Live-in Care in Chatham

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 Chatham and the wider Medway area, it is one of the most substantial alternatives to a care home, and for many older people it allows them to remain in familiar surroundings, close to the places and communities they know. Chatham sits at the heart of Medway, a densely populated urban area where demand for home care is real and growing. There are approximately 53 CQC-registered home care agencies operating in this area ^[4], which gives families genuine choice but also requires careful comparison. Live-in care is not a fixed arrangement. For someone living with dementia, Parkinson's disease, or the aftermath of a stroke, care needs will change over months and years, and any agency you choose should be able to demonstrate how it adapts support as those needs evolve. A carer living in the home provides continuity that rotating visit-based care often cannot — the same person learns the routines, the preferences, and the early warning signs that matter. This page sets out what live-in care involves in a Chatham context: how hospital discharge pathways connect to home care here, what funding routes are open to Medway families, what questions to ask agencies before you commit, and how to verify that the providers you are considering are operating legally and to an acceptable standard.

The main acute hospital serving Chatham and the Medway towns is Medway Maritime Hospital, run by Medway NHS Foundation Trust. When an older person is admitted there — following a fall, a stroke, a hip fracture, or an acute episode of a longer-term condition — the discharge team will begin planning their return home relatively early in the admission ^[8]. The NHS uses a structured framework for this. Under Discharge to Assess (D2A), patients may be moved out of an acute bed before their full care needs have been formally established, with assessment continuing at home or in an interim setting. This means families can sometimes feel pressured by the pace of discharge; understanding the pathway helps you push back constructively or prepare more effectively. Patients leaving Medway Maritime Hospital may be discharged under Pathway 1 (home with some support), Pathway 2 (a short-term bed-based placement), or Pathway 3 (a longer-term residential or nursing placement). Live-in care is most relevant to Pathway 1, and in some cases it can make Pathway 1 viable where it might otherwise not have been considered. If your relative's needs are substantial and arise primarily from a health condition, they may be eligible for NHS Continuing Healthcare (NHS CHC), which is a fully funded NHS package assessed against a national framework ^[2][3]. The Medway NHS Foundation Trust's continuing healthcare team coordinates these assessments locally. Separately, if your relative was detained under the Mental Health Act, Section 117 aftercare may apply, covering some or all of the support costs. Early Supported Discharge pathways also exist for some stroke and orthopaedic patients, enabling a return home sooner with therapy input alongside care.

Choosing a live-in care agency is not a decision most families have made before, and the market varies considerably in quality. Certain practical signals are worth looking for when comparing providers in the Chatham area.

• CQC registration is not optional. Under the Health and Social Care Act 2008 ^[6], it is a criminal offence to provide regulated personal care in England without being registered with the Care Quality Commission ^[4]. Every agency listed on CareAH is CQC-registered; if you encounter an agency that cannot provide its CQC registration number, it is operating illegally. You can verify any agency's registration and inspection rating directly on the CQC website.
• Ask how continuity of carer is managed. For someone with dementia or a progressive neurological condition, frequent changes of carer cause real distress. Ask specifically what happens when the live-in carer takes their weekly break — whether a regular relief carer is provided, and how much notice the agency gives before a change.
• Confirm the agency's experience with the specific condition your relative is living with. A general statement about training is not enough; ask whether their carers have worked with people at a similar stage of that condition.
• Understand what is and is not included in the quoted fee. Some agencies charge separately for overnight support, continence care, or accompanying to medical appointments.
• Ask how the agency responds if needs increase. A well-run agency will have a clear process for reviewing and adjusting the care package, without requiring the family to restart the search.
• Check whether the agency has local knowledge of Medway — familiarity with Medway Maritime Hospital, local GP practices, and Medway Council's adult social care processes is a practical advantage.

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

A Care Act 2014 needs assessment ^[5] is the starting point for local authority support. Medway Council has a duty to assess anyone who appears to have care needs, regardless of their financial situation. Following the assessment, a financial assessment (means test) determines whether the council contributes. Currently, if your relative's assets — including savings, but usually not the value of their home while they are living in it — are above £23,250, they are expected to fund their own care. Between £14,250 and £23,250, a sliding-scale contribution applies. Below £14,250, the local authority meets the full assessed cost ^[1]. For a Care Act 2014 needs assessment, search 'Medway Council adult social care' for current contact details and opening hours.

If your relative's needs are primarily health-related and meet the threshold, NHS Continuing Healthcare provides fully funded care with no means test ^[2][3]. This is assessed by Medway NHS Foundation Trust's CHC team. Free independent advice on challenging or appealing a CHC decision is available from Beacon ^[10].

Direct Payments allow eligible individuals to receive the assessed funding amount directly, then arrange and purchase their own care ^[9]. This can offer more flexibility in choosing a live-in carer, though it carries more administrative responsibility. Personal Health Budgets work similarly within NHS CHC.