Live-in Care vs a Care Home: An Honest Comparison

There usually comes a point when visits during the day are no longer enough. Your parent should not really be alone, and the family is running out of ways to cover the gaps. At that point most families are weighing up two options: a carer who lives in the home, or a move into a care home.

Neither is right for everyone. This guide sets out the differences honestly, including the situations where a care home, or a nursing home, is the better answer.

What each option actually means

Live-in care means a carer lives in your parent’s home and supports them through the day. They help with getting up, washing, dressing, meals, medication reminders, housework, appointments and company. The carer sleeps in the home at night, in their own room, so someone is there if something happens. With Viola, the main carer typically stays for three to four weeks before another carer takes over, so there is usually a small, familiar group of people.

A residential care home provides a room, meals, activities and support from staff who work in shifts. Your parent moves out of their home and into a shared setting.

A nursing home is a care home that also has registered nurses on site around the clock, for people whose health needs require nursing care.

The cost in London

Here is how the weekly costs compare.

Option	Typical weekly cost
Live-in care with Viola	from £1,050 (from £150 a day)
Residential care home, Greater London	£1,189 on average
Nursing home, Greater London	£1,513 on average

The care home figures are averages for for-profit homes in 2024/25, from LaingBuisson as reported by Which?. LaingBuisson also found that people who pay for themselves are usually charged more than councils pay: across the UK, self-funders paid on average £1,278 a week for residential care and £1,594 for nursing care in 2024/25. Fees for new residents today may be higher.

A few things to keep in mind when comparing:

A care home fee covers food, heating and the building. With live-in care your parent keeps paying their household bills as now.
A live-in carer needs a spare bedroom. If there is no suitable room, live-in care is not possible.
Live-in care is for one person, or a couple. For a couple who want to stay together, one live-in arrangement may work out better than two care home places. Ask about this when you get a quote.

For a fuller breakdown, including hourly and overnight care, see how much home care costs in London.

Daily life: how they feel different

At home with a live-in carer

Your parent keeps their own routine, their own bed, their neighbours and, often, their pet.
Support is one to one. The carer’s attention is on one person, not a corridor of residents.
Familiar surroundings can matter a great deal for someone living with dementia. We cover this in caring for a parent with dementia at home.
Family can visit whenever they like, without visiting hours.

In a care home

There are other people around all day, which some people really enjoy, especially if they have become isolated at home.
Activities, meals and laundry are organised for them.
Staff are on duty through the night, awake.
There is no house to maintain, which can be a relief for both your parent and the family.

Who live-in care usually suits

Live-in care tends to work well when:

your parent has a strong wish to stay at home and is unsettled by change;
they need help through the day and someone nearby at night, but do not need nursing;
they are living with dementia and do best with a calm, familiar routine;
a couple want to stay together in their own home;
there is a spare room for the carer.

Who a care home usually suits

A residential care home can be the better choice when:

your parent is lonely at home and would enjoy company and activities;
the house is no longer suitable and adapting it is not realistic;
there is no spare room for a live-in carer;
your parent themselves would prefer the move.

When a nursing home is the better choice

Carers introduced through Viola support everyday living. They do not carry out medical procedures such as injections, wound care, IV drips or taking blood, and live-in care is not a substitute for nursing.

A nursing home is often the right answer when your parent:

needs nursing care several times a day or through the night;
has complex health needs that change quickly and need a nurse’s judgement;
needs regular clinical procedures that only nurses can carry out.

Some people manage at home with a live-in carer plus visits from community or district nurses arranged through the GP. Whether that is safe depends on your parent’s health, so talk it through with their GP or care team. If your parent has long-term complex health needs, ask whether they should be assessed for NHS Continuing Healthcare, which can fund care in full.

Questions to help you decide

What does your parent want, if they can tell you?
Can they safely be on their own for any part of the night?
Is there a spare bedroom?
Do they need nursing, or help with everyday living?
Are they lonely, or happiest in their own space?
What can the family realistically cover, and for how long?

If you are not at the stage of 24-hour support yet, overnight care or a few hours a day may be enough for now. Our guide on how many hours of care your parent actually needs can help you work that out.

Talking it through

If you are leaning towards care at home, we can tell you within a day or two whether live-in care will work for your parent’s situation and home, and what it would cost each week. Read more on our live-in care page or tell us about your parent through the enquiry form. Live-in care can usually be arranged within about five days.

Frequently asked questions

Is live-in care cheaper than a care home in London? Often, yes. Live-in care with Viola starts from £1,050 a week, while the average London residential care home fee was £1,189 a week in 2024/25. Remember your parent will still pay household bills at home.

Does a live-in carer work through the night? A live-in carer sleeps at night in their own room and is there if something happens. If your parent needs help several times every night, talk to us about the right arrangement.

Can a live-in carer look after someone with dementia? Yes, many families choose live-in care for a parent with dementia because staying in familiar surroundings can help. See our dementia care page.

Can a live-in carer give injections or change dressings? No. Carers introduced through Viola do not carry out medical procedures. Those are arranged with the GP or community nurses.

How long is the minimum for live-in care? Usually one month for long-term arrangements. Shorter stays are considered case by case.