Live-in Care in Lewisham

Visits or someone living in? Choosing when we are already down the road

Our office is in SE13, and every part of Lewisham is within about half an hour of it, so regular visiting care is realistic across the borough, subject to carer availability. The choice here is about need, not distance. Live-in care makes sense when visits keep leaving gaps: someone with dementia who walks out in the afternoon, repeated falls between calls, or a family carer who is worn out. We will tell you at the assessment which we think fits, and why.

A Corbett terrace, a Brockley conversion or a Downham cottage: is there room?

A live-in carer needs a bedroom of their own and use of the kitchen and bathroom. Lewisham's housing makes that easy in some streets and hard in others.

• Whole Victorian terraces. On the Corbett Estate in Hither Green, and across Catford, Lee and Ladywell, older owners often still have the whole house and a spare back bedroom. The room is rarely the problem; the straight, steep staircase is, so we look at stairlifts, bathing and night-time toilet trips.
• Converted flats. Most of the big houses in Brockley, Forest Hill and Sydenham are now flats. An upper floor with no lift can still work if there are two bedrooms, but every trip out depends on the shared stair.
• Downham and Bellingham. The 1920s and 30s London County Council cottage houses have gardens and often a second or third bedroom, and are among the easiest homes in the borough for live-in care.
• Estates and new blocks. In Deptford, New Cross and around Lewisham station, a two-bedroom flat with a working lift suits hoists and wheelchairs. A one-bedroom flat does not work, and we will say so. Council and housing association tenants should tell their landlord a carer will be staying.

Two people, one carer

When one partner needs a lot of help and the other is coping but tired, the usual alternative splits them: a care home place for one, the other alone in the house. A live-in carer can give full personal care to one and a lighter hand to the other, cook for both, and keep them in the streets, church and market they know. One carer supporting a couple is usually a smaller bill than two care home places, and we will put the figures side by side after the assessment.

From University Hospital Lewisham to home, with someone living in

Most Lewisham residents are discharged from University Hospital Lewisham, a short walk from our office. The council offers free enablement for up to six weeks after a hospital stay, with eligibility assessed during discharge planning. If someone clearly needs more than visits can give, start talking about live-in care while they are still on the ward, and if a care home is suggested, tell the ward and the social care assessor you want care at home considered. See our hospital discharge support page.

Lewisham is also home to St Christopher's Hospice in Sydenham, founded by Dame Cicely Saunders in 1967 and widely recognised as the first modern hospice. Its community teams support people at home, and a live-in carer can work alongside them; see our palliative care page.

Does Lewisham Council count the house?

This often decides between live-in care and a care home. For a care home, Lewisham's page on paying for residential and nursing care says a home you own is ignored for the first 12 weeks, then included unless an exemption applies, such as a spouse still living there. A deferred payment agreement can delay repayment until the house is sold.

For care at home, the NHS guide to paying for your own care says the property you own only counts if you move into a care home. Lewisham bases a home-care contribution on income, savings and disability-related expenses, and its list of those expenses includes extra household costs due to a live-in carer.

How much does live-in care cost in Lewisham?

It depends on how much support is needed, for one person or two, and whether there is night-time care. We give you a written figure after the home assessment, not a number over the phone. On who pays:

• Lewisham Council. Start with the online wellbeing self-assessment on the council's assessment page, or call Adult Social Care on 020 8314 7777. The council says a full assessment can take up to six weeks. For care at home, it says anyone with more than £23,250 in capital pays the full cost plus a brokerage fee; below that, the charge is based on disposable income after a protected allowance.
• Direct payments. The council says a direct payment can be used for an agency, live-in or overnight care. It is paid onto a prepaid card every four weeks.
• NHS Continuing Healthcare. Where needs are mainly health needs, the NHS may fund the whole package; in Lewisham the decision sits with NHS South East London Integrated Care Board.
• Paying privately, sometimes while the council process runs. Our guide to paying for care in London covers the options.

The carer's daily break and holidays

The carer's daily break can be covered by a relative calling in or a short visit from us, which is simple to arrange from SE13. Or the time can go on a day out: the council's Ladywell Dementia Day Service on Dressington Avenue takes people with mild to advanced dementia, and the Calabash Centre on George Lane has served older people from Lewisham's African and Caribbean communities for decades. For holidays, we arrange replacement cover in advance and introduce the new carer before the handover.

What we can help with in Lewisham

• 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