Live-in Care in the City of London

Spare bedrooms are scarce in the Square Mile

Census 2021 gives a blunt answer for the Square Mile: not many. Of the 4,915 households counted, 2,626 (53%) had one bedroom and 1,578 (32%) had two. Only around one household in three, 1,548 of them, were recorded with a bedroom to spare. Nearly 87% lived in purpose-built flats.

The carer sleeps in the flat, so they must have a private room to sleep and unwind in, not the settee. Tired carers make mistakes, which is why we will not place someone without it. Estate by estate, that works out like this:

• Barbican Estate: a wide mix of layouts, with plenty of two- and three-bedroom flats and maisonettes. Many can take a carer. See live-in care in the Barbican.
• Golden Lane Estate: mostly studios and one-bedroom flats, so only a minority of homes work. See live-in care on Golden Lane.
• Middlesex Street Estate and the rest of Aldgate: depends on the individual flat. See live-in care in Aldgate.

No second bedroom? Then plan around visiting home care in the City, which is realistic because the estates are within easy rail reach of our office.

The NHS team a live-in carer works alongside here

Resident carers are not nurses. They give personal care, keep the day running and notice changes, and they work with the local NHS services that do the clinical side. For City residents those are:

• Homerton Healthcare's district nurses, who come out to people who cannot leave home, every day of the year, but stop at 10pm. A GP or ward has to make the referral. Between 10pm and 8:30am there is no nurse on the rota, so a carer sleeping in the next room is often the only person in the building who knows the patient.
• St Joseph's Hospice, in Mare Street, Hackney. Its community palliative care nurses and doctors take City patients, and a family can make the referral itself; the hospice's First Contact Team answers on 0300 30 30 400.
• ELFT's memory team for City and Hackney, which stays with a person living with dementia right through to their last months, and names one professional the household can ring.
• The family doctor, whether at Half Moon Court, the one practice within the Square Mile, or at a surgery in Islington or Hackney.

Put together, hospice, nurses and a resident carer are how many City residents manage to stay in their own flat to the end. Our palliative care page explains what our carers do and do not do.

Couples in the Square Mile

The Census found 201 City households that were a family in which everyone was 66 or over. Where a husband needs washing, dressing and turning while his wife mainly needs cooking for and company on the way to the shops, a single resident carer can usually do both. Nobody has to leave a flat they may have lived in since the estate was new. The arithmetic is two bedrooms: the couple share one, the carer sleeps in the other.

Will the Corporation pay for live-in care?

It may contribute. The door in is a Care Act assessment from the Corporation's social workers on 020 7332 1224; they visit the person at home, and a decision you disagree with can be challenged within a fortnight. The assessment decides what needs must be met, not where. If residential care is suggested, you can ask for care at home to be weighed up too. If the person is eligible, a financial assessment decides their share, and the rest can come as a direct payment that pays for care meeting the support plan. The Corporation can even manage the direct payment for you through its own Direct Payment Service.

Health-led needs are a different matter. If the main problem is clinical, City residents can be screened for NHS Continuing Healthcare, which the City and Hackney part of NHS North East London decides and which, if granted, covers the whole bill. The screening tool is a short checklist; a ward nurse, district nurse or GP can complete it.

Breaks, nights and holidays

Resident carers get a daily rest period and, normally, sleep through. Before day one we fix the rest hours with the family and book holiday cover well ahead. Someone who is up four times a night needs a second person on nights, and we would rather tell you that at the start than burn out a carer in week two. Relatives who want to cover a few rest periods and stay over have an unusual option here: the Corporation lets estate guest rooms on Golden Lane and Middlesex Street, and Barbican households can book the Golden Lane ones as well.

What live-in care costs in the City

Three things move the figure: how much help is needed, whether the carer supports one resident or two, and how often they are woken at night. Our quote comes on paper once we have seen the flat. What you pay yourself depends on funding: the Corporation's financial assessment if it contributes, CHC in full where it applies, otherwise private. The means test is set out in our guide to funding care; day-to-day life with a resident carer is covered on our London live-in page.

How live-in care works →