as help with washing, dressing or the toilet, must be registered with the Care Quality Commission (CQC), which regulates health and adult social care in England. Check the provider's CQC page before you agree to anything. Where an agency only introduces a carer you then employ or pay yourself, the CQC does not regulate that arrangement, so ask who is responsible for the carer's checks, training and cover.

Questions families ask

How we can help

To be clear about what we do at night: JNP Sidona Support Services provides live-in care across London, for individuals and for couples, and we do not currently provide separate sleeping-night or waking-night shifts. A live-in carer can settle your parent at bedtime and help with an occasional call in the night, then sleeps in their own room. If your parent needs someone awake most of the night, one live-in carer is not enough, and we will tell you that plainly at the assessment so you can look at other options, such as a care home with staff awake at night. Our sit-in service covers a few hours in the day or evening, not whole nights.

We are registered with the CQC (registered October 2023, not yet inspected), and our office is on Lewisham High Street, SE13. Jackie, our registered manager, will visit for a free home assessment. Bring your night log. We give you a written care plan, and a quote after the assessment. See the areas we serve.