Live-in Care in Brighton

Live-in care means a trained carer moves into your relative's home and provides support around the clock — through the night as well as during the day. For families in Brighton and Hove, it is one of the most meaningful alternatives to a care home, allowing an older person to remain in familiar surroundings: their own street, their own garden, close to friends and the communities they have built over a lifetime. Brighton's population skews older along the seafront wards and inland neighbourhoods such as Hangleton and Portslade, and many families here are weighing exactly this question: how do we keep Mum or Dad at home as their needs grow more complex? Live-in care is not a single, fixed arrangement. It usually begins with support for personal care, medication prompts, and meal preparation, and it can evolve over months or years to include more intensive help with mobility, continence, or the behavioural changes associated with dementia. Because a carer is present throughout the day and overnight, it also offers a degree of reassurance that hourly visiting care cannot match — for the person being cared for and for the family members who might otherwise be driving across the city at midnight. There are around 42 CQC-registered home care agencies operating in the Brighton area ^[4], offering varying levels of specialism, staffing models, and fees. CareAH brings those agencies together in one place so that families can compare options in a structured way, without having to ring around or rely on word of mouth.

Most older people in Brighton and Hove who need hospital care are treated at the Royal Sussex County Hospital on Eastern Road, which is part of University Hospitals Sussex NHS Foundation Trust. When a patient is well enough to leave hospital but not yet ready to return home unaided, the Trust and Brighton and Hove City Council use a structured discharge pathway to determine what support is needed ^[8]. Under the national Discharge to Assess (D2A) framework, the emphasis is on assessing a person's long-term needs in their own home rather than in an acute bed — which means families are sometimes asked to make rapid decisions about care arrangements before a full picture of needs has emerged. Discharge Pathway 1 typically covers short-term reablement or therapy-led support at home. Pathway 2 involves a period of bed-based intermediate care. Pathway 3 is reserved for those with the most complex needs requiring ongoing nursing or residential placement. Live-in care most commonly becomes relevant for people on Pathway 1 who require more continuous support than a reablement team alone can provide, or for those stepping down from Pathway 2 who still need overnight cover. Where a condition — dementia, Parkinson's disease, a progressive neurological illness — means that needs are expected to increase steadily, Early Supported Discharge from hospital combined with a live-in care package can allow someone to return home more quickly and remain there longer than would otherwise be possible. If a person's primary need is judged to be a health need rather than a social care need, they may be eligible for NHS Continuing Healthcare funding, which is assessed against the national framework ^[2][3] and coordinated locally through the Sussex Integrated Care Board. The distinction between health and social care needs matters significantly for how care is funded, so it is worth requesting a checklist assessment if there is any doubt.

Finding the right live-in care agency requires looking beyond headline rates. Here are the practical signals worth examining:

• CQC registration is the legal baseline. Under the Health and Social Care Act 2008 ^[6], any provider delivering regulated personal care in England must be registered with the Care Quality Commission ^[4]. Providing such care without registration is a criminal offence, not a technicality. Every agency listed on CareAH is CQC-registered; an unregistered provider is operating illegally and should not be considered regardless of price or personal recommendation.
• CQC inspection ratings. An agency's most recent inspection report is publicly available on the CQC website ^[4]. Look at the rating in each of the five domains — safe, effective, caring, responsive, and well-led — rather than just the headline judgement. An agency rated 'Requires Improvement' in 'safe' warrants closer scrutiny.
• Carer continuity. Ask how the agency handles carer absence, illness, or leave. Frequent rotations of live-in carers can be destabilising, particularly for someone living with dementia.
• Experience with your relative's specific condition. Ask directly: how many people with this condition are you currently supporting, and what additional training have carers received?
• How escalation is handled. What happens if a carer is concerned about a change in health overnight? Is there a clinical lead or on-call supervisor available?
• Transparency about costs. Ask for a written breakdown of weekly fees, what is included, and how fees change if care needs increase.
• Notice periods and contract terms. Understand what flexibility exists if the arrangement needs to change.

Funding a live-in care package is one of the first practical questions families face, and in Brighton and Hove there are several routes worth understanding.

Local authority funding: Brighton and Hove City Council has a legal duty under the Care Act 2014 ^[5] to assess any adult who appears to need care and support, regardless of their financial position. Following a needs assessment, a financial assessment determines whether the council contributes to costs. If your relative has capital — savings, property — above £23,250, they are expected to meet the full cost themselves. Between £14,250 and £23,250, a sliding contribution applies. Below £14,250, capital is disregarded for means-testing purposes ^[1]. For a Care Act needs assessment, search 'Brighton and Hove City Council adult social care' for current contact details and opening hours.

NHS Continuing Healthcare (CHC): Where a person's primary need is a health need, they may qualify for fully funded NHS CHC, assessed against the national framework ^[2][3]. A free advisory service is available through Beacon ^[10] if you are uncertain whether your relative should be assessed or wish to challenge a decision.

Direct Payments: Rather than receiving council-arranged care, your relative may prefer to receive Direct Payments ^[9] and use these to engage a live-in carer of their own choosing, subject to a care plan.

Self-funding: Many families in Brighton fund care privately, at least initially. Getting the needs assessment completed regardless of finances is still worthwhile, as eligibility can change.