Live-in Care in Bexley

The three-bedroom semi already has the room

Live-in care needs one thing that many London homes cannot offer: a spare bedroom for the carer. Bexley is unusual in how often it can. Most of the borough is interwar housing, owner-occupied, and the typical three-bedroom semi in Bexleyheath, Welling, Blackfen or Barnehurst usually has a back bedroom or box room. The larger Edwardian and 1930s houses in Sidcup and Upper Belvedere generally have more space again.

The carer needs their own room with a bed and somewhere to keep their things, plus use of the kitchen and bathroom. It does not have to be large. Where the space runs short is in the flats: Erith's post-war blocks, newer riverside developments, and one-bedroom flats near town centres. In a flat with no second bedroom, live-in care is not possible, and regular visits are the usual answer instead.

When the stairs are the problem

The same houses have a straight, steep staircase and the only bathroom upstairs. With a live-in carer that matters less than with visits, because someone is there for the slow trip up at bedtime and down again in the morning, and is on hand if a night-time trip to the toilet goes wrong. Where stairs have become unsafe altogether, a bed downstairs with a commode, or a stairlift, makes the house workable again. Ask the council for an occupational therapy assessment for equipment; it comes through the same Adult Social Care route as any other care assessment.

Couples staying in the house they bought

Bexley is mostly owner-occupied, and it is common for a couple to have been in the same house for decades. When one of them needs a lot of care, the standard route can separate them: a residential or nursing placement for one, the other left on their own in the house. A live-in carer supports both people under one roof. Full personal care for one, a lighter hand for the other, meals cooked for two, and someone else in the house overnight.

Charging for one carer supporting two people is generally considerably more affordable than two care home places, and it keeps the household together.

Who covers the carer's own time off?

A live-in carer needs a proper break every day and a proper night's sleep. If someone needs help through the night as a matter of routine, that is a different arrangement, and we will say so instead of stretching one carer across twenty-four hours. The daily break can often be covered by a family member, by a short visit, or by a day centre. In Bexley, Age UK Bexley runs a day care centre in Sidcup, including a dementia day service, which some families use for exactly this.

When the regular carer takes holiday, we plan replacement cover in advance and introduce the new carer before the handover.

Live-in care or a care home: how Bexley's route works

Bexley's adult social care and local NHS services work together as Bexley Care, with a Home First approach to hospital discharge. "Discharge to assess" can happen at home, but it can also happen in a local nursing home, and a temporary bed can drift into a longer stay unless someone asks about the alternatives. If you want care at home to be considered, say so to the ward and to the assessor early.

A needs assessment comes through the Single Point of Contact on 020 8303 7777, the council's online self-assessment, or a OneBexley charity. The council's needs assessment route on GOV.UK links to the same place. Where someone is approaching the end of life, the Greenwich & Bexley Community Hospice works with families at home, and live-in care can sit alongside it; see our palliative care page.

How much does live-in care cost in Bexley?

It depends on the level of support, whether it is for one person or two, and whether there is regular night-time care. We give you a written figure after the assessment, not a guess over the phone. On funding:

• Council funding. If Bexley assesses someone as eligible, a financial assessment decides how much they contribute. Council funding can be taken as a direct payment, paid onto a prepaid card or a dedicated account every four weeks, and used to pay for live-in care.
• NHS Continuing Healthcare. Where needs are mainly health needs, the NHS may fund the whole package. In Bexley, that decision sits with the NHS South East London Integrated Care Board. The NHS guide to Continuing Healthcare explains the checklist and assessment.
• Paying privately. Many Bexley households own their home, which affects a care home means test differently from care at home. Our guide to paying for care in London sets out the difference.

What we can help with in Bexley

• A carer living in, with their own room
• Care for one person or a couple
• Personal care through the day
• Medication support
• Cooking, housekeeping and laundry
• Dementia support at home
• Company, outings and appointments
• Cover arranged for the carer's breaks