24 hour care at home: your options, costs and who pays

24 hour care at home means someone is on hand around the clock, so your relative is never left without help. There are three main ways to arrange it: a live-in carer, daytime visits combined with a night carer, or a rota of carers working in shifts. Each suits different needs and costs very different amounts.

Related guide: 24-hour care at home: costs and options.

This guide explains how each option works, what night sitters and overnight carers do, why overnight care can be harder to book than daytime care, and what families in England can expect to pay.

In short: live-in care, at around £1,540–£1,610 a week, is usually the most affordable way to get someone there day and night. If your relative needs someone awake and active all night, you will need waking nights or a shift rota, which cost considerably more.

What are the options for 24 hour care at home?

Before you ring agencies, be clear about what happens at night. That single question shapes which option works.

Live-in care

One carer lives in the home, usually for one or two weeks at a time, then hands over to another. They help through the day and can get up occasionally at night, but they need to sleep and they need a daily break. It works well when night needs are occasional. Our live-in care guide (written for West Sussex, but the model is the same everywhere) covers it in detail.

Day visits plus sleeping or waking nights

Visiting carers call at set times through the day, and a separate night carer comes in each evening.

• Sleeping night: the carer sleeps in the home and can be woken if needed, typically once or twice.
• Waking night: the carer stays awake all night, checking, turning, helping to the toilet, or settling someone with dementia who is up and about.

This suits someone who can manage safely alone for some of the day but not at night. Read more in our guide to overnight care at home.

A rota of carers in shifts

Carers work fixed shifts, for example two day shifts and a waking night, so someone fresh and awake is always there. This is the model used for very high needs, such as advanced illness or where two carers are needed for moving and handling. It is the most expensive option and is often funded through NHS Continuing Healthcare.

What does a night sitter for the elderly do?

A night sitter for an elderly person stays overnight to keep them safe, give reassurance and help with things like getting to the toilet, changing pads, repositioning in bed or settling after a bad dream. Depending on the arrangement, they may sleep or stay awake.

Night sitting is often used:

• after a hospital stay, while someone regains confidence;
• when a person with dementia is restless, wandering or confused at night (see our guide to sundowning);
• when there is a high risk of falls going to the toilet;
• to give a family carer who is up every night a chance to sleep;
• at the end of life, when family want someone experienced with them.

If you are not sure whether night help is needed yet, our article on when overnight care is needed sets out the warning signs.

Overnight care: why nights are harder to book

Overnight care is available in most parts of England, but night shifts are harder to staff than daytime visits. Many agencies have only a small pool of night carers, so it is common to hear that there is a waiting list or that they can cover some nights but not all seven.

Practical tips that help:

• Ask several agencies at once. One may cover weeknights and another weekends, although a single provider is easier to manage.
• Be flexible on start dates. Agencies often find it easier to recruit for a planned package than an emergency one.
• Consider live-in care. If night needs are occasional, a live-in carer is often easier to arrange than a nightly waking carer.
• Be accurate about night needs. If you describe a sleeping night but your relative is up four times, the arrangement will break down.
• Keep a simple night diary for a week. Note when your relative wakes and why. It helps agencies, the GP and the council assessor.

How much does 24 hour care at home cost?

Costs depend heavily on how the care is organised. The table below uses indicative England-wide rates for 2026; prices vary by region and are usually higher in London and the South East. Actual quotes vary by agency, needs, weekends and bank holidays.

The Lottie Care Index for Q3 2026 puts the median hourly rate at £33.49, and many agencies charge £26–£38. The Homecare Association’s minimum price for council-funded homecare in England for 2026/27 is £34.42 an hour, a useful benchmark when comparing hourly quotes. To work out your own figure, use our home care cost calculator.

Who pays for 24 hour care?

Most families pay for 24-hour care from a mix of sources. Check each one, because the amounts involved are large.

NHS Continuing Healthcare

If your relative’s needs are mainly health needs, for example complex medication, breathing problems or severe challenging behaviour, the NHS (through your local integrated care board) may fund the whole care package at home. It is not means-tested. For someone who is rapidly deteriorating and may be approaching the end of life, a clinician can use the Fast Track Pathway Tool. See our guide to NHS Continuing Healthcare at home.

Your local council

If your relative has eligible care needs, the council may fund part or all of their care after a financial assessment. For care at home, the value of their home is not counted. People with more than £23,250 in savings pay the full cost. The council will look for the most cost-effective way to meet assessed needs, so it may offer live-in care or a care home place rather than a full shift rota. Start by contacting your council’s adult social care team and asking for a care needs assessment (for example, West Sussex adult social care).

Benefits

Attendance Allowance is paid at the higher rate of £114.60 a week in 2026/27 to people who need help both day and night. It is not means-tested. People who may have 12 months or less to live can claim under special rules with an SR1 form from a doctor or nurse. See the GOV.UK Attendance Allowance page or our Attendance Allowance guide.

Use our free funding checker to see which of these your relative may be able to get.

Is 24 hour care at home better than a care home?

Not always. 24-hour care at home keeps someone in familiar surroundings with one-to-one attention, which many people strongly prefer. But if your relative needs two carers for most tasks, frequent nursing input, or waking care every night, a nursing home may be safer and more sustainable. Our guide on when it is time for a care home can help you weigh this up.

Frequently asked questions

Can a live-in carer provide 24-hour care?

A live-in carer is there around the clock, but they are not awake for 24 hours. They need to sleep at night and have a daily break. If your relative needs help several times every night, you will usually need a waking night carer as well.

What is the difference between a sleeping night and a waking night?

On a sleeping night the carer goes to bed in the home and gets up if needed, usually no more than once or twice. On a waking night the carer stays awake throughout. Waking nights cost more because the carer is working the whole shift.

Will the council pay for 24 hour care at home?

It may, if your relative has eligible needs and does not have savings above £23,250. The council will fund a way of meeting needs that it considers cost-effective, which might be live-in care rather than a shift rota. If needs are mainly health-related, ask about NHS Continuing Healthcare.

How quickly can overnight care be arranged?

It varies. Some agencies can start within days, while others have waiting lists for night carers. Contact several providers, be flexible on start dates, and consider live-in care if night needs are occasional.

Can I get a night sitter just for a few nights?

Yes. Many agencies provide short-term night care, for example after a hospital discharge or to give a family carer a break. Short bookings may cost more per night, so ask for the price in writing.

The Care Panel is an independent publication. We are not a care provider and are not regulated by the Care Quality Commission, because we do not deliver care. Always check a provider’s own CQC registration and inspection report before you commit.

Written and fact-checked by The Care Panel. Last updated September 2026. Sources: GOV.UK Attendance Allowance guidance, council adult social care and charging guidance (including West Sussex County Council), Lottie Care Index Q3 2026, Age UK factsheet on NHS Continuing Healthcare, Homecare Association. General information, not financial, legal or medical advice — figures are indicative and subject to change.

Reviewed by The Care Panel team on 15 October 2026. This guide is general information about care in England, not legal, medical or financial advice. Rules and rates change; check with your council or an adviser before making decisions.