Arranging care at home in London is usually decided quickly and under pressure, which is exactly when the expensive mistakes are made. The most common one is hiring at the wrong level: a companion where nursing skills are needed, or a nurse-trained carer where the real requirement is company, meals and a steady routine. Below are the current rates and the practical distinctions.
What a live-in carer in London costs
According to the Royal Keeper household staff salary review (data as of summer 2026), a carer in the UK is at GBP 3,000-4,800 per month, most commonly on a live-in basis. The figure is derived from daily rates of GBP 100-160 per day.
These are premium-segment rates for private placements through an agency, not local authority or standard domiciliary care rates.
For context, the same review gives:
Housekeeper, UK - GBP 2,500-4,600 per month
Carer, France - EUR 2,000-3,500 per month
Carer, Monaco - EUR 3,000-7,500 per month, where the lower end is a companion role and the upper end a carer with medical training
Carer, Switzerland - CHF 5,800-10,000 per month
Gross, with employer contributions on top
UK figures are gross salary, before tax and National Insurance. The carer receives less; the household pays employer National Insurance and pension contributions in addition to the gross salary. For a live-in arrangement, accommodation and board are provided as well, and there are specific rules about how that interacts with minimum wage calculations.
The comparison families most often get wrong is with the Gulf. In the UAE a carer is quoted at AED 3,000-5,000 for standard roles and AED 8,000-15,000 for western-trained or nursing-qualified carers - and those are take-home figures, with housing, visa and insurance provided separately. A London number and a Dubai number describe different things.
Carer, companion, nurse: the distinctions that matter
Companion - presence, conversation, walks, outings, light household support. No personal care. Suited to someone independent who is mainly isolated.
Carer - personal care: washing, dressing, mobility support, meals, medication reminders, keeping the daily routine, accompanying to appointments. The role most private households actually need.
Nurse-qualified carer - the above plus clinical tasks within their registration: wound care, injections, catheter and stoma care, monitoring. Priced at the top of the range, and worth it only where there is a real clinical requirement.
A carer supports daily life; they do not diagnose, prescribe or replace a doctor or a district nurse. Clinical decisions stay with the treating medical team, and the care plan should come from them.
Working formats
Live-in, single carer - the most common arrangement. Requires a private room and defined rest breaks; a carer who is never off duty burns out within weeks.
Live-in rotation - two carers alternating on a set cycle. More expensive overall and far more sustainable for long-term care.
Waking nights - a separate role and a separate cost. A live-in day carer cannot also cover nights.
Live-out, hourly or daily visits - for earlier stages, where the requirement is a few hours of structured support.
What moves the rate
Level of dependency and whether transfers or hoisting are involved
Dementia experience and documented training
Nursing registration and clinical tasks in the plan
Night cover and the number of disturbed nights expected
Driving, and whether the carer will use the family car
Language requirements and the household's other staff
Mistakes and red flags
No written care plan. Without one, nobody can tell whether the carer is doing the job or quietly doing a different one.
Rest breaks assumed rather than scheduled. The single biggest cause of live-in placements failing in the first two months.
One carer expected to cover days and nights. It is not sustainable and it is not safe.
Skipping DBS checks and reference calls. Both are basic and both are routinely skipped when the hire is urgent.
Housekeeping quietly added to the brief. A carer whose day fills with cleaning has less time for the person they are there for.
Hiring a nurse-level carer for a companionship need. Expensive, and the placement rarely lasts, because the work does not match the training.
Legal and medical note
Employing a carer directly in the UK means payroll registration, tax and National Insurance, pension auto-enrolment, working time and rest rules, and specific minimum wage treatment for live-in arrangements. Requirements change and depend on how the arrangement is structured.
This is general information, not legal or medical advice. The employment contract and payroll setup should be prepared or reviewed by a UK employment lawyer or a specialist payroll provider, and the care plan agreed with the treating doctor or clinical team. A carer does not replace medical care.
Hiring through Royal Keeper
Royal Keeper places carers with private households in the UK and internationally. We start from the care plan and the level of support actually required, so the household is not paying for clinical qualifications it will not use - or discovering three weeks in that it needed them.
Regional pages: United Kingdom, France, Switzerland
Royal Keeper - all household staff services
Frequently Asked Questions (FAQ)
Is GBP 3,000-4,800 what the carer receives?
No. It is the gross monthly salary. The carer receives less after tax and National Insurance, and the household pays employer contributions on top. For live-in roles, accommodation and board are provided in addition, with specific minimum wage rules that apply to that arrangement.
What is the difference between a carer and a nurse?
A carer supports daily living: personal care, meals, mobility, routine, medication reminders. A nurse-qualified carer can additionally perform clinical tasks within their registration. Neither replaces the treating doctor, and the care plan should come from the medical team.
Can one live-in carer cover nights as well?
No, not sustainably. A live-in carer needs defined rest breaks and uninterrupted sleep. Regular night care requires a waking night carer or a rotation, and both are costed separately.
How quickly can a carer start?
Urgent placements are possible, but DBS checks and reference calls take time and should not be skipped. For a defined role with a written care plan, expect a few weeks to a well-matched permanent placement, with interim cover arranged if the situation cannot wait.