Live-in Care in Greenwich

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Live-in Care in Greenwich

Live-in care means a trained carer moves into your relative's home and provides support around the clock — including overnight — so that the person you care about can remain in familiar surroundings rather than moving into a residential setting. For families in Greenwich, this is increasingly the preferred alternative to a care home, particularly where a parent or partner has a progressive condition such as dementia, Parkinson's disease, or advanced heart failure, and whose needs are likely to change over months and years rather than stabilising. The Royal Borough of Greenwich sits across a varied landscape — from the riverside communities of Woolwich and Charlton to the quieter residential streets of Blackheath and Eltham — and the practicalities of arranging care here reflect that mix: a busy acute hospital in Queen Elizabeth Hospital Woolwich, a local NHS Trust managing discharge pathways under real pressure, and a local authority that has statutory duties under the Care Act 2014 [5] to assess and, where eligible, contribute to the cost of care. CareAH connects families in Greenwich to CQC-registered home care agencies operating in the area — there are approximately 110 such agencies registered locally [4] — so that you can compare, ask questions, and make an informed choice at what is often a stressful and time-pressured moment. This page covers what live-in care involves, how hospital discharge pathways work locally, what to look for in an agency, and how funding may be accessed.

The local picture in Greenwich

Queen Elizabeth Hospital Woolwich is the main acute site serving Greenwich residents and is managed by Lewisham and Greenwich NHS Trust. When an older person is admitted here — whether following a fall, a stroke, a period of acute illness, or a worsening of a long-term condition — the clinical team is required to plan for discharge from an early stage. NHS England's Discharge to Assess (D2A) framework [8] means that patients who are medically stable are often discharged before a long-term care package is fully confirmed, with assessment continuing at home or in a step-down setting. Understanding which pathway applies to your relative matters practically: Pathway 0 is for people who can go home with little or no additional support; Pathway 1 covers a short period of community-based reablement; Pathway 2 involves a short-term bed in a care facility; and Pathway 3 is for those requiring complex nursing care. For families considering live-in care, Pathway 1 is often the most relevant entry point — the Trust's discharge team may arrange a short-term reablement package, after which a longer-term live-in arrangement can be put in place. It is worth noting that the Discharge to Assess model is intended to avoid decisions about permanent care being made under the pressure of an acute hospital stay [8]. If your relative has particularly complex or high-intensity health needs, a full NHS Continuing Healthcare (CHC) checklist assessment should be requested before discharge; eligibility for CHC means the NHS — rather than the individual or the local authority — funds the full cost of care [2][3]. The Lewisham and Greenwich NHS Trust discharge team and the Royal Borough of Greenwich adult social care team co-ordinate on these pathways, though the process can feel opaque to families. Asking explicitly which pathway applies, and whether a CHC checklist has been completed, are among the most useful questions you can put to the ward team.

What good looks like

Choosing a live-in care agency is not a single decision — it is the start of an ongoing relationship that may span years, particularly where a progressive condition is involved. The following are practical signals worth looking for and questions worth asking.

  • CQC registration is a legal requirement, not a badge of quality. Under the Health and Social Care Act 2008 [6], providing regulated personal care in England without being registered with the Care Quality Commission is a criminal offence [4]. Every agency listed on CareAH is CQC-registered. If you encounter an agency that is not registered, it is operating illegally and you should not engage it. You can verify any agency's registration status and view its inspection reports at no cost on the CQC website [4].
  • Ask how the agency handles changing needs. A live-in care arrangement for someone with early-stage dementia will look very different in two years. Does the agency have a process for reviewing and adjusting the care plan? Who holds clinical oversight?
  • Carer continuity matters. Frequent changes of carer are disruptive, particularly for someone with cognitive impairment. Ask what the agency's typical carer rotation looks like and how handovers are managed.
  • Check the agency's experience with the specific condition your relative has. General personal care skills and condition-specific knowledge are different things.
  • Understand the contract terms. What notice period applies? What happens if a carer is unwell and cannot work?
  • Ask about communication with family members. How and how often will updates be shared? Is there a named care manager you can contact?
  • Look at the most recent CQC inspection report. Pay attention to the 'Well-led' and 'Responsive' domains, which tend to reflect how the agency handles problems when they arise.

Funding live-in care in Greenwich

Funding for live-in care in Greenwich can come from several sources, and in practice many families draw on more than one.

Local authority funding: The Royal Borough of Greenwich has a duty under the Care Act 2014 [5] to carry out a needs assessment for any adult who appears to need care and support. If your relative meets the eligibility threshold, the council may contribute to costs. The amount you pay depends on a means test. The current capital thresholds are an upper limit of £23,250 — above which the individual funds their own care entirely — and a lower limit of £14,250, below which savings are disregarded [1]. For a needs assessment, search 'Royal Borough of Greenwich adult social care' for current contact details and opening hours.

NHS Continuing Healthcare: Where a person's primary need is a health need rather than a social care need, they may qualify for NHS Continuing Healthcare (CHC), which is fully funded by the NHS and is not means-tested [2][3]. This is worth pursuing proactively if your relative has a rapidly deteriorating or highly complex condition. The organisation Beacon offers free independent advice to families going through the CHC process [10].

Direct Payments: Rather than receiving a council-arranged care package, your relative may be entitled to a Direct Payment — money paid directly to them (or a nominated person) to purchase their own care [9]. This gives more control over which agency is used and how the care is structured.

Self-funding: Families who are self-funding can use CareAH to compare home care agencies in Greenwich and request quotes directly.

Questions to ask before you commit

  • 1.How do you match a live-in carer to the specific needs and preferences of the person receiving care?
  • 2.What is your process for reviewing and updating the care plan as needs change over time?
  • 3.How many different carers might my relative have over a twelve-month period, and how are handovers managed?
  • 4.What training do your carers have in the condition my relative has been diagnosed with?
  • 5.Who is our named point of contact if a concern arises, and what are your response times?
  • 6.What happens if the live-in carer becomes unwell and cannot work — how quickly is cover arranged?
  • 7.What notice period applies if we need to end or significantly change the care arrangement?

CQC-registered home care agencies in Greenwich

When comparing live-in care agencies in Greenwich, start with the CQC inspection report for each agency — pay particular attention to the 'Responsive' and 'Well-led' ratings, which indicate how agencies handle problems and change over time. Look at the date of the most recent inspection; a report that is several years old may not reflect current practice. Consider whether the agency has relevant experience with the specific condition your relative has, and ask directly how they manage the transition if care needs escalate. For families whose relative has recently been discharged from Queen Elizabeth Hospital Woolwich, check whether the agency has experience working alongside the Lewisham and Greenwich NHS Trust discharge and community teams. Price is a legitimate factor, but the lowest quote does not always reflect the most sustainable arrangement — ask what is and is not included in the weekly rate before comparing figures.

  • No CQC-registered agencies found for Greenwich. Try a nearby town.

Frequently asked questions

What does a live-in carer actually do day to day?

A live-in carer provides personal care — washing, dressing, continence support — as well as meal preparation, medication prompting, light household tasks, and companionship. Overnight, they are available if needed. The exact scope is set out in a care plan agreed between the agency, the family, and the person receiving care. As needs change over time, the care plan should be reviewed and updated accordingly.

How is live-in care different from a care home?

Live-in care allows your relative to remain in their own home, maintaining familiar routines, pets, and surroundings. Care is one-to-one rather than shared across multiple residents. For people with progressive conditions, this continuity can be significant. The cost comparison with a care home varies considerably depending on the level of need and the agency, so it is worth obtaining quotes for both before deciding.

Can live-in care begin immediately after a hospital stay at Queen Elizabeth Hospital Woolwich?

It can, though it requires some planning. The discharge team at the hospital will assign your relative to a discharge pathway [8]. For Pathway 1, a short-term reablement package may be arranged first. If your relative is being discharged and you want a private live-in arrangement to start promptly, contacting agencies before discharge is strongly advisable. CareAH allows you to search and compare agencies in the area so that groundwork can be done in advance.

What is NHS Continuing Healthcare and could my relative qualify?

NHS Continuing Healthcare (CHC) is a package of care arranged and fully funded by the NHS for adults whose primary need is a health need [2][3]. It is not means-tested. Eligibility is assessed using a Decision Support Tool, and the process can be requested at any point — including during a hospital stay. If you feel your relative may qualify, ask the ward team or the discharge coordinator to initiate a checklist assessment. Beacon offers free independent support to families navigating CHC [10].

Is CQC registration legally required for a home care agency?

Yes. 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. Providing regulated care without registration is a criminal offence. You can check whether any agency is registered, and view its inspection ratings, on the CQC website at no cost [4]. Every agency listed on CareAH is CQC-registered.

How does a Direct Payment work if my relative wants to choose their own agency?

If the Royal Borough of Greenwich agrees that your relative has eligible care needs following a Care Act 2014 assessment [5], they can opt to receive a Direct Payment rather than a council-arranged package [9]. The money is paid into a designated account and used to purchase care — including from an agency found through CareAH. A Direct Payment gives more flexibility over who provides the care and when, but it does carry administrative responsibilities.

What happens if my relative's needs increase significantly over time?

A good live-in care arrangement should be able to adapt. The care plan can be revised as needs change, and additional hours or specialist input can be introduced. If needs increase to a level where the primary driver is a health need, it is worth requesting a reassessment for NHS Continuing Healthcare [2][3]. If the local authority is contributing to funding, a review of the care and support plan under the Care Act 2014 [5] can be requested at any time.

How many home care agencies operate in the Greenwich area?

There are approximately 110 CQC-registered home care agencies operating in the Greenwich area [4]. The range in size, specialism, and inspection rating is considerable. CareAH allows families to compare agencies based on their specific requirements — including condition-specific experience, availability, and the type of care package needed — rather than having to approach agencies individually.

Sources

  1. [1]GOV.UK — Social care charging 2026 to 2027
  2. [2]GOV.UK — National framework for NHS continuing healthcare
  3. [3]NHS England — NHS Continuing Healthcare
  4. [4]Care Quality Commission
  5. [5]Care Act 2014 (legislation.gov.uk)
  6. [6]Health and Social Care Act 2008 (legislation.gov.uk)
  7. [8]NHS — Leaving hospital after being an inpatient
  8. [9]GOV.UK — Apply for direct payments
  9. [10]Beacon — Free NHS Continuing Healthcare advice

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Page guidance last updated May 2026. Funding figures and council details may change — always check current information at the official source.